Materiały źródłowe

• #1 Central sleep apnea: Risk factors, clinical presentation, and diagnosis – UpToDate

  https://www.uptodate.com/contents/central-sleep-apnea-risk-factors-clinical-presentation-and-diagnosis/print

  Central sleep apnea (CSA) is a disorder characterized by repetitive cessation or decrease of both airflow and ventilatory effort during sleep. CSA is less common than obstructive sleep apnea (OSA) and is often associated with other medical conditions, especially heart failure, stroke, and opioid medications. Rare cases are primary or idiopathic. […] CSA is common, although less prevalent in the general population than obstructive sleep apnea (OSA). In a population-based study that included 5804 community-dwelling adults aged 40 years and older, the overall prevalence of CSA on polysomnography was 0.9 percent. Approximately half of the CSA cases were associated with Cheyne-Stokes breathing (0.4 percent overall). The median age of patients with CSA was 69 years. CSA was more common among patients with heart failure (4.8 percent) and in males compared with females (1.8 versus 0.2 percent). […] The prevalence of symptomatic CSA (ie, CSA syndrome) appears to be higher among older adults, males, those with certain comorbid medical conditions such as heart failure, and patients who chronically use opioids.

• #2 Central sleep apnea – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/central-sleep-apnea/symptoms-causes/syc-20352109

  Central sleep apnea is a disorder in which breathing repeatedly stops and starts during sleep. […] Central sleep apnea is less common than obstructive sleep apnea. […] Central sleep apnea can result from other conditions, such as heart failure and stroke. […] Central sleep apnea occurs when your brain doesn’t transmit signals to your breathing muscles. […] The brainstem links the brain to the spinal cord. It controls many functions, including heart rate and breathing. Central sleep apnea can be caused by a number of conditions that affect the ability of the brainstem to control breathing. […] Certain factors put you at increased risk of central sleep apnea: Males are more likely to develop central sleep apnea than are females. […] Central sleep apnea is more common among older adults, especially those older than age 60.

• #3 Prevalence and Characteristics of Central Compared to Obstructive Sleep Apnea: Analyses from the Sleep Heart Health Study Cohort

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4909617/

  Determine the prevalence of central sleep apnea (CSA) in a large community-based cohort using current definitions and contrast the clinical characteristics of subjects with CSA to those with obstructive sleep apnea (OSA) and no sleep apnea. […] The prevalences of CSA and Cheyne Stokes respiration (CSR) in this sample were 0.9 (95% confidence intervals [CI]: 0.71.2)% and 0.4 (95% CI: 0.30.6)%, respectively. […] This is the largest community-based study of the prevalence and characteristics of CSA to date and demonstrates a prevalence of CSA that is intermediate to those previously noted. […] According to contemporary criteria in the largest sleep cohort available, the current work demonstrates CSA prevalence to be 0.9% in adults aged 40 and older. […] The prevalence of CSA (defined as CSA-G in our sample) was noted to be quite low (0.9%) relative to the prevalence of OSA. […] Among subjects with heart failure the prevalence of OSA vastly exceeded CSA-G and CSR. […] This analysis of SHHS participants confirms a number of previously described associations regarding CSA, and estimates the prevalence of CSA in women for the first time in a large non-clinic based cohort.

• #4 Central sleep apnea: Risk factors, clinical presentation, and diagnosis – UpToDate

  https://www.uptodate.com/contents/central-sleep-apnea-risk-factors-clinical-presentation-and-diagnosis/print

  Central sleep apnea (CSA) is a disorder characterized by repetitive cessation or decrease of both airflow and ventilatory effort during sleep. CSA is less common than obstructive sleep apnea (OSA) and is often associated with other medical conditions, especially heart failure, stroke, and opioid medications. Rare cases are primary or idiopathic. […] CSA is common, although less prevalent in the general population than obstructive sleep apnea (OSA). In a population-based study that included 5804 community-dwelling adults aged 40 years and older, the overall prevalence of CSA on polysomnography was 0.9 percent. Approximately half of the CSA cases were associated with Cheyne-Stokes breathing (0.4 percent overall). The median age of patients with CSA was 69 years. CSA was more common among patients with heart failure (4.8 percent) and in males compared with females (1.8 versus 0.2 percent). […] The prevalence of symptomatic CSA (ie, CSA syndrome) appears to be higher among older adults, males, those with certain comorbid medical conditions such as heart failure, and patients who chronically use opioids.

• #5

  https://link.springer.com/article/10.1007/s11910-022-01199-2

  The epidemiology of CSA is less well studied, but the prevalence of CSA is estimated to be 5 to 10% of patients with SDB. […] Central sleep apnea is a heterogeneous disease with multiple clinical manifestations. […] OSA is by far the more common condition; however, CSA is highly prevalent among certain patient groups. […] Complex sleep apnea (CompSA) is defined as the occurrence/emergence of CSA upon treatment of OSA. […] Central sleep apnea has a number of etiologies that also have varying underlying mechanisms, and broadly can be attributed to either inadequate ventilatory drive or a paradoxically excessive drive (elevated loop gain). […] In adults, CSA is often defined as the presence of at least 5 central events per hour, which can include central apneas or central hypopneas.

• #6 The Quest for a Better PAP Titration Protocol for Central Sleep Apnea | Sleep Review

  https://sleepreviewmag.com/sleep-disorders/breathing-disorders/central-sleep-apnea/pap-titration-protocol-csa/

  Sleep-disordered breathing (SDB) is defined as the repetitive cessation or decrease of airflow during sleep and encompasses both obstructive sleep apnea (OSA), characterized by occlusion of the airway with continued effort to breathe, and central sleep apnea (CSA), characterized by the absence of respiratory drive to breathe and absence of respiratory effort on the polysomnogram (PSG). […] CSA comprises a small percentage of patients referred to the sleep laboratory and accounts for about 5% to 10% of patients with SDB. […] Treatment protocols for CSA are less well established. […] We contacted several sleep laboratories in our region and found no consensus on a PAP titration protocol for CSA; in some sleep labs, a written protocol did not even exist. […] The frequency of patients exhibiting CSA in any given sleep center is highly dependent on the referral pattern for that center.

