Positive Airway Pressure Therapy for Hyperventilatory Central Sleep Apnea: Idiopathic, Heart Failure, Cerebrovascular Disease, and High Altitude

Abstract

Central sleep apnea (CSA) and Hunter-Cheyne-Stokes breathing (HCSB) are caused by failure of the pontomedullary pacemaker generating breathing rhythm. CSA/HCSB may complicate several disorders causing recurrent arousals and desaturations. Common causes of CSA in adults are congestive heart failure, stroke, and chronic use of opioids; opioids have hypoventilatory effects. Diagnosis and treatment of hyperventilatory CSA may improve quality of life, and, when associated with heart failure or cerebrovascular disease, reduce morbidity and perhaps mortality.

Keywords: Adaptive servoventilation; Bilevel positive airway pressure; Central sleep apnea; Cerebrovascular disease; Continuous positive airway pressure; Heart failure; High altitude; Hunter-Cheyne-Stokes breathing.