II. Definitions

  1. Central Sleep Apnea
    1. Cessation of air flow and respiratory effort for at least 10 seconds
    2. Effects diaphragmatic or intercostal effort

III. Causes

  1. Decreased responsivity of central Chemoreceptors
    1. Chronic Obstructive Pulmonary Disease
    2. Obesity-Hypoventilation Syndrome (Pickwickian syndrome)
  2. Increased responsiveness of Chemoreceptors
    1. High altitude
  3. Delayed transit of information
    1. Cerebrovascular Accident
    2. Congestive Heart Failure

IV. Symptoms

  1. Insomnia
  2. Mild and intermittent snoring
  3. Major Depression

V. Management

  1. See Obesity-Hypoventilation Syndrome (Pickwickian syndrome)
  2. Positive Airways Pressure (BiPAP)
    1. Avoid CPAP (worsens Central Sleep Apnea)
    2. Use BiPap for patients with Central Sleep Apnea (by Sleep Study)
  3. Tricyclic Antidepressants
  4. Progesterone
  5. Acetazolamide

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