%0 Journal Article %A M Berger %A G Solehac %A C Horvath %A R Heinzer %A A Brill %T Treatment-emergent central sleep apnea associated with non-positive airway pressure therapies: a systematic review %D 2021 %R 10.1183/23120541.sleepandbreathing-2021.11 %J ERJ Open Research %P 11 %V 7 %N suppl 7 %X Background: Obstructive sleep apnea patients are increasingly managed with alternative treatment modalities to continuous positive airway pressure (CPAP). While treatment-emergent central sleep apnea (TECSA) occurring with CPAP is well-known, the prevalence of the phenomenon with non-CPAP treatment modalities remains largely unknown.Objectives: To evaluate the frequency, pathophysiology and clinical management of patients with obstructive sleep apnea who develop TECSA with non-CPAP treatment modalities.Methods: Systematic review of the databases of PubMed, Embase, Web of science, and the Cochrane Library up to the end of June 2020 for studies or reports on TECSA occurring with alternative treatment modalities.Results: Out of 729 identified studies, 18 studies were included in the analysis (n=284 patients). TECSA was described with the use of mandibular advancement devices, hypoglossