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Treatments and drugs

By Mayo Clinic staff

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Illustration of 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, appropriate therapy for heart failure may eliminate 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. The mask is attached to a small pump that supplies 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 so that adjustments can be made.
  • Bilevel positive airway pressure (BPAP). Unlike CPAP, which supplies steady, constant pressure to your upper airway as you breathe in and out, BPAP builds to a higher pressure when you inhale and decreases to a lower pressure when you exhale. The goal of this treatment is to boost the weak breathing pattern of central sleep apnea. Some BPAP devices can be set to automatically deliver a breath if the device detects you haven't taken a breath after a certain number of seconds.
  • Adaptive servo-ventilation (ASV). Some studies have shown this airflow device to be more effective than the CPAP or BPAP for treating central sleep apnea. ASV is designed to treat central sleep apnea and complex sleep apnea by monitoring your normal breathing pattern and storing the information in a built-in computer. After you fall asleep, the machine uses pressure to regulate your breathing pattern and prevent pauses in your breathing.
  • Supplemental oxygen. Using supplemental oxygen while you sleep may help if you have central sleep apnea. Various forms of oxygen are available as well as different devices to deliver oxygen to your lungs.
  • Medications. Certain medications have been used to stimulate breathing in people with central sleep apnea. For example, some doctors prescribe acetazolamide to prevent central sleep apnea in high altitude.
Tests and diagnosis
References
  1. Badr MS. Central sleep apnea syndrome: Risk factors, clinical presentation, and diagnosis. http://www.uptodate.com/home/index/html. Accessed April 11, 2011.
  2. NINDS sleep apnea information page. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/sleep_apnea/sleep_apnea.htm. Accessed April 10, 2011.
  3. Javaheri S. Central sleep apnea. Clinics in Chest Medicine. 2010;31:235.
  4. Ropper AH, et al. Sleep and its abnormalities. In: Ropper AH, et al. Adams & Victor's Principles of Neurology. 9th ed. New York, N.Y.: The McGraw-Hill Companies; 2009. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=54. Accessed April 8, 2011.
  5. Malhotra A. What is central sleep apnea? Respiratory Care. 2010;55:1168.
  6. Badr MS. Central sleep apnea syndrome: Pathogenesis. http://www.uptodate.com/home/index/html. Accessed April 11, 2011.
  7. Budhiraja R. Sleep-disordered breathing and cardiovascular disorders. Respiratory Care. 2010;55:1322.
  8. Collop N. Portable monitoring in obstructive sleep apnea in adults. http://www.uptodate.com/home/index/html. Accessed April 11, 2011.
  9. Millman RP. Polysomnography in obstructive sleep apnea in adults. http://www.uptodate.com/home/index/html. Accessed April 11, 2011.
  10. Your guide to healthy sleep. National Heart, Lung and Blood Institute. http://www.nhlbi.nih.gov/health/public/sleep/healthy_sleep.pdf. Accessed April 9, 2011.
  11. Central sleep apnea. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/print/sec05/ch061/ch061d.html. Accessed April 12, 2011.
  12. Badr MS. Central sleep apnea: Treatment. http://www.uptodate.com/home/index/html. Accessed April 11, 2011.
  13. Hastings PC, et al. Adaptive servo-ventilation in heart failure patients with sleep apnea: A real world study. International Journal of Cardiology. 2010;139:17.
  14. Randerath WJ, et al. Combined adaptive servo-ventilation and automatic positive airway pressure (anticyclic modulated ventilation) in co-existing obstructive and central sleep apnea syndrome and periodic breathing. Sleep Medicine. 2009;10:898.
  15. Ono H, et al. Sleep apnea syndrome: Central sleep apnea and pulmonary hypertension worsened during treatment with auto-CPAP, but improved by adaptive servo-ventilation. Internal Medicine. 2010;49:415.
  16. Olson EJ (expert opinion). Mayo Clinic, Rochester, Minn. April 15, 2011.
DS00995 June 16, 2011

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