• #7 Central Sleep Apnea (CSA) Prevalence: Evolution of recent evidence

  https://www.sefam-uk.co.uk/post/central-sleep-apnea-csa-prevalence-evolution-of-recent-evidence

  Central sleep apnea (CSA) is a sleep disorder characterised by a lack of respiratory effort during sleep due to a failure of the brain to send appropriate signals to the muscles that control breathing. CSA can lead to disrupted sleep and low oxygen levels in the blood, and is commonly associated with other medical conditions, such as heart failure. […] The reported prevalence of CSA varies widely depending on the population being studied, the various diagnostic methods employed, and the specific definition used. There is a clear need for standardised diagnostic criteria and more robust epidemiological data. […] CSA is generally reported to range from 5-10% of individuals with sleep-related breathing disorders (SRBDs) in the general population. […] Idiopathic CSA represents 4-7% within sleep centre populations however this may underestimate the true prevalence due to limitations in current diagnostic approaches and verification biases.

• #8 Central sleep apnea: Risk factors, clinical presentation, and diagnosis – UpToDate

  https://www.uptodate.com/contents/central-sleep-apnea-risk-factors-clinical-presentation-and-diagnosis/print

  Central sleep apnea (CSA) is a disorder characterized by repetitive cessation or decrease of both airflow and ventilatory effort during sleep. CSA is less common than obstructive sleep apnea (OSA) and is often associated with other medical conditions, especially heart failure, stroke, and opioid medications. Rare cases are primary or idiopathic. […] CSA is common, although less prevalent in the general population than obstructive sleep apnea (OSA). In a population-based study that included 5804 community-dwelling adults aged 40 years and older, the overall prevalence of CSA on polysomnography was 0.9 percent. Approximately half of the CSA cases were associated with Cheyne-Stokes breathing (0.4 percent overall). The median age of patients with CSA was 69 years. CSA was more common among patients with heart failure (4.8 percent) and in males compared with females (1.8 versus 0.2 percent). […] The prevalence of symptomatic CSA (ie, CSA syndrome) appears to be higher among older adults, males, those with certain comorbid medical conditions such as heart failure, and patients who chronically use opioids.

• #9 The Prevalence of Central Sleep Apnea in a Community Based Study | remedē System

  https://remede.zoll.com/prevalence-csa-community-based-study/

  The study defined the CSA group as those whose central apnea index was greater than 5. Those with cheyne-stokes respiration were also included in the CSA group. […] Of the 5,804 participants: 0.9% had CSA. […] People with CSA were found to be older (65 years) and predominantly male (90.9%) compared to those with OSA. […] Furthermore, people who had CSA “were more likely to have a self-reported history of cardiovascular diseases or cardiovascular procedure”. […] Because prevalence of CSA and CSR is lower than that of OSA, knowledge and awareness of CSA remains somewhat limited. Thus, the chances of a misdiagnosis of CSA remains quite high.

• #10 Central Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK578199/

  Bixler et al. demonstrated that the central apnea index was higher in older adults when compared to the middle age group (12.1% vs. 1.8%). The prevalence of CSA tends to increase with age and is higher in the elderly population above 65 years of age. A cross-sectional study reported the prevalence of CSA in men aged 65 years and older as 2.7% by using a modified form of the ICSD-3 classification. […] It can be explained by relatively increased chemo responsiveness in the elderly population that prone them to develop central apnea, particularly during non-rapid eye movement (NREM) sleep. Compared with men, women are less susceptible and often require a larger magnitude of hypocapnia to develop central apnea.

• #11 Central Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK578199/

  Bixler et al. demonstrated that the central apnea index was higher in older adults when compared to the middle age group (12.1% vs. 1.8%). The prevalence of CSA tends to increase with age and is higher in the elderly population above 65 years of age. A cross-sectional study reported the prevalence of CSA in men aged 65 years and older as 2.7% by using a modified form of the ICSD-3 classification. […] It can be explained by relatively increased chemo responsiveness in the elderly population that prone them to develop central apnea, particularly during non-rapid eye movement (NREM) sleep. Compared with men, women are less susceptible and often require a larger magnitude of hypocapnia to develop central apnea.

• #12 Central Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK578199/

  Bixler et al. demonstrated that the central apnea index was higher in older adults when compared to the middle age group (12.1% vs. 1.8%). The prevalence of CSA tends to increase with age and is higher in the elderly population above 65 years of age. A cross-sectional study reported the prevalence of CSA in men aged 65 years and older as 2.7% by using a modified form of the ICSD-3 classification. […] It can be explained by relatively increased chemo responsiveness in the elderly population that prone them to develop central apnea, particularly during non-rapid eye movement (NREM) sleep. Compared with men, women are less susceptible and often require a larger magnitude of hypocapnia to develop central apnea.

• #13 Central sleep apnea: Risk factors, clinical presentation, and diagnosis – UpToDate

  https://www.uptodate.com/contents/central-sleep-apnea-risk-factors-clinical-presentation-and-diagnosis/print

  Central sleep apnea (CSA) is a disorder characterized by repetitive cessation or decrease of both airflow and ventilatory effort during sleep. CSA is less common than obstructive sleep apnea (OSA) and is often associated with other medical conditions, especially heart failure, stroke, and opioid medications. Rare cases are primary or idiopathic. […] CSA is common, although less prevalent in the general population than obstructive sleep apnea (OSA). In a population-based study that included 5804 community-dwelling adults aged 40 years and older, the overall prevalence of CSA on polysomnography was 0.9 percent. Approximately half of the CSA cases were associated with Cheyne-Stokes breathing (0.4 percent overall). The median age of patients with CSA was 69 years. CSA was more common among patients with heart failure (4.8 percent) and in males compared with females (1.8 versus 0.2 percent). […] The prevalence of symptomatic CSA (ie, CSA syndrome) appears to be higher among older adults, males, those with certain comorbid medical conditions such as heart failure, and patients who chronically use opioids.

• #14 Central Sleep Apnea – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK578199/

  Bixler et al. demonstrated that the central apnea index was higher in older adults when compared to the middle age group (12.1% vs. 1.8%). The prevalence of CSA tends to increase with age and is higher in the elderly population above 65 years of age. A cross-sectional study reported the prevalence of CSA in men aged 65 years and older as 2.7% by using a modified form of the ICSD-3 classification. […] It can be explained by relatively increased chemo responsiveness in the elderly population that prone them to develop central apnea, particularly during non-rapid eye movement (NREM) sleep. Compared with men, women are less susceptible and often require a larger magnitude of hypocapnia to develop central apnea.

