Management of CSAS typically first involves improving the underlying disorder, such as aggressive management of chronic heart failure for patients with Cheyne-Stokes respiration. Reducing the dose of opiates or eliminating them completely may help as well.
Other treatment options include respiratory stimulants, such as acetazolamide or theophylline,1 as well as supplemental O2 or CO2. For Cheyne-Stokes respiration in patient with heart failure, CPAP and Auto-SV devices have been shown to be effective in some patients; the use of Auto-SV devices is now controversial, however, due to one study that suggested an increased mortality on ASV devices.
Benzodiazepines may be used for patients with sleep-onset CSAS (CSAS that occurs as the person is falling asleep).2
- Javaheri S, Ahmed M, Parker TJ, Brown CR. Effects of nasal O2 on sleep-related disordered breathing in ambulatory patients with stable heart failure. Sleep. 1999;22:1101-1106.
- Hanley P, Powles P. Hypnotics should never be used in patients with sleep apnea. J Psychosom Res 1993;37:59-65.