Central Sleep Apnea

Central sleep apnea (CSA) is a sleep-related breathing disorder that is characterized by repetitive cessation of airflow due to diminished or absent ventilatory effort. There are several types of CSA, and these can be classified into two general types, namely hypercapnic (central alveolar hypoventilation, secondary to neuromuscular disorders or chronic use of long-acting opioids) or non-hypercapnic forms (idiopathic CSA, CSA due to heart failure, sleep-onset periodic breathing, high-altitude central apneas, and continuous positive airway pressure-emergent CSA). Whatever its cause(s), CSA can give rise to sleep disturbance, repetitive awakenings, insomnia or excessive sleepiness. Definitive diagnosis of CSA requires polysomnography. Therapy should be individualized depending on the nature and severity of central apnea; this may include use of oxygen supplementation, drug therapy or positive airway pressure.