Treatment of Central Sleep Apnea Syndromes in Adults
Publication Date: May 1, 2016
Last Updated: March 14, 2022
Primary CSAS
Positive airway pressure therapy may be considered for the treatment of primary CSAS. (OPTION)
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Acetazolamide has limited supporting evidence but may be considered for the treatment of primary CSAS. (OPTION)
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The use of zolpidem and triazolam may be considered for the treatment of primary CSAS only if the patient does not have underlying risk factors for respiratory depression. (OPTION)
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CSAS Due to Congestive Heart Failure (CHF) Including Cheyne Stokes Breathing Pattern (CSBP) and Not Cheyne Stokes Breathing
CPAP therapy targeted to normalize the apnea hypopnea index (AHI) is indicated for the initial treatment of CSAS related to CHF. (STANDARD)
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BPAP therapy in a spontaneous timed (ST) mode targeted to normalize the apnea hypopnea index (AHI) may be considered for the treatment of CSAS related to CHF only if there is no response to adequate trials of CPAP, ASV, and oxygen therapies. (OPTION)
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Adaptive Servo-Ventilation (ASV) targeted to normalize the apnea-hypopnea index (AHI) is indicated for the treatment of CSAS related to CHF. (STANDARD)
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Nocturnal oxygen therapy is indicated for the treatment of CSAS related to CHF. (STANDARD)
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The following therapies have limited supporting evidence but may be considered for the treatment of CSAS related to CHF, after optimization of standard medical therapy, if PAP therapy is not tolerated, and if accompanied by close clinical follow-up: acetazolamide and theophylline. (OPTION)
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The following possible treatment options for CSAS related to end stage renal disease may be considered: CPAP, supplemental oxygen, bicarbonate buffer use during dialysis, and nocturnal dialysis. (OPTION)
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Recommendation Grading
Overview
Title
Treatment of Central Sleep Apnea Syndromes in Adults
Authoring Organization
American Academy of Sleep Medicine
Publication Month/Year
May 1, 2016
Last Updated Month/Year
June 1, 2023
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
The purpose of this practice parameter is to review the available data for the treatment and management of CSAS in adults. When possible, a relative determination was made as to the most effective treatment option.
Target Patient Population
Patients with central sleep apnea syndrome
Inclusion Criteria
Female, Male, Adolescent, Adult, Older adult
Health Care Settings
Ambulatory, Outpatient
Intended Users
Nurse, nurse practitioner, physician, physician assistant
Scope
Assessment and screening, Management, Treatment
Diseases/Conditions (MeSH)
D012891 - Sleep Apnea Syndromes, D020182 - Sleep Apnea, Central
Keywords
sleep apnea, central sleep apnea
Source Citation
J Clin Sleep Med 2016;12(5):757-761.