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Updated: Jun 5, 2025
07:54
Drug-Induced Sleep Endoscopy DISE with Target Controlled Infusion TCI and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
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Treatment-emergent central sleep apnea resolves with lower inspiratory pressure
William H Noah1, Ludovico Messineo2, Bernard Hete1
1Sleep Centers of Middle Tennessee, Murfreesboro, Tennessee.
Summary
Treatment-emergent central sleep apnea (TECSA) was effectively resolved by reducing inspiratory positive airway pressure (IPAP) with a novel device. This study demonstrates that lowering IPAP can eliminate central apneas in patients undergoing CPAP therapy.
Area of Science:
- Sleep Medicine
- Respiratory Physiology
Background:
- Treatment-emergent central sleep apnea (TECSA) is a common complication during continuous positive airway pressure (CPAP) therapy for obstructive sleep apnea.
- The exact mechanisms leading to TECSA are not fully understood, but increased tidal volume has been implicated.
Purpose of the Study:
- To evaluate the efficacy of a device designed to reduce inspiratory positive airway pressure (IPAP) in resolving TECSA.
- To determine if reducing IPAP can eliminate central apneas in patients with TECSA.
Main Methods:
- A device reducing IPAP was added to the CPAP circuit during split-night titrations in patients who developed TECSA.
- Central apnea index was measured before and after the device was implemented.
Main Results:
- The study included 1,613 patients, with 19 developing TECSA.
- The device completely resolved TECSA in all patients with adequate data (n=13).
- The central apnea index significantly decreased from 17.3 ± 11.0 to 1.5 ± 1.7 events/h (P < .001).
Conclusions:
- Reducing IPAP with the tested device effectively resolved TECSA in all participants.
- Lowering IPAP appears to be a promising strategy for managing central respiratory events in CPAP-treated patients.
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