Complex sleep apnea syndrome (CompSAS) is a form of sleep apnea specifically identified by the presence or emergence of central apneas or hypopneas upon exposure to continuous positive airway pressure (CPAP) or a Bi-level positive airway pressure (BIPAP) device when obstructive events have disappeared.

These patients have predominantly obstructive sleep apnea or mixed sleep apnea during the diagnostic sleep study occurring at greater than or equal to 5 times per hour.

With the use of CPAP or BiPAP they show a pattern of apneas and hypopneas that meets the definition of Central sleep apnea (CSA). As central hypopneas are rarely scored in clinical practice, the definition requires the occurrence of central apneas that make up more than 50% of all scored respiratory events, a threshold that could miss clinically significant non obstructive events. 

Another definition based on pathophysiology of concomitant upper airway obstruction due to respiratory control dysfunction. Comp SAS is associated with a typical polysomnographic pattern, specific therapeutic response to positive pressure (improvement of obstruction but worsening of periodic breathing with or without induction of central apneas) and a sensitivity to direct or indirect manipulations of carbon dioxide levels (by decreasing hyperventilation with adaptive forms of positive airway pressure, exogenous CO2or allowing rebreathing of CO2).

 

 Source: Indian Journal of Sleep Medicine

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Filed under: BiPAP • Central Sleep Apnea • Complex Sleep Apnea • CPAP • Mixed Sleep Apnea • Obstructive Sleep Apnea • Polysomnography • Sleep • Sleep Apnea • Sleep Apnea Diagnosis • Sleep Apnea Research • Sleep Apnea Test • Sleep Disordered Breathing • Sleep Problems

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