• #15 Central sleep apnea: Risk factors, clinical presentation, and diagnosis – UpToDate

  https://www.uptodate.com/contents/central-sleep-apnea-risk-factors-clinical-presentation-and-diagnosis/print

  Central sleep apnea (CSA) is a disorder characterized by repetitive cessation or decrease of both airflow and ventilatory effort during sleep. CSA is less common than obstructive sleep apnea (OSA) and is often associated with other medical conditions, especially heart failure, stroke, and opioid medications. Rare cases are primary or idiopathic. […] CSA is common, although less prevalent in the general population than obstructive sleep apnea (OSA). In a population-based study that included 5804 community-dwelling adults aged 40 years and older, the overall prevalence of CSA on polysomnography was 0.9 percent. Approximately half of the CSA cases were associated with Cheyne-Stokes breathing (0.4 percent overall). The median age of patients with CSA was 69 years. CSA was more common among patients with heart failure (4.8 percent) and in males compared with females (1.8 versus 0.2 percent). […] The prevalence of symptomatic CSA (ie, CSA syndrome) appears to be higher among older adults, males, those with certain comorbid medical conditions such as heart failure, and patients who chronically use opioids.

• #16

  https://link.springer.com/article/10.1007/s11910-022-01199-2

  For patients with heart failure, criteria vary but the diagnosis of CSA is typically at least 15 events per hour with at least 50% of events being central. […] However, since effort is not directly measured (such as via diaphragm EMG or esophageal pressure), identifying central events (particularly hypopneas) can be difficult, leading to CSAs being underreported. […] Cheyne-Stokes breathing occurs in a large proportion of patients with heart failure and is a well-described phenomenon. […] It is present in 20-40% of patients with left ventricular systolic dysfunction and is a common clinical manifestation of central apnea. […] Approximately 10% of patients with obstructive sleep apnea (OSA) also clinically demonstrate CSA during CPAP titration studies, which can contribute to poor adherence with therapy.

• #17 Identification and Treatment of Central Sleep Apnoea: Beyond SERVE-HF | CFR Journal

  https://www.cfrjournal.com/articles/identification-and-treatment-central-sleep-apnoea-beyond-serve-hf?language_content_entity=en

  Central sleep apnoea (CSA) occurs in a large proportion of HF patients. CSA has clear detrimental effects, resulting in intermittent hypoxia and sympathetic activation, and is associated with significant morbidity and mortality. […] Central sleep apnoea (CSA) occurs in approximately one-third of patients with HF and is associated with a significant increase in morbidity and mortality compared to HF patients without CSA. CSA results in intermittent hypoxia and activation of the reninangiotensin system, which contributes to worsening HF. […] The prevalence of CSA in patients with HF and reduced ejection fraction (HFrEF) is well documented and has remained remarkably stable, estimated at 37-51 %, even with guideline-directed medical therapy. […] The prevalence of CSA increases with the severity of HF, but it also occurs in patients with mild symptoms.

• #18 Central Sleep Apnea (CSA) Prevalence: Evolution of recent evidence

  https://www.sefam-uk.co.uk/post/central-sleep-apnea-csa-prevalence-evolution-of-recent-evidence

  Significant variation exists: Prevalence ranges from 7% to 69% depending on the left ventricular ejection fraction (LVEF) and the clinical presentation of the CHF. […] Studies show that it is highly prevalent in patients with symptomatic left ventricular systolic dysfunction (55%) and moderate to severe HF with reduced EF (34%-69%). […] Studies with a more stable CHF population report much lower figures (7-15%). […] Studies confirm significant night-to-night variability in CSA severity and even type of apnoea (CSA vs. OSA). […] Data reported in recent published studies offer a range of prevalence figures, reflecting the heterogeneous nature of CSA and the challenges in precisely defining and measuring its occurrence across diverse patient populations. […] A recent publication by Joskin and Bruyneel 2024 report on the prevalence of CSA in the elderly which does shine a spotlight on the importance of proper diagnosis, reporting and documenting CSA in this population.

• #19 Central Sleep Apnea (CSA) Prevalence: Evolution of recent evidence

  https://www.sefam-uk.co.uk/post/central-sleep-apnea-csa-prevalence-evolution-of-recent-evidence

  Significant variation exists: Prevalence ranges from 7% to 69% depending on the left ventricular ejection fraction (LVEF) and the clinical presentation of the CHF. […] Studies show that it is highly prevalent in patients with symptomatic left ventricular systolic dysfunction (55%) and moderate to severe HF with reduced EF (34%-69%). […] Studies with a more stable CHF population report much lower figures (7-15%). […] Studies confirm significant night-to-night variability in CSA severity and even type of apnoea (CSA vs. OSA). […] Data reported in recent published studies offer a range of prevalence figures, reflecting the heterogeneous nature of CSA and the challenges in precisely defining and measuring its occurrence across diverse patient populations. […] A recent publication by Joskin and Bruyneel 2024 report on the prevalence of CSA in the elderly which does shine a spotlight on the importance of proper diagnosis, reporting and documenting CSA in this population.

• #20 Central Sleep Apnea (CSA) Prevalence: Evolution of recent evidence

  https://www.sefam-uk.co.uk/post/central-sleep-apnea-csa-prevalence-evolution-of-recent-evidence

  Significant variation exists: Prevalence ranges from 7% to 69% depending on the left ventricular ejection fraction (LVEF) and the clinical presentation of the CHF. […] Studies show that it is highly prevalent in patients with symptomatic left ventricular systolic dysfunction (55%) and moderate to severe HF with reduced EF (34%-69%). […] Studies with a more stable CHF population report much lower figures (7-15%). […] Studies confirm significant night-to-night variability in CSA severity and even type of apnoea (CSA vs. OSA). […] Data reported in recent published studies offer a range of prevalence figures, reflecting the heterogeneous nature of CSA and the challenges in precisely defining and measuring its occurrence across diverse patient populations. […] A recent publication by Joskin and Bruyneel 2024 report on the prevalence of CSA in the elderly which does shine a spotlight on the importance of proper diagnosis, reporting and documenting CSA in this population.

