Rapid-eye-movement sleep-predominant central sleep apnea relieved by positive airway pressure: a case report

Noah P. Jouett, Michael L. Smith, Donald E. Watenpaugh, Maryam Siddiqui, Maleeha Ahmad, Farrukh Siddiqui

Research output: Contribution to journalArticle


Central Sleep Apnea (CSA) is characterized by intermittent apneas and hypopneas during sleep that result from absent central respiratory drive. CSA occurs almost exclusively during non-rapid-eye-movement (NREM) sleep due to enhanced neuronal ventilatory drive during REM sleep that makes central apneas highly unlikely to form. A 45-year-old obese African American female presented with co-existing Obstructive Sleep Apnea (OSA) and CSA, not in the form of mixed or complex sleep apnea. Peculiarly, her CSA occurred only during rapid-eye-movement (REM) sleep, which is exceedingly rare. The patient's CSA was resolved when appropriate positive airway pressure (PAP) was prescribed. Our patient remains stable and has reported significant benefit from PAP usage. We offer possible neuro-physiological mechanisms herein, including enhanced loop gain and/or malfunction or malformation of the pre-Botzinger nucleus or other neurological process, that could explain the unique findings of this case.

Original languageEnglish
Article numbere13254
JournalPhysiological Reports
Issue number9
Publication statusPublished - May 2017



  • Carbon dioxide
  • chemoreceptor
  • chemoreflex
  • oxygen
  • sleep apnea

Cite this