Which mode of ventilation is recommended for a patient with central sleep apnea?

• A. VC-CMV
• B. CPAP
• C. Bi-level PAP
• D. SIMV

Answer: (C)

The recommended mode of ventilation for a patient with central sleep apnea is Bi-level Positive Airway Pressure (Bi-level PAP). This mode effectively addresses the unique needs of patients with central sleep apnea by providing varying levels of pressure during inhalation and exhalation, assisting with the initiation of breaths while allowing for respiratory effort when it occurs.

Central sleep apnea is characterized by a lack of respiratory effort during sleep due to a failure of the brain to send appropriate signals to the muscles that control breathing. Bi-level PAP offers a tailored approach where the higher pressure during inhalation (IPAP) helps to facilitate breathing, while the lower pressure during exhalation (EPAP) helps to maintain airway patency and prevent collapse. This dual pressure support can significantly alleviate the apnea events and improve overall oxygenation and ventilation during sleep.

In contrast, Continuous Positive Airway Pressure (CPAP) provides a constant level of pressure which may be beneficial for obstructive sleep apnea but is less effective for central sleep apnea because it does not assist with the initiation of breaths. Modes such as VC-CMV (Volume-Constant Continuous Mandatory Ventilation) and SIMV (Synchronized Intermittent Mandatory Ventilation) are primarily designed for patients who have the potential for respiratory drive and