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Treatment-emergent central sleep apnea: a unique sleep-disordered breathing
Jing Zhang1, Le Wang, Heng-Juan Guo
1Department of Respiratory and Critical Care Medicine, Tianjin Medical University General Hospital, Tianjin 300052, China.
Chinese Medical Journal
|October 3, 2020
Summary
Treatment-emergent central sleep apnea (TECSA) can arise during obstructive sleep apnea treatment. While some cases resolve spontaneously with continuous positive airway pressure (CPAP), others require further investigation and alternative therapies.
Area of Science:
- Sleep Medicine
- Respiratory Physiology
- Pulmonology
Background:
- Treatment-emergent central sleep apnea (TECSA) is a complex sleep-disordered breathing condition.
- It is characterized by central apneas emerging or persisting during obstructive sleep apnea treatment.
Purpose of the Study:
- To review the definition, epidemiology, mechanisms, clinical features, and treatment of TECSA.
- To identify knowledge gaps and suggest future research directions for TECSA.
Main Methods:
- A comprehensive literature search was conducted in the PubMed database up to January 31, 2020.
- Relevant articles were identified and synthesized to summarize current understanding of TECSA.
Main Results:
- TECSA prevalence varies significantly across studies.
- Potential mechanisms include ventilatory control instability, low arousal threshold, lung receptor activation, and prolonged circulation time.
- TECSA may spontaneously resolve with continuous positive airway pressure (CPAP) in some patients, but others require advanced therapies like adaptive servo-ventilation.
Conclusions:
- Further large-scale surveys and clinical trials are needed to clarify TECSA irregularities.
- Detailed evaluation of patient demographic and polysomnographic data is crucial for understanding TECSA.
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