Complex Sleep Apnoea
Understanding Complex Sleep Apnoea
Complex sleep apnoea, also known as treatment-emergent central sleep apnoea (TECSA), is a sleep disorder that combines features of both obstructive sleep apnoea (OSA) and central sleep apnoea (CSA). It is essential to recognise and understand this condition to provide adequate treatment and improve sleep quality.
Symptoms
Symptoms of complex sleep apnoea are similar to those of obstructive and central sleep apnoea and may include:
-
Loud snoring
-
Episodes of breathing cessation during sleep observed by another person
-
Abrupt awakenings with shortness of breath
-
Difficulty staying asleep (insomnia)
-
Excessive daytime sleepiness (hypersomnia)
-
Attention problems
-
Irritability or mood changes
What is complex Sleep Apnoea
Complex sleep apnoea occurs when a person who has been diagnosed with OSA develops CSA during treatment with CPAP therapy. In OSA the airway becomes partially or completely blocked during sleep, causing interrupted breathing. CSA, however, involves a failure of the brain's respiratory control centres to send the appropriate signals to the muscles that control breathing. the prevalence of complex sleep apnoea is estimated to be from 10- 20% 1-2.
Causes
Diagnosis of complex sleep apnoea typically involves:
-
An overnight sleep study (polysomnography) to monitor breathing patterns.
-
Assessment of medical history and symptoms by a Sleep Medicine Clinician.
-
Evaluation of any existing treatment, particularly use of PAP therapy.
Complex sleep apnoea is a nuanced condition that requires comprehensive management tailored to each individual’s needs. If you suspect complex sleep apnoea, it is essential to consult a healthcare professional for evaluation and to discuss the most appropriate treatment options.
By understanding complex sleep apnoea and its implications, patients and healthcare providers can work together to improve sleep quality and overall health. Keep in mind that ongoing research continues to enhance our understanding of this condition and its effective management strategies.
References
1. Randerath W, Baillieul S, Tamisier R. Central sleep apnoea: not just one phenotype. European Respiratory Review. 2024 Jan 31;33(171).
2. Pépin JL, Schwartz AR, Khayat R, Germany R, McKane S, Warde M, Ngo V, Baillieul S, Bailly S, Tamisier R. Multidimensional phenotyping to distinguish among central (CSA), obstructive (OSA) and co-existing central and obstructive sleep apnea (CSA-OSA) phenotypes in real-world data. Sleep Medicine. 2024 Dec 1;124:426-33.
