Chapter 3: Sleep-Related Breathing Disorders
Assessment and Diagnosis
CSAS assessment occurs in a sleep disorders center, through a full-night polysomnography (PSG). CSAS assessment occurs in a sleep disorders center, through a full-night polysomnography (PSG). A complete assessment involves confirming that the apnea-hypopneas are central in nature, with no inspiratory effort occurring during the event.1 (See Figure 3b.)
Diagnostic criteria for CSAS include an Apnea-Hypopnea Index (AHI) of five or more (> 5) central apneas-hypopneas per hour of sleep; reported excessive daytime sleepiness; frequent nocturnal awakenings; or waking up feeling short of breath. 2
A diagnosis of Cheyne-Stokes respiration is based on at least 10 central apneas and hypopneas per hour of sleep, and a waxing and waning respiratory pattern. 3
Figure 3b: Polysomnographic recording of two episodes of central sleep apnea. Note the lack of respiratory effort during each CSA event.
Once a diagnosis of CSAS is established by determining the number of events and the resulting degree of sleep disturbance and O2 desaturation, the patient’s response to potential treatments is assessed.
References
- Wellman A, and D White, “Central Sleep Apnea and Periodic Breathing,” in Kryger M, Roth T, Dement W (ed.), Principles and Practice of Sleep Medicine (5th Edition), St. Louis: Elsevier Saunders, 2011, pages 1140-1152.
- Wellman A, and D White, “Central Sleep Apnea and Periodic Breathing,” in Kryger M, Roth T, Dement W (ed.), Principles and Practice of Sleep Medicine (5th Edition), St. Louis: Elsevier Saunders, 2011, pages 1140-1152.
- Wellman A, and D White, “Central Sleep Apnea and Periodic Breathing,” in Kryger M, Roth T, Dement W (ed.), Principles and Practice of Sleep Medicine (5th Edition), St. Louis: Elsevier Saunders, 2011, pages 1140-1152.