Table 5.
Risk factor studies of central apnea and TECSA
| Reference | N | Comments |
|---|---|---|
| Morgenthaler et al11 | 243 | Male sex was risk factor; no difference in clinical history otherwise to predict treatment-evoked centrals NREM dominance was more common during diagnostic PSG in complex apnea |
| Pusalavidyasagar et al7 | 167 | 20% with TECSA; male sex, lower BMI, and centrals at baseline, but no other clinical or demographic variables or PAP or medications, were linked to TECSA |
| Dernaika et al25 | 21 | No demographic or baseline PSG differences. Titration PSG had higher CPAP, more fragmentation, 12 of 14 who had repeat PSG showed resolution of CSA Exclusion: CHF, COPD, narcotic use, patients with centrals during diagnostic PSG |
| Lehman et al12 | 99 | Baseline central apnea, higher severity, male sex, and cardiac disease predicted treatment-evoked centrals |
| Endo et al13 | 1,312 | 6% with central or TECSA; male sex and higher AHI were predictors of TECSA, but no other clinical or demographic factors were identified |
| Kuzniar et al4 | 200 | 6.5% had TECSA; NREM dominance and higher ESS scores at baseline, but not age or sex or CPAP, were associated with TECSA |
| Javaheri et al3 | 1,286 | 6.5% of cohort had CAI >5. 42 of 84 returned for second PSG: n=9 with persistent CSA had more severe apnea, or were on opiates, or had centrals at baseline No difference in medical history of 84 CSA and 84 non-CSA matched for age, sex, and BMI |
| Yaegashi et al15 | 297 | 5.7% had TECSA; centrals at baseline and NREM dominance were predictors No clinical or comorbidity differences between groups |
| Bitter et al8 | 192 | N=34 with complex apnea, no demographic or clinical predictors. Hypercapnic ventilator response was elevated (and small differences in diuretic use, CHF severity, and PCO2). |
| Cassel et al14 | 675 | Older age (but no other clinical factors) and centrals at baseline predicted TECSA. Some patients initially without TECSA developed it on subsequent retitration |
| Westhoff et al28 | 1,776 | No difference in demographics or PSG features during diagnostic testing Exclusion: elevated BNP, central apnea with opiates |
| Montesi et al26 | 310 | CAI >5 in n=30; no difference in demographics, but did show higher leak values than non-CSA group Exclusion: CHF, atrial fibrillation |
Abbreviations: TECSA, Treatment-emergent central sleep apnea; CSA, central sleep apnea; NREM, non-rapid eye movement; PSG, polysomnography; BMI, body mass index; PAP, positive airway pressure; CPAP, continuous positive airway pressure; CHF, congestive heart failure; COPD, chronic obstructive pulmonary disease; CAI, central apnea index; AHI, apnea–hypopnea index; PCO2, partial pressure of carbon dioxide; BNP, brain natriuretic peptide; ESS, Epworth Sleepiness Scale.