• #21

  https://link.springer.com/article/10.1007/s11910-022-01199-2

  Primary or idiopathic CSA occurs without any identifiable cardiac or neurological cause or medication use that could induce CSA. […] Central sleep apnea occurs in practically all people at arrival to high altitude (e.g., elevations above 2500 m). […] Opioid-induced CSA is a relatively newly recognized phenomenon and studies suggest that approximately one-third of patients on chronic opioids have some degree of CSA. […] This pattern usually occurs in patients with cardiac, renal, or neuromuscular disease, but who do not demonstrate Cheyne-Stokes breathing. […] Ultimately, although central respiratory events during sleep are seen in neurological diseases, the majority of central apnea observed clinically is from other etiologies.

• #22

  https://journals.lww.com/anesthesia-analgesia/fulltext/2015/06000/chronic_opioid_use_and_central_sleep_apnea__a.17.aspx

  Chronic opioid use has been associated with the development of sleep-disordered breathing (SDB) such as central sleep apnea (CSA). […] The overall prevalence of CSA in patients taking chronic opioids was high (24%). […] The overall prevalence of CSA in patients taking chronic opioids was 24%. […] Limited data are available on the perioperative management of patients with CSA associated with chronic opioid use.

• #23 Central Sleep Apnea Syndromes: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/304967-overview

  Predominant central apnea is uncommon and is seen in less than 10% of patients presenting for PSG. In the general population, the prevalence of central sleep apnea is less than 1%. […] CSB-CSA has been reported in 25-40% of patients with heart failure and in 10% of patients who have had a stroke. CSA related to chronic kidney disease has been reported as in up to 10% of patients. […] Although data is insufficient to establish the prevalence, CSA occurs in neurological disorders with impaired central command and/or peripheral muscle weakness including multiple-system atrophy, amyotrophic lateral sclerosis, multiple sclerosis and neuromuscular disease. […] One study has reported the prevalence rate of central sleep apnea at 30% in a population of patients in a stable methadone maintenance program.

• #24 Central Sleep Apnea: Potential Impact of Benzodiazepines, Opioids, and CYP3A4 Inhibitors

  https://www.uspharmacist.com/article/central-sleep-apnea-potential-impact-of-benzodiazepines-opioids-and-cyp3a4-inhibitors

  While CSA is most often associated with obstructive sleep apnea syndromes, it is also associated with or caused by an underlying medical condition, a recent ascent to high altitude, drugs, or substance abuse. […] The prevalence of CSA is less than 1% in the general population, Wang et al reported the prevalence rate of CSA at 30% in a population of patients in a stable methadone maintenance program. […] Vigilance regarding the use of opioids and benzodiazepines, among others, in the elderly and in the elderly and other individuals with cardiac, respiratory, or neurologic disease is necessary to protect those at greater risk of CSA.

• #25 Central sleep apnea – Wikipedia

  https://en.wikipedia.org/wiki/Central_sleep_apnea

  Central sleep apnea is less prevalent than obstructive sleep apnea. In one study, CSA is stated to have a prevalence of 0.9% in comparison to OSA. […] There are many factors that increase the risk of developing CSA. Chronic opioid use produces a mean prevalence in central sleep apnea development of 24%. An estimate of 10% of chronic kidney disease (CKD) patients have a CSA diagnosis. Cohort studies of stroke patients show a 70% development rate of CSA within 72 hours of the stroke event, although CSA was detected in less than 17% after 3 months of follow-up. Another cohort study from the Sleep Heart Healthy study showed incidence of CSA in heart failure patients to be 0.9%. […] Central sleep apnea is common in preterm, newborn, and infancy stages but a decrease in risk is found with aging and maturity of the central nervous system. Underlying neurological disorders are the most common cause of CSA in full term infants. Of the apnea related events in preterm infants born at less than 29 weeks, 25% are central in origin.

• #26 Central sleep apnea | MedLink Neurology

  https://www.medlink.com/articles/central-sleep-apnea

  Although heart failure is a risk factor for central sleep apnea and Cheyne-Stokes respiration, studies have failed to consistently show improved central sleep apnea or Cheyne-Stokes respiration with heart transplant or cardiac-assisted device. […] Prevalence and incidence of atrial fibrillation were higher in patients with central sleep apnea than in those with obstructive or no sleep apnea. […] According to a meta-analysis of 75 studies, the overall prevalence of central sleep apnea was seen in 10% (95%CI 6.5 – 14.9) of patients after stroke. […] A review of eight studies reported an aggregate point prevalence of 9.6% for central sleep apnea in chronic kidney disease. […] The most common class of medications associated with central sleep apnea is opioids. […] The reported prevalence of treatment-emergent sleep apnea ranges from 5% to 20.3%, with a higher prevalence in split-night studies compared to full-night titration.

• #27 Central sleep apnea – Wikipedia

  https://en.wikipedia.org/wiki/Central_sleep_apnea

  Central sleep apnea is less prevalent than obstructive sleep apnea. In one study, CSA is stated to have a prevalence of 0.9% in comparison to OSA. […] There are many factors that increase the risk of developing CSA. Chronic opioid use produces a mean prevalence in central sleep apnea development of 24%. An estimate of 10% of chronic kidney disease (CKD) patients have a CSA diagnosis. Cohort studies of stroke patients show a 70% development rate of CSA within 72 hours of the stroke event, although CSA was detected in less than 17% after 3 months of follow-up. Another cohort study from the Sleep Heart Healthy study showed incidence of CSA in heart failure patients to be 0.9%. […] Central sleep apnea is common in preterm, newborn, and infancy stages but a decrease in risk is found with aging and maturity of the central nervous system. Underlying neurological disorders are the most common cause of CSA in full term infants. Of the apnea related events in preterm infants born at less than 29 weeks, 25% are central in origin.

• #28 Central sleep apnea | MedLink Neurology

  https://www.medlink.com/articles/central-sleep-apnea

  Although heart failure is a risk factor for central sleep apnea and Cheyne-Stokes respiration, studies have failed to consistently show improved central sleep apnea or Cheyne-Stokes respiration with heart transplant or cardiac-assisted device. […] Prevalence and incidence of atrial fibrillation were higher in patients with central sleep apnea than in those with obstructive or no sleep apnea. […] According to a meta-analysis of 75 studies, the overall prevalence of central sleep apnea was seen in 10% (95%CI 6.5 – 14.9) of patients after stroke. […] A review of eight studies reported an aggregate point prevalence of 9.6% for central sleep apnea in chronic kidney disease. […] The most common class of medications associated with central sleep apnea is opioids. […] The reported prevalence of treatment-emergent sleep apnea ranges from 5% to 20.3%, with a higher prevalence in split-night studies compared to full-night titration.

