Which therapy is often recommended for patients with central sleep apnea who do not respond to CPAP?

In patients with central sleep apnea, particularly those who do not respond to continuous positive airway pressure (CPAP) therapy, adaptive servo-ventilation (ASV) is often recommended as an alternative treatment. ASV is a sophisticated form of positive pressure ventilation that adapts to the patient’s breathing patterns in real-time. It provides varying levels of pressure support based on the detected respiratory effort, which can help to stabilize breathing patterns in individuals with central sleep apnea.

This therapy is particularly beneficial because it addresses the specific needs of patients with central sleep apnea, where there is a lack of respiratory effort during sleep instead of an obstruction in the airway. ASV can help in reducing episodes of apnea and improve overall sleep quality and oxygenation, making it a targeted therapy option for those who have not achieved adequate results with CPAP alone.

While other options may have their uses in managing sleep apnea, they are either more generalized (like supplemental oxygen therapy) or not specifically designed to respond dynamically to the patient's breathing patterns (like automated positive pressure ventilation).