Table 1.
Type of Central Apnea | Mechanism | Treatment |
---|---|---|
Sleep transition apnea | Ventilatory response to arousal drives PCO2 below apnea threshold | Reassurance Sleep hygiene Hypnotic therapy Oxygen |
Narcotic-induced central apnea | Unclear, suppressed output from respiratory pattern generator | Reduce narcotic dose Consider advanced PAP device |
Cheyne-Stokes breathing | High loop gain from extravascular lung water and robust chemoresponsiveness | Optimize medical therapy Consider PAP |
Complex sleep apnea | CPAP reduces upper-airway resistance, improving the efficiency of CO2 excretion | Reassurance Expectant management |
Idiopathic central apnea | Unknown | Acetazolamide Consider bi-level PAP |
PAP = positive airway pressure
CPAP = continuous positive airway pressure