title: Treatment Options for Central Sleep Apnea: Comparison of Ventilator, Oxygen, and Drug Therapies.
abstract: Central sleep apnea (CSA) is a sleep-related disorder characterized by pauses in breathing during sleep when the brain respiratory network momentarily interrupts transmission of impulses to the respiratory musculature. CSA presents significant problems being an independent risk factor for cardiovascular events and death. There are several available treatment options according to CSA severity. Currently, adaptive servo-ventilation is considered best for CSA patients. The goal of the present study was to retrospectively investigate different treatment methods employed for CSA, such as different modes of ventilation, oxygen therapy, and drugs to determine the most effective one. Data were obtained from hospital records during 2010-2015. The diagnosis of CSA and the optimal treatment method were supported by polysomnography examinations. Devices used during sleep to support breathing included continuous positive airway pressure, bi-level positive airway pressure, or adaptive servo-ventilation. We classified 71 (2.9 %) patients as having CSA from 2,463 patients with sleep-disordered breathing. Of those 71 patients, 54 (76.1 %, 95 % CI 66.2-86.0 %) were male and 17 (23.9 %, 95 % CI 14.0-33.8 %) were female, and they had a mean age of 67.1 ± 14.1. Four (5.6 %) patients underwent a combination therapy, 39 (54.9 %) received a ventilator in proper ventilation mode, 25 (35.2 %) received oxygen therapy, 7 (9.9 %) received medication, and 4 (5.6 %) received no treatment. We conclude that although the majority of patients needed treatment for central sleep apnea, a clear advantage in using ventilators when compared to oxygen therapy or drug therapy could not be found.
authors.affiliation: Department of Internal Medicine, Division of Pulmonary, Allergy, and Sleep Medicine, HELIOS Clinic Wuppertal, Witten/Herdecke University, Heusnerstr. 40, 42283, Wuppertal, Germany. josef.yayan@hotmail.com.
authors.forename: Josef
authors.initials: J
authors.lastname: Yayan
authors.affiliation: Department of Internal Medicine, Division of Pulmonary, Allergy, and Sleep Medicine, HELIOS Clinic Wuppertal, Witten/Herdecke University, Heusnerstr. 40, 42283, Wuppertal, Germany.
authors.forename: Kurt
authors.initials: K
authors.lastname: Rasche
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D003024:Clozapine / Q000627:therapeutic use; D045422:Continuous Positive Airway Pressure / Q000379:methods*; D015259:Dopamine Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D008803:Mianserin / Q000031:analogs & derivatives / Q000627:therapeutic use; D008875:Middle Aged; D000078785:Mirtazapine; D010102:Oxygen Inhalation Therapy / Q000379:methods*; D017286:Polysomnography; D011725:Pyridines / Q000627:therapeutic use; D012189:Retrospective Studies; D012702:Serotonin Antagonists / Q000627:therapeutic use*; D020182:Sleep Apnea, Central / Q000175:diagnosis / Q000628:therapy*; D013843:Thiazines / Q000627:therapeutic use; D013993:Tilidine / Q000627:therapeutic use; D016896:Treatment Outcome; D000077334:Zolpidem
chemical_list: D000317:Adrenergic alpha-Antagonists; D000701:Analgesics, Opioid; D015259:Dopamine Agents; D006993:Hypnotics and Sedatives; D011725:Pyridines; D012702:Serotonin Antagonists; D013843:Thiazines; D008803:Mianserin; D007980:Levodopa; C069248:prothipendyl; D000077334:Zolpidem; D000078785:Mirtazapine; D013993:Tilidine; D003024:Clozapine
keywords: Adaptive servo-ventilation; Bi-level positive airway pressure; Central sleep apnea; Continuous positive airway pressure; Drugs; Oxygen therapy