Continuous positive airway pressure (CPAP)
A CPAP machine consists of a small air pump that blows air through a mask which is worn over your nose or nose and mouth. The mask directs this pressurised air through your airways. This helps to stabilise the amount of oxygen and carbon dioxide in your body, reducing the number of central apnoeas. You can read more about CPAP in our CPAP guide.
Bilevel positive airway pressure (BiPAP)
A BiPAP machine uses air pressure to help you breathe. BiPAP delivers high air pressure when you breathe in and low air pressure when you breathe out, assisting your natural breathing patterns. It can also force you to breathe when you fail to inflate your chest during central apnoeas.
BiPAP machines can be set to different modes. Two of the more popular are:
- BiPAP (spontaneous/timed) – used to treat Central Sleep Apnoea
- BiPAP (Volume Assured Pressure Support) – used to treat shallow breathing and Central Sleep Apnoea.
Oxygen therapy
Some people may require oxygen therapy in addition to CPAP or BiPAP. The oxygen is usually supplied by a concentrator or gas cylinder which is installed in your home. You can connect oxygen tubing from the concentrator to your CPAP or BiPAP machine.
This allows extra oxygen to enrich the air delivered to your lungs by your machine and makes sure the level of oxygen in your body remains high. In some cases, this helps to treat Central Sleep Apnoea.
Oxygen therapy without CPAP or BiPAP has also been used to treat certain types of Central Sleep Apnoea. The decision to treat Central Sleep Apnoea with oxygen alone should only be made after significant discussion between specialist physicians.
Adaptive servo-ventilation (ASV)
An ASV machine uses air pressure to treat abnormal breathing patterns and Central Sleep Apnoea. It can help treat Cheyne-Stokes respiration and abnormal breathing patterns experienced by long-term opioid users.
An ASV machine alters its air pressure, breath by breath, to match your breathing patterns and compensate for any instability.
- If your breathing gradually deepens, the ASV machine decreases the pressure it delivers to your airways.
- If your breathing is becoming shallower, the ASV machine increases the pressure it delivers.
This helps to even out your breathing pattern.
It can also force you to breathe when you fail to inflate your chest, making it suitable for treating central apnoeas. ASV can be highly effective and more comfortable than BiPAP in treating abnormal breathing patterns. However, it may not always be suitable if you have advanced heart failure.
Medication
There are four main medications used to help treat Central Sleep Apnoea:
- Acetazolamide
- Zolpidem
- Triazolam
- Theophylline
They are mainly used to treat certain types of Central Sleep Apnoea in combination with CPAP or BiPAP but can also be used to treat some cases of Idiopathic Central Sleep Apnoea on their own.
