Central sleep apnoea in adults

Central sleep apnoea is a condition in which the patient experiences either brief periodic or prolonged loss of respiratory drive during sleep. Diagnosis and management of central sleep apnoea requires specialist referral.

Brief periodic loss of respiratory drive is common in:

• patients with heart failure (known as Cheyne-Stokes respiration)
• patients who regularly use opioids
• premature infants
• healthy people sleeping at high altitude (higher than 2500 metres).

Central sleep apnoea in these patients is generally associated with a low partial pressure of carbon dioxide (PaCO₂).

Prolonged loss of respiratory drive usually indicates a neuromuscular disorder (eg motor neurone disease) or chest wall disorder (eg kyphoscoliosis), or severe obesity (see Obesity hypoventilation syndrome). Central sleep apnoea in these patients is usually associated with elevated PaCO₂, or a PaCO₂ rise of more than 5 mmHg from the beginning to the end of sleep.