• #29

  https://journals.lww.com/cmj/fulltext/2020/11200/treatment_emergent_central_sleep_apnea__a_unique.12.aspx

  Treatment-emergent central sleep apnea (TECSA) is a specific form of sleep-disordered breathing, characterized by the emergence or persistence of central apneas during treatment for obstructive sleep apnea. […] The prevalence of TECSA varied widely in different studies. […] The prevalence of TECSA appears to vary widely among different studies ranging from 0.56% to 20.3%. […] Most studies on the prevalence of TECSA are retrospective studies, and they often have limitations such as selection bias. […] The estimated range of the prevalence of TECSA in patients with untreated OSA was from 5% to 20%. […] The differences in the procedures used in studies on TECSA may be responsible for the differences in the recorded prevalence of TECSA, especially for split-night or full-night studies.

• #30 Complex Sleep Apnea Causes and Treatment

  https://www.verywellhealth.com/what-is-complex-or-treatmentemergent-sleep-apnea-3015311

  Complex sleep apnea may be relatively common during the initial treatment period with CPAP or even bilevel therapy. […] Complex sleep apnea is estimated to affect from 2% to 20% of people as they start using CPAP therapy and may be seen more often on the first or second night of use. […] The true incidence and degree of persistence are not well defined because the condition can resolve as treatment continues. […] Complex sleep apnea may be noted to persist on routine download of PAP compliance data. […] If more than five central apnea events are occurring per hour, despite the obstructive sleep apnea events resolving, this might prompt changes. […] Persistent complex sleep apnea associated with a high residual AHI may cause continued sleep fragmentation and oxygen desaturation (low oxygen levels in the blood). […] Complex sleep apnea will usually improve in 98% of cases as therapy continues (after about eight weeks). […] Complex sleep apnea is a condition that develops during the use of CPAP to treat obstructive sleep apnea.

• #31

  https://journals.lww.com/cmj/fulltext/2020/11200/treatment_emergent_central_sleep_apnea__a_unique.12.aspx

  Treatment-emergent central sleep apnea (TECSA) is a specific form of sleep-disordered breathing, characterized by the emergence or persistence of central apneas during treatment for obstructive sleep apnea. […] The prevalence of TECSA varied widely in different studies. […] The prevalence of TECSA appears to vary widely among different studies ranging from 0.56% to 20.3%. […] Most studies on the prevalence of TECSA are retrospective studies, and they often have limitations such as selection bias. […] The estimated range of the prevalence of TECSA in patients with untreated OSA was from 5% to 20%. […] The differences in the procedures used in studies on TECSA may be responsible for the differences in the recorded prevalence of TECSA, especially for split-night or full-night studies.

• #32

  https://link.springer.com/article/10.1007/s11325-024-02999-1

  To investigate the prevalence of treatment-emergent central sleep apnea (TECSA) in individuals with obstructive sleep apnea syndrome (OSAS) during continuous positive airway pressure (CPAP) titration and assess their polysomnographic characteristics. […] While on CPAP titration, 20 of the 116 patients developed central sleep apnea (CSA). The prevalence of TECSA in the patients with OSAS was 17.2%, being separately determined as 16.3% and 2.2% for the male and female patients, respectively. […] TECSA is a phenomenon that can occur with obstructive sleep apnea treatment and mostly regress spontaneously following appropriate CPAP treatment. TECSA is observed at different rates of prevalence. In this study, the prevalence of TECSA was higher than previously reported.

• #33 Emergent central sleep apnea during CPAP therapy-clinical implications – Mador – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/16430/html

  CPAP emergent central sleep apnea (CSA) (classified as treatment emergent CSA) is a well-recognized phenomenon that has been included in the current edition of the International Classification of Sleep Disorders. […] CPAP emergent CSAs prevalence is highly variable in the literature. In a recent systematic review and meta-analysis, nine studies were identified that addressed the prevalence of CPAP emergent CSA. Prevalence varied from 5.0% to 20.3% with an aggregate point estimate of 8.4%. […] CPAP emergent CSA usually resolves over time. However, it can also persist over time (defined as CPAP persistent CSA) and can develop later in the course of PAP treatment despite being absent during the initial diagnostic sleep study (defined as emergent CSA). […] In a recent study, a different approach to examining CPAP emergent CSA was employed.

• #34 Emergent central sleep apnea during CPAP therapy-clinical implications – Mador – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/16430/html

  They found that 3.5% of patients had CPAP emergent CSA, in 55.1% it was transient, 25.2% had persistent and 19.7% had late CPAP emergent CSA. […] Finally, the authors showed that subjects who developed CPAP emergent CSA had lower CPAP compliance during the first 90 days and were more likely to stop using CPAP.

• #35 Emergent central sleep apnea during CPAP therapy-clinical implications – Mador – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/16430/html

  CPAP emergent central sleep apnea (CSA) (classified as treatment emergent CSA) is a well-recognized phenomenon that has been included in the current edition of the International Classification of Sleep Disorders. […] CPAP emergent CSAs prevalence is highly variable in the literature. In a recent systematic review and meta-analysis, nine studies were identified that addressed the prevalence of CPAP emergent CSA. Prevalence varied from 5.0% to 20.3% with an aggregate point estimate of 8.4%. […] CPAP emergent CSA usually resolves over time. However, it can also persist over time (defined as CPAP persistent CSA) and can develop later in the course of PAP treatment despite being absent during the initial diagnostic sleep study (defined as emergent CSA). […] In a recent study, a different approach to examining CPAP emergent CSA was employed.

