Central sleep apnoea

Central sleep apnoea and Cheyne-Stokes respiration are common forms of sleep-disordered breathing, particularly in patients with co-morbidities such as cardiac and renal disease which, however, often do not require specific treatment. Physicians may encounter such patients in their outpatient clinics or as ward referrals in hospital. A typical case is presented to aid the approach to such patients, including how to make an accurate diagnosis, which of the various treatment modalities to use, and what to do if a treatment fails. The evidence for the different interventions is explored, including oxygen, modes of non-invasive positive airway pressure, and drug treatments, with particular attention to groundbreaking studies.