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Treatments and drugs

By Mayo Clinic staff

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Illustration showing continuous positive airway pressure (CPAP) mask Continuous positive airway pressure (CPAP)

Treatments for central sleep apnea may include:

  • Addressing associated medical problems. Possible causes of central sleep apnea include other disorders, and treating those conditions may help your central sleep apnea. For example, therapy for heart failure may improve central sleep apnea.
  • Reduction of opioid medications. If opioid medications are causing your central sleep apnea, your doctor may gradually reduce your dose of those medications.

  • Continuous positive airway pressure (CPAP). This method, also used to treat obstructive sleep apnea, involves wearing a mask over your nose while you sleep. CPAP is usually the first treatment given for central sleep apnea.

    The mask is attached to a small pump that supplies a continuous amount of pressurized air to hold open your upper airway. CPAP may prevent the airway closure that can trigger central sleep apnea.

    As with obstructive sleep apnea, it's important that you use the device only as directed. If your mask is uncomfortable or the pressure feels too strong, talk with your doctor. Several types of masks are available. Doctors can also adjust the air pressure.

  • Adaptive servo-ventilation (ASV). If CPAP hasn't effectively treated your condition, you may be given ASV.

    Like CPAP, ASV also delivers pressurized air. However, unlike CPAP, ASV adjusts the amount of pressure during inspiration on a breath-by-breath basis to smooth out the breathing pattern. The device may also automatically deliver a breath if you haven't taken a breath within a certain number of seconds.

  • Bilevel positive airway pressure (BPAP). Like ASV, BPAP delivers pressure when you breathe in and a different amount of pressure when you breathe out. Unlike ASV, the amount of pressure during inspiration is fixed rather than variable.

    BPAP can also be configured to deliver a breath if you haven't taken a breath within a certain number of seconds.

  • Supplemental oxygen. Using supplemental oxygen while you sleep may help if you have central sleep apnea. Various devices are available to deliver oxygen to your lungs.

  • Medications. Certain medications, such as acetazolamide (Diamox) or theophylline (Theo-24, Theochron, others), have been used to stimulate breathing in people with central sleep apnea.

    Doctors may prescribe medications to help your breathing as you sleep if you can't take positive airway pressure. Also, some doctors prescribe medications to prevent central sleep apnea in high altitude.

Tests and diagnosis
References
  1. NINDS sleep apnea information page. National Institute of Neurological Diseases and Stroke. http://www.ninds.nih.gov/disorders/sleep_apnea/sleep_apnea.htm. Accessed April 18, 2013.
  2. Badr MS. Central sleep apnea: Risk factors, clinical presentation, and diagnosis. http://www.uptodate.com/home. Accessed April 4, 2013.
  3. Javaheri S. Central sleep apnea. Clinics in Chest Medicine. 2010;31:235.
  4. Central sleep apnea. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/pulmonary_disorders/sleep_apnea/central_sleep_apnea.html?qt=central%20sleep%20apnea&alt=sh. Accessed April 18, 2013.
  5. What is sleep apnea? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/. Accessed April 17, 2013.
  6. Malhotra A, et al. What is central sleep apnea? Respiratory Care. 2010;55:1168.
  7. Badr MS. Central sleep apnea: Pathogenesis. http://www.uptodate.com/home. Accessed April 18, 2013.
  8. Malhotra A, et al. Cheyne-Stokes breathing and obstructive sleep apnea in heart failure. http://www.uptodate.com/home. Accessed April 19, 2013.
  9. Leung RS, et al. Mechanisms of sleep-disordered breathing: Causes and consequences. Pflugers Archiv. 2012;463:213.
  10. Millman RP, et al. Polysomnography in obstructive sleep apnea in adults. http://www.uptodate.com/home. Accessed April 16, 2013.
  11. Badr MS. Central sleep apnea: Treatment. http://www.uptodate.com/home. Accessed April 4, 2013.
  12. Dave NB. Initiation of positive airway pressure therapy for obstructive sleep apnea in adults. http://www.uptodate.com/home. Accessed April 12, 2013.
  13. Find a sleep center near you. American Academy of Sleep Medicine. http://www.sleepcenters.org/. Accessed April 4, 2013.
  14. U.S. News best hospitals 2012-2013. U.S. News & World Report. http://health.usnews.com/best-hospitals/rankings. Accessed April 4, 2013.
  15. Olson EJ (expert opinion). Mayo Clinic, Rochester, Minn. April 29, 2013.
DS00995 June 28, 2013

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