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Related Concept Videos

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea07:54

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The aim of this study was to establish a standardized protocol for sleep endoscopy to differentiate obstruction patterns in obstructive sleep apnea (OSA). Target-controlled infusion (TCI) of the sedative was combined with real-time monitoring of the depth of sedation using bispectral...
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Related Experiment Video

Updated: Jan 20, 2026

Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
07:54

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Published on: December 6, 2016

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Ticagrelor-Associated Shift From Obstructive to Central Sleep Apnea: A Case Report.

Caroline Paboeuf1, Pascaline Priou2, Nicole Meslier2

  • 1Département de Pneumologie, Centre Hospitalier Universitaire, Angers, France.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|September 5, 2019
PubMed
Summary

Ticagrelor may shift obstructive sleep apnea (OSA) to central sleep apnea (CSA) by increasing hypercapnia sensitivity. This effect was observed in a patient and reversed upon ticagrelor discontinuation.

Keywords:
central sleep apnearemote positive airway pressure-telemonitoringticagrelor

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Area of Science:

  • Cardiology
  • Sleep Medicine
  • Pharmacology

Background:

  • Ticagrelor, a P2Y12 antagonist, is prescribed with aspirin for coronary artery disease.
  • Emerging evidence suggests ticagrelor may induce central sleep apnea (CSA) by enhancing hypercapnia sensitivity.

Observation:

  • A patient with obstructive sleep apnea (OSA) on positive airway pressure (PAP) therapy developed CSA and Cheyne-Stokes respiration (CSR) after starting ticagrelor for acute coronary syndrome.
  • Respiratory polygraphy confirmed a ticagrelor-induced shift from OSA to CSA, linked to increased hypercapnia sensitivity.
  • The condition resolved with ticagrelor cessation and recurred transiently upon accidental reintroduction.

Findings:

  • Ticagrelor initiation was associated with a shift from OSA to CSA and Cheyne-Stokes respiration (CSR).
  • This shift correlated with increased hypercapnic ventilatory response.
  • Withdrawal of ticagrelor led to the resolution of CSA and normalization of hypercapnic ventilatory response.

Implications:

  • Ticagrelor may be an underrecognized cause of central sleep apnea in susceptible patients.
  • Further research is needed to elucidate the mechanisms, incidence, and clinical consequences of ticagrelor-associated CSA.
  • Clinicians should consider sleep apnea changes in patients on ticagrelor therapy.