PT  - JOURNAL ARTICLE
AU  - Margarida Aguiar
AU  - Susana Moreira
AU  - Richard Staats
AU  - Fatima Caeiro
AU  - João Valença
AU  - Antόnio Bugalho de Almeida
TI  - How we treat central apneas?
DP  - 2011 Sep 01
TA  - European Respiratory Journal
PG  - p2214
VI  - 38
IP  - Suppl 55
4099  - http://erj.ersjournals.com/content/38/Suppl_55/p2214.short
4100  - http://erj.ersjournals.com/content/38/Suppl_55/p2214.full
SO  - Eur Respir J2011 Sep 01; 38
AB  - In a time when sleep studies are progressively done out of sleep laboratories and the positive pressure devices have many automatic features that allow easy home titration, our sleep clinic thought it would be important to review the cases of central sleep apnea and their titration in the sleep laboratory.Between 2009 and 2010 patients with central sleep apnea were selected and prospectively followed in our sleep clinic. Demographics, anatomic features, clinical symptoms, initial and therapeutic standard polissonography, associated pathologies and eventual improvements were described.A total of eleven patients were selected, one female, mean age 64,5±13,3, mean body mass index 30,3± 3,9 kg/m2, all snorers, nine referring hypertension, four with heart failure and five with a disease of the central nervous system. All but one referred daytime sleepiness and scored more than 10 in the Epworth scale. The polissonographies showed a mean apnea/hyponea index (AHI) of 44,1±14,7/H and a mean central apnea index of 21,3±8,9 representing 75±21,3% of all apneas.All patients initiated treatment in our sleep laboratory, at first with continuous positive airway pressure (CPAP) at a fixed pressure but seven patients had the need for bilevel positive airway pressure (BiPAP) Auto SV. In five patients most respiratory events were corrected allowing a normal AHI and there was a significant improvement in the remaining (mean therapeutic AHI-14,3). All patients improved their daytime sleepiness, maximum ESE of 6.In conclusion effective treatment is possible with CPAP allowing reduction of costs but this is only possible if the therapy is titrated and started in a sleep laboratory.