Chest
ORIGINAL RESEARCHSLEEP MEDICINEThe Significance and Outcome of Continuous Positive Airway Pressure-Related Central Sleep Apnea During Split-Night Sleep Studies
Section snippets
Patients
Patients were considered eligible for the study if they were ≥ 18 years old and seen from September 2004 through December 2005 with OSA identified using split-night polysomnography, and who also demonstrated CSA events exclusively during the CPAP titration portion of the sleep study (CSA group). CSA was defined as a CSA index (CSAI) ≥ 5/h. During CPAP titration, the pressure was raised only to eliminate obstructive and not central events. Subjects were excluded if they demonstrated CSA during
Results
A total of 116 patients with OSA who met criteria for a split-night study were evaluated. Twenty-three patients (19.8%) showed CSA events during CPAP titration. Two subjects with CPAP-related CSA were further excluded from the study because of an unsuccessful titration to eliminate obstructive events, leaving 21 subjects with CPAP-related CSA (CSA group; CSAI, 22.1 ± 13.8). These patients were compared to an equal number of control subjects (CSAI, 0.5 ± 0.9) identified by review of sleep logs
Discussion
CHF is associated with Cheyne-Stokes breathing during wakefulness and sleep. This type of respiration is quite distinct with a crescendo and decrescendo ventilatory pattern with an apnea or hypopnea at the nadir. Javaheri and Parker1 found that up to 45% of patients with CHF (LVEF ≤ 40%) had > 20 central apneas or hypopneas per hour of sleep.
CPAP therapy has been proven highly effective in treating OSA, leading to improvement in both subjective and objective daytime alertness as well as quality
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The authors have no conflicts of interest to disclose.