| Abstract: | Patients with a primary diagnosis of obstructive sleep apnea frequently demonstrate central sleep apnea that emerges during treatment with CPAP. Although a number of mechanisms for this finding have been hypothesized, the pathophysiology is not definitively known. Controversy exists as to whether the concomitant appearance of the two phenomena represents a distinct meaningful entity. Regardless, the coincidence of these diseases may have important clinical implications. Herein, we review the proposed mechanisms for obstructive sleep apnea complicated by central sleep apnea. Future research is needed to elucidate the relative importance and susceptibility to intervention of the various pathophysiologic mechanisms responsible for this phenomenon, and whether a treatment approach distinct from that of pure obstructive apnea is justified.From the Emory University School of Medicine (Drs Hoffman and Schulman), Atlanta, GA.Correspondence to: David A. Schulman, MD, MPH, FCCP, Emory University School of Medicine, 615 Michael St, Ste 205, Atlanta, GA 30322; e-mail: daschul@emory.eduFinancial/nonfinancial disclosures: The authors have reported to CHEST that no potential conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details. |
