Central sleep apnea
ICD-10 G47.3 · ICD-11 7A40

Central Sleep Apnea Emerging or Persisting During Therapy for Upper Airway Obstruction

Clinical scenario

Treatment-emergent central sleep apnoea (TECSA), also called complex sleep apnoea, refers to the emergence or persistence of central sleep apnea during therapy for upper airway obstruction. This pattern can arise with CPAP as well as with non-PAP modalities used to manage obstructive sleep apnoea.

Approach overview

Management centres on continuing the existing airway therapy with careful, targeted optimisation — the complete stepwise protocol specifies what to adjust and in what order.

Treatment goal: Improvement in the frequency of central events.
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References

DOI: 10.1183/20734735.0235-2023

The emergence or persistence of CSA during therapy for upper airway obstruction (often associated with CPAP, but can also occur with non-PAP OSA treatment modalities) is termed complex sleep apnoea or treatment-emergent CSA (TECSA).

In most instances, the frequency of central events improves with time without the need to switch out CPAP therapy, while avoiding excessive titration, mask leak minimisation and optimising other sleep disorders contributing to arousals (insomnia, sleep insufficiency).

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