Treatment

Treatments for central sleep apnea might include:

• Addressing associated medical problems. Possible causes of central sleep apnea include other disorders and treating those conditions might help your central sleep apnea. For example, therapy for heart failure might improve central sleep apnea.
• Reduction of opioid medications. If opioid medications are causing your central sleep apnea, your doctor might 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 or your nose and mouth while asleep.

  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 doesn't effectively treat your condition, you might be given ASV. Like CPAP, ASV also delivers pressurized air.

  Unlike CPAP, ASV adjusts the amount of pressure breath-by-breath during inhalation to smooth out your breathing pattern. The device might also automatically deliver a breath if you haven't taken a breath within a certain number of seconds.

  ASV isn't recommended for people with symptomatic heart failure.

• 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 set to deliver a breath if you haven't taken a breath within a certain number of seconds.

  BPAP could worsen central sleep apnea in people with heart failure. Talk to your doctor about the potential risks of BPAP if you have heart failure.

• Supplemental oxygen. Using supplemental oxygen while you sleep might help if you have central sleep apnea. Various devices are available to deliver oxygen to your lungs.
• Medications. Medications such as acetazolamide have been used to stimulate breathing in people with central sleep apnea. These medications might be prescribed to help your breathing as you sleep if you can't tolerate positive airway pressure.

Surgery or other procedures

A newer therapy for central sleep apnea is transvenous phrenic nerve stimulation. A system approved by the U.S. Food and Drug Administration (remede System) delivers an electrical pulse to the nerve that controls the diaphragm (phrenic nerve) during sleep, which causes you to take a breath. This involves a battery-powered pulse generator that's implanted under the skin in the upper chest.

Used for moderate to severe central sleep apnea, this system produces a steady breathing pattern. More study is needed.