Management of Complex Sleep Apnea Syndromes (Including Treatment Emergent and Treatment Persistent Central Sleep Apnea)

Complex sleep apnea refers to patents with obstructive sleep apnea who develop central apneas on continuous positive airway pressure (CPAP). It occurs most frequently during the first initiation of CPAP therapy, but can also evolve later on. The prevalence has been reported between 1.5% and 20%. Complex sleep apnea is a mostly a transient phenomenon. If it becomes chronic, the most applicable treatment options include adaptive servoventilation, BPAP with back-up rate, medication, or supplemental oxygen. However, successful clinical management often needs a multi-modality approach involving all individual aspects of the underlying pathology