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Central Sleep Apnea: a Brief Review
M Safwan Badr1, John D Dingell2, Shahrokh Javaheri3
1Department of Internal Medicine, Division of pulmonary, critical; care and sleep medicine.
Current Pulmonology Reports
|December 3, 2019
Summary
Central apnea, a sleep disorder, involves breathing instability and airway narrowing. Management includes positive pressure therapy (PAP) and other options, but adaptive-servo ventilation (ASV) has contraindications in heart failure patients.
Area of Science:
- Sleep Medicine
- Respiratory Physiology
Background:
- Central apnea is characterized by breathing instability and upper airway narrowing.
- It is clinically associated with conditions like heart failure, atrial fibrillation, and chronic opioid use.
Purpose of the Study:
- To review the pathogenesis, clinical manifestations, diagnosis, and treatment of central apnea.
- To highlight areas of controversy and uncertainty in central apnea management.
Main Methods:
- Literature review of pathogenesis, clinical features, and therapeutic strategies for central apnea.
- Discussion of current treatment options and their limitations.
Main Results:
- Central apnea can result from hypoventilation or hypocapnia, leading to persistent breathing instability and airway narrowing.
- Positive pressure therapy (PAP) is a standard treatment; adaptive-servo ventilation (ASV) is contraindicated in heart failure with reduced ejection fraction due to increased mortality.
- Associated conditions include obstructive sleep apnea, heart failure, atrial fibrillation, cerebrovascular accidents, tetraplegia, and chronic opioid use.
Conclusions:
- Multiple therapeutic options exist for central apnea.
- Further randomized controlled studies are necessary to determine the long-term efficacy of various treatment modalities for different types of central apnea.
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