The Mount Sinai Integrative Sleep Center
Evaluation for Hypoxemic and Hypercapnic Respiratory Failure

Heart Failure
Cardiovascular disease is a leading cause of morbidity and mortality. Congestive heart failure (CHF) is the leading cause of hospitalization in people over 65.

Central sleep apnea is commonly present in patients with CHF. Many patients can have both obstructive and central sleep apnea.

CPAP is the treatment of choice for obstructive apnea. Patients with central apnea may need variable positive airway pressure with adaptive servo-ventilation. The treatment of obstructive and central apnea improves outcomes and quality of life.

Obesity Hypoventilation
Patients with morbid obesity have a higher risk of developing hypoventilation. They can have very low levels of oxygen and elevated CO2. A sleep evaluation will define the existence of this disorder and provide adequate non-invasive ventilation with bilevel positive airway pressure support.

Chronic Lung Disease
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death in the general population. COPD is characterized by chronic airway obstruction, inflammation and enlargement of air spaces. Patients with COPD have abnormalities in gas exchange: oxygenation and or elimination of carbon dioxide. Many patients with advanced COPD commonly have worsening of the gas exchange during sleep and require treatment.

A sleep evaluation includes a consultation and a nocturnal polysomnogram to evaluate the need for positive airway pressure or oxygen supplementation during sleep. Treatment improves oxygenation, perfusion-ventilation relationship and hemodynamics.

Sleep Evaluation
  • Pulmonary Function Test
  • CO2 Response
  • Ventilation Study
  • P100

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