• #36 Evaluation of the Impact of Body Position on Primary Central Sleep Apnea Syndrome | Archivos de Bronconeumología

  https://www.archbronconeumol.org/en-evaluation-impact-body-position-on-articulo-S0300289620300818

  Overall, 39 subjects diagnosed with primary CSA were included in the study; 61.5% of the subjects had primary PCSA. […] Our results demonstrated that the rate of primary PCSA was high (61.5%) and primary PCSA was associated with milder disease severity compared with non-PCSA. […] In this study, we aimed to investigate the impact of body position on primary central sleep apnea syndrome. Our results demonstrated that primary PCSA was observed in 61.5% of patients with primary CSA. Additionally, primary PCSA was associated with milder disease severity compared with non-PCSA. […] The classification of patients with primary CSA regarding positional dependency may be helpful in terms of developing clinical approaches and treatment recommendations. Further clinical studies are required to validate this approach.

• #37 Evaluation of the Impact of Body Position on Primary Central Sleep Apnea Syndrome | Archivos de Bronconeumología

  https://www.archbronconeumol.org/en-evaluation-impact-body-position-on-articulo-S0300289620300818

  Overall, 39 subjects diagnosed with primary CSA were included in the study; 61.5% of the subjects had primary PCSA. […] Our results demonstrated that the rate of primary PCSA was high (61.5%) and primary PCSA was associated with milder disease severity compared with non-PCSA. […] In this study, we aimed to investigate the impact of body position on primary central sleep apnea syndrome. Our results demonstrated that primary PCSA was observed in 61.5% of patients with primary CSA. Additionally, primary PCSA was associated with milder disease severity compared with non-PCSA. […] The classification of patients with primary CSA regarding positional dependency may be helpful in terms of developing clinical approaches and treatment recommendations. Further clinical studies are required to validate this approach.

• #38 Central sleep apnea – Wikipedia

  https://en.wikipedia.org/wiki/Central_sleep_apnea

  Central sleep apnea is less prevalent than obstructive sleep apnea. In one study, CSA is stated to have a prevalence of 0.9% in comparison to OSA. […] There are many factors that increase the risk of developing CSA. Chronic opioid use produces a mean prevalence in central sleep apnea development of 24%. An estimate of 10% of chronic kidney disease (CKD) patients have a CSA diagnosis. Cohort studies of stroke patients show a 70% development rate of CSA within 72 hours of the stroke event, although CSA was detected in less than 17% after 3 months of follow-up. Another cohort study from the Sleep Heart Healthy study showed incidence of CSA in heart failure patients to be 0.9%. […] Central sleep apnea is common in preterm, newborn, and infancy stages but a decrease in risk is found with aging and maturity of the central nervous system. Underlying neurological disorders are the most common cause of CSA in full term infants. Of the apnea related events in preterm infants born at less than 29 weeks, 25% are central in origin.

• #39 Central sleep apnea – Wikipedia

  https://en.wikipedia.org/wiki/Central_sleep_apnea

  Central sleep apnea is less prevalent than obstructive sleep apnea. In one study, CSA is stated to have a prevalence of 0.9% in comparison to OSA. […] There are many factors that increase the risk of developing CSA. Chronic opioid use produces a mean prevalence in central sleep apnea development of 24%. An estimate of 10% of chronic kidney disease (CKD) patients have a CSA diagnosis. Cohort studies of stroke patients show a 70% development rate of CSA within 72 hours of the stroke event, although CSA was detected in less than 17% after 3 months of follow-up. Another cohort study from the Sleep Heart Healthy study showed incidence of CSA in heart failure patients to be 0.9%. […] Central sleep apnea is common in preterm, newborn, and infancy stages but a decrease in risk is found with aging and maturity of the central nervous system. Underlying neurological disorders are the most common cause of CSA in full term infants. Of the apnea related events in preterm infants born at less than 29 weeks, 25% are central in origin.

• #40 Central sleep apnea – Wikipedia

  https://en.wikipedia.org/wiki/Central_sleep_apnea

  CSA is less common after 2 years of age. The prevalence of CSA in healthy children aging 10 to 18 years is 30%. Children with underlying medical conditions fall under a prevalence rate of 4-6%. For children diagnosed with Prader-Willi syndrome (PWS), CSA is more common and can occur in up to 53% of cases. […] Research shows that rates of sleep apnea are higher in adults over the age of 65 years, due to older individuals having higher risks of developing CSA due to pre-existing medical conditions. Recorded prevalence in a cohort study of 2,911 men over the age of 65 was 7.5%. There is reduced risk of CSA in women, and a higher incidence in men. One study showed the incidence of CSA in men was 7.8% and 0.3% in women, stating a difference in hormones have an effect on the apneic threshold (AT) for apnea.

• #41 Central Sleep Apnoea in Children

  https://www.oatext.com/central-sleep-apnoea-in-children.php

  Central sleep apnoea (CSA) has been described in the adult population but there is limited information in children. So, the objective of this study was to focus epidemiology, clinical manifestations, pathophysiology, investigation and proper management of CSA in children. […] The prevalence of Central sleep apnoea (CSA) in healthy children is thought to be about 46%. […] The overall prevalence of CSA in children is about 4 to 6%. […] Whole night polysomnography is the gold standard test for diagnosis of central sleep apnoea in children. […] In healthy children CSA is rare but if happened need extensive investigation and to find out exact underlying condition, most common of which may be neuroanatomical abnormalities and remain asymptomatic long time.

• #42 Central sleep apnea – Wikipedia

  https://en.wikipedia.org/wiki/Central_sleep_apnea

  CSA is less common after 2 years of age. The prevalence of CSA in healthy children aging 10 to 18 years is 30%. Children with underlying medical conditions fall under a prevalence rate of 4-6%. For children diagnosed with Prader-Willi syndrome (PWS), CSA is more common and can occur in up to 53% of cases. […] Research shows that rates of sleep apnea are higher in adults over the age of 65 years, due to older individuals having higher risks of developing CSA due to pre-existing medical conditions. Recorded prevalence in a cohort study of 2,911 men over the age of 65 was 7.5%. There is reduced risk of CSA in women, and a higher incidence in men. One study showed the incidence of CSA in men was 7.8% and 0.3% in women, stating a difference in hormones have an effect on the apneic threshold (AT) for apnea.

