Central Sleep Apnea Treatment Options

First-Line Therapies

• CPAP has been shown to reduce apnea-hypopnea index (AHI) to fewer than 15 events/hour in approximately 45% of patients with CSA associated with heart failure, according to the American Academy of Sleep Medicine 1

Pharmacological Therapy

• Other drug therapies have not demonstrated sufficient efficacy for CSA treatment, as reported by the European Respiratory Society 2 and the European Respiratory Society 3

Special Considerations for Heart Failure Patients

• The American Academy of Sleep Medicine recommends that ASV should be avoided in patients with heart failure with reduced ejection fraction (HFrEF) due to increased cardiovascular mortality demonstrated in the SERVE-HF trial 4 and 5
• The American Academy of Sleep Medicine also notes that ASV treatment in HFrEF patients showed worsened all-cause and cardiovascular mortality despite reduction in AHI, as seen in the SERVE-HF trial 6 and 1
• Benzodiazepines should not be prescribed for long-term treatment of CSA associated with heart failure, as advised by the American Academy of Sleep Medicine 1

Treatment Considerations

• Transvenous Phrenic Nerve Stimulation (TPNS) is associated with high costs and carries risk of serious adverse effects in approximately 10% of patients, according to the American Academy of Sleep Medicine 1