Table 2.

Summary of Potential Treatment Strategies and Their Effectiveness for Nonhypercapnic CSA^*

Variables	Intervention	Benefits	Limitations	Level of Evidence
CSB/CSA in heart failure	Optimization of therapy	Likely ↓ in SDB		Several, small, non-RCTs61,80–82
	CPAP	Approximately 50% ↓ in AHI	No evidence for ↓ mortality	Several, including one large study83
	Adaptive NIV	Approximate 85% ↓ in AHI; ↑ in LVEF and QOL	Further studies on long-term hemodynamic effects required	Several, small, short/moderate-term RCTs84–86 and one non-RCT87
	CO2; ↑ dead space	Normalizes AHI	No long-term safety data; may lead to anxiety/panic/insomnia	Several, small, short-term non- RCTs88,89
	O2	Approximate 50% ↓ in AHI	Hemodynamic effects not consistent	Several, small, short-term, non- RCTs70,91 and RCTs92,93
	CRT	Normalizes AHI in some patients; ↑in LVEF	Not effective for all patients	Two small, short/moderate-term non-RCTs94,95
	Theophylline	Approximate 50% ↓ in AHI	No change in LVEF; ↑ risk of cardiac events	One small, short-term RCT96
	Acetazolamide	Approximate 40% ↓ in AHI; ↓ DTS and fatigue	No long-term safety data	One small, short-term RCT97
ICSA	CPAP	May normalize AHI in some patients	Very limited data available	Case report98 and one small, short- term non-RCT99
	CO2; ↑ dead space	Normalizes AHI	No long-term safety data; may lead to anxiety/panic/ insomnia	One small, short-term non-RCT100
	O2	Normalizes AHI	Very limited data available	One small (two ICSA patients) non-RCT90
	Atrial overdrive pacing	Approximate 60% ↓ in AHI in one study (OSA plus CSA)	Several subsequent negative studies	Several, small short-term RCTs101–107
	Acetazolamide	Approximate 70% ↓ in AHI; ↓ DTS	No long-term safety data	One small, short-term non-RCT108

^*CRT = cardiac resynchronization therapy; DTS = daytime sleepiness; LVEF = left ventricular ejection fraction; NIV = noninvasive ventilation. See Table 1 for expansion of abbreviation.