OVERVIEW

Sleep-disordered breathing is characterized by the presence of both obstructive and central events. Common pathophysiologic mechanisms may produce mixed or blended sleep breathing disorders. Yet, ‘pure’ forms of both may dominate the clinical picture. Patients who predominantly present with central sleep apnoea (CSA) are often difficult to treat. The efficacy of conventional treatments such as medications, oxygen administration and positive airway pressure (PAP) therapy may be unsatisfactory. In recent years, phrenic stimulation has been introduced as a safe and viable treatment alternative for selected CSA patients. In the current webinar, expert opinion will be presented on the rationale of CSA treatment and on the do’s and don’ts of the different treatment options. 

This webinar will be moderated by ESRS Vice President (Clinical) Prof. Dr. Dirk Pevernagie. He will be joined by several panellists who will address the following topics:

• Pathophysiology and clinical relevance of CSA – Prof. Dr. Johan Verbraecken: Central sleep apnoea (CSA) is considered more and more to be an increased loop gain disorder, but at the same time the central type of apnoea can also be considered as an obstructive event, because it causes pharyngeal narrowing, associated with prolonged expiration and passive collapse. Current pathophysiological insights will be discussed. Its relevance is associated with cardiovascular and metabolic comorbidities, the increasing opioid use, the coincidence with highly prevalent diseases (COPD and obesity) and the explosion of CPAP prescription for obstructive sleep apnoea (treatment-emergent CSA). It is under debate whether CSA or its treatment is of any prognostic significance and has to be discussed with respect to the underlying phenotype.
• Conventional treatment modalities of CSA – Dr. Jerryll Asin: It is important to look carefully at a possible cause of CSA. Before starting therapy, the underlying cause if demonstrable must be treated. The focus will be on CSA in comorbid heart disease and treatment induced CSA. The treatment modalities will be discussed according to stepped care.
• Phrenic nerve stimulation: a game changer? – Dr. Robin Germany: Phrenic nerve stimulation is an implantable solution for the treatment of central sleep apnea. Studies have looked at the effects on safety, AHI, daytime sleepiness and quality of life. Patient selection is a key factor in identifying appropriate patients for this therapy.

For more information please visit the official event page.