nosed with central sleep apnea.

Data on medical history, hypertension, diabetes, body mass index, polysomnography, and treatment were reviewed. They excluded all patients with a clinical history of congestive heart failure or a left ventricular ejection fraction at 40% or less, leaving at total of 219 patients for analysis.

The researchers proposed that patients have obstructive apnea if they had five or more combined episodes of obstructive apnea and hypoapneas per hour, or if the patients complained of sleepiness and had 10 or more respiratory-related arousals per hour, which is consistent with the presence of the upper airway resistance syndrome. Patients who have the central apnea index was higher than five events per hour, and at least 50% of the total apnea-hypoapnea index was central in origin and without obstructive components was said to have central sleep apnea. Failure of continuous positive airway pressure to resolve apparent obstructive sleep apnea, complex sleep apnea syndrome may result according to researchers Timothy Morgenthaler, M.D., of the Mayo Clinic, and colleagues, reported in the Sept. 1 issue of Sleep reports that complex sleep apnea syndrome may cause a patient to lose sleep from a combination of physical and neurologic causes.

According to the researchers t poor sleepers with symptoms consistent with both the obstructive and central forms of sleep apnea constitute a poorly recognized class of patients requiring novel therapies.

A consensus panel of sleep experts from the Europe, United States, Asia and Australia recently recommended classification of sleep-related breathing disorders into three clinical entities which are obstructive sleep apnea or hypoapnea syndrome marked by physical causes of airway disruption, central apnea-hypoapnea syndrome, and the Cheyne-Stokes breathing syndrome are related to abnormalities in central nervous control of respiration. However Mayo investigators have
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