• #43

  https://journals.lww.com/cmj/fulltext/2020/11200/treatment_emergent_central_sleep_apnea__a_unique.12.aspx

  Treatment-emergent central sleep apnea (TECSA) is a specific form of sleep-disordered breathing, characterized by the emergence or persistence of central apneas during treatment for obstructive sleep apnea. […] The prevalence of TECSA varied widely in different studies. […] The prevalence of TECSA appears to vary widely among different studies ranging from 0.56% to 20.3%. […] Most studies on the prevalence of TECSA are retrospective studies, and they often have limitations such as selection bias. […] The estimated range of the prevalence of TECSA in patients with untreated OSA was from 5% to 20%. […] The differences in the procedures used in studies on TECSA may be responsible for the differences in the recorded prevalence of TECSA, especially for split-night or full-night studies.

• #44

  https://journals.lww.com/cmj/fulltext/2020/11200/treatment_emergent_central_sleep_apnea__a_unique.12.aspx

  The inclusion criteria for the subjects in the TECSA prevalence studies varied, thus, the reported prevalence of TECSA varied as well, especially in studies that involved specific populations. […] The high prevalence (18%) of CSA in OSA patients with CHF and the low prevalence (0.56%) of CSA in OSA patients without evidence of heart failure indicate that CHF is a potentially important risk factor for TECSA. […] Despite so many findings from several studies, many questions regarding TECSA remain. First, the reported prevalence and natural course of TECSA vary widely in different studies. Therefore, it is necessary to carry out a large epidemiological survey with rigorous and superior scientific design.

• #45

  https://journals.lww.com/cmj/fulltext/2020/11200/treatment_emergent_central_sleep_apnea__a_unique.12.aspx

  Treatment-emergent central sleep apnea (TECSA) is a specific form of sleep-disordered breathing, characterized by the emergence or persistence of central apneas during treatment for obstructive sleep apnea. […] The prevalence of TECSA varied widely in different studies. […] The prevalence of TECSA appears to vary widely among different studies ranging from 0.56% to 20.3%. […] Most studies on the prevalence of TECSA are retrospective studies, and they often have limitations such as selection bias. […] The estimated range of the prevalence of TECSA in patients with untreated OSA was from 5% to 20%. […] The differences in the procedures used in studies on TECSA may be responsible for the differences in the recorded prevalence of TECSA, especially for split-night or full-night studies.

• #46

  https://link.springer.com/article/10.1007/s11910-022-01199-2

  The epidemiology of CSA is less well studied, but the prevalence of CSA is estimated to be 5 to 10% of patients with SDB. […] Central sleep apnea is a heterogeneous disease with multiple clinical manifestations. […] OSA is by far the more common condition; however, CSA is highly prevalent among certain patient groups. […] Complex sleep apnea (CompSA) is defined as the occurrence/emergence of CSA upon treatment of OSA. […] Central sleep apnea has a number of etiologies that also have varying underlying mechanisms, and broadly can be attributed to either inadequate ventilatory drive or a paradoxically excessive drive (elevated loop gain). […] In adults, CSA is often defined as the presence of at least 5 central events per hour, which can include central apneas or central hypopneas.

• #47 Central Sleep Apnea (CSA) Prevalence: Evolution of recent evidence

  https://www.sefam-uk.co.uk/post/central-sleep-apnea-csa-prevalence-evolution-of-recent-evidence

  Significant variation exists: Prevalence ranges from 7% to 69% depending on the left ventricular ejection fraction (LVEF) and the clinical presentation of the CHF. […] Studies show that it is highly prevalent in patients with symptomatic left ventricular systolic dysfunction (55%) and moderate to severe HF with reduced EF (34%-69%). […] Studies with a more stable CHF population report much lower figures (7-15%). […] Studies confirm significant night-to-night variability in CSA severity and even type of apnoea (CSA vs. OSA). […] Data reported in recent published studies offer a range of prevalence figures, reflecting the heterogeneous nature of CSA and the challenges in precisely defining and measuring its occurrence across diverse patient populations. […] A recent publication by Joskin and Bruyneel 2024 report on the prevalence of CSA in the elderly which does shine a spotlight on the importance of proper diagnosis, reporting and documenting CSA in this population.

• #48 Central Sleep Apnea (CSA) Prevalence: Evolution of recent evidence

  https://www.sefam-uk.co.uk/post/central-sleep-apnea-csa-prevalence-evolution-of-recent-evidence

  CSA is particularly prevalent among elderly patients with congestive heart failure (CHF), with prevalence rates varying widely (7-69%) depending on the severity and type of CHF. […] There is a pressing need for more research to better define the different phenotypes of CSA in elderly patients, to develop improved diagnostic tools, and to assess the long-term efficacy and safety of different treatment strategies across various subgroups. […] It is apparent that the scope of epidemiological research needs expansion and standardisation to yield clearer prevalence metrics.

• #49 Central sleep apnea – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/central-sleep-apnea/symptoms-causes/syc-20352109

  Heart problems put people at higher risk of central sleep apnea. […] These brain conditions can affect the brain’s ability to regulate breathing. […] Opioid medicines may increase the risk of central sleep apnea. […] Central sleep apnea is a serious medical condition. Some complications include: The repeated awakenings associated with sleep apnea make restorative sleep impossible. […] Sudden drops in blood oxygen levels that occur during central sleep apnea can affect heart health.

• #50 Central sleep apnea – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/central-sleep-apnea/symptoms-causes/syc-20352109

  Heart problems put people at higher risk of central sleep apnea. […] These brain conditions can affect the brain’s ability to regulate breathing. […] Opioid medicines may increase the risk of central sleep apnea. […] Central sleep apnea is a serious medical condition. Some complications include: The repeated awakenings associated with sleep apnea make restorative sleep impossible. […] Sudden drops in blood oxygen levels that occur during central sleep apnea can affect heart health.

• #51 The Quest for a Better PAP Titration Protocol for Central Sleep Apnea | Sleep Review

  https://sleepreviewmag.com/sleep-disorders/breathing-disorders/central-sleep-apnea/pap-titration-protocol-csa/

  The detrimental effects of CSA include recurrent hypoxemia, non-restorative sleep, excessive daytime sleepiness, fatigue, and cognitive dysfunction. […] In the sleep laboratory, it is critical the technologist be able to differentiate between obstructive and central events to appropriately choose a treatment pathway. […] Published PAP titration protocols for CSA have included use of the range of PAP therapies including CPAP, bilevel PAP (BPAP), and adaptive servoventilation (ASV) with ASV emerging as the therapy of choice. […] However, the 2015 report related to the SERVE-HF study showing an increase in mortality in patients treated with ASV therapy who had an ejection fraction of ? 45% prompted the recommendation that ASV not be used in this subset of the population. […] Our protocol is based on a split-night study. […] We continue to re-assess our CSA PAP titration protocol relative to new research, updated practice parameters, and ongoing experience in our laboratory to ensure we continue to maximize patient treatment outcomes.

• #52 Identification and Treatment of Central Sleep Apnoea: Beyond SERVE-HF | CFR Journal

  https://www.cfrjournal.com/articles/identification-and-treatment-central-sleep-apnoea-beyond-serve-hf?language_content_entity=en

  Regardless of whether the pattern is Cheyne-Stokes or non-Cheyne-Stokes, the effects of the breathing disorder result in a number of devastating effects to the cardiovascular system. Intermittent hypoxia leads to inflammation, tissue ischaemia and endothelial dysfunction. […] Each arousal results in a discrete release of norepinephrine. Norepinephrine can lead to cardiac myocyte apoptosis, cardiac arrhythmias, sodium retention and activation of the renin-angiotensin system. Long term, these effects contribute to the downward cycle of HF; therefore, it is not surprising that patients with HF and CSA have an increased risk of recurrent hospitalisation and death. […] A number of therapeutic approaches have been utilised for the treatment of CSA. […] The largest randomised controlled trial with the use of continuous PAP (CPAP; single level of air pressure delivered throughout the night) was the Canadian CPAP for Patients with CSA and HF (CANPAP) trial.

• #53 Identification and Treatment of Central Sleep Apnoea: Beyond SERVE-HF | CFR Journal

  https://www.cfrjournal.com/articles/identification-and-treatment-central-sleep-apnoea-beyond-serve-hf?language_content_entity=en

  Regardless of whether the pattern is Cheyne-Stokes or non-Cheyne-Stokes, the effects of the breathing disorder result in a number of devastating effects to the cardiovascular system. Intermittent hypoxia leads to inflammation, tissue ischaemia and endothelial dysfunction. […] Each arousal results in a discrete release of norepinephrine. Norepinephrine can lead to cardiac myocyte apoptosis, cardiac arrhythmias, sodium retention and activation of the renin-angiotensin system. Long term, these effects contribute to the downward cycle of HF; therefore, it is not surprising that patients with HF and CSA have an increased risk of recurrent hospitalisation and death. […] A number of therapeutic approaches have been utilised for the treatment of CSA. […] The largest randomised controlled trial with the use of continuous PAP (CPAP; single level of air pressure delivered throughout the night) was the Canadian CPAP for Patients with CSA and HF (CANPAP) trial.

• #54 Central Sleep Apnea in Adults: An Interdisciplinary Approach to Diagnosis and Management—A Narrative Review

  https://www.mdpi.com/2077-0383/14/7/2369

  The main objectives are to stabilize sleep and treat the causes that led to CSA. […] Diagnosis relies on polysomnography and polygraphy, with treatment requiring a multidisciplinary approach. […] Given the heterogeneity of CSA, individualized management strategies are crucial to optimizing patient outcomes and improving quality of life.

• #55 Central Sleep Apnea in Adults: An Interdisciplinary Approach to Diagnosis and Management—A Narrative Review

  https://www.mdpi.com/2077-0383/14/7/2369

  Central sleep apnea (CSA) is a heterogeneous group of sleep-related breathing disorders characterized by intermittent absence of respiratory effort during sleep. […] CSA is found in approximately 5% of all cases of sleep apnea. […] CSA is more common in the elderly than in the middle-aged, and it is quite rare compared to OSA (about 2–3% of all sleep apnea). […] Common risk factors for CSA are frequently encountered as complex forms of heart failure due to systolic deficit, significant rhythm disturbances, cerebrovascular and central nervous diseases in general, and in case of opioid use. […] The treatment of CSA should be managed by a multidisciplinary team—pulmonologist, cardiologist, physiotherapist, and specialist of internal medicine (to treat underlying cause of CSA) when secondary causes of CSA might be present and treatment and recommendations from a sleep specialist could overlook the presence of significant comorbidities.

• #56 Central Sleep Apnea – Pulmonary Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/pulmonary-disorders/sleep-apnea/central-sleep-apnea

  Central sleep apnea (CSA) is much less common than obstructive sleep apnea but is not rare. CSA is present in about 0.9% of people in the community (1). CSA is more common in older adults, males, and patients with cardiovascular disease such as heart failure. CSA also may occur in children (2). […] Diagnosis of CSA is based on careful review of medical history, medication review, and clinical findings, and, when necessary, is confirmed by sleep testing at home with portable equipment or in a sleep laboratory using polysomnography (1, 2). […] Primary treatment of symptomatic central sleep apnea is often optimal management of underlying disorders (eg, heart failure) and avoidance or reduction of opioids, alcohol, and other sedatives (1).

• #57 Central Sleep Apnea (CSA) Prevalence: Evolution of recent evidence

  https://www.sefam-uk.co.uk/post/central-sleep-apnea-csa-prevalence-evolution-of-recent-evidence

  CSA is particularly prevalent among elderly patients with congestive heart failure (CHF), with prevalence rates varying widely (7-69%) depending on the severity and type of CHF. […] There is a pressing need for more research to better define the different phenotypes of CSA in elderly patients, to develop improved diagnostic tools, and to assess the long-term efficacy and safety of different treatment strategies across various subgroups. […] It is apparent that the scope of epidemiological research needs expansion and standardisation to yield clearer prevalence metrics.

• #58 The Prevalence of Central Sleep Apnea in a Community Based Study | remedē System

  https://remede.zoll.com/prevalence-csa-community-based-study/

  The study defined the CSA group as those whose central apnea index was greater than 5. Those with cheyne-stokes respiration were also included in the CSA group. […] Of the 5,804 participants: 0.9% had CSA. […] People with CSA were found to be older (65 years) and predominantly male (90.9%) compared to those with OSA. […] Furthermore, people who had CSA “were more likely to have a self-reported history of cardiovascular diseases or cardiovascular procedure”. […] Because prevalence of CSA and CSR is lower than that of OSA, knowledge and awareness of CSA remains somewhat limited. Thus, the chances of a misdiagnosis of CSA remains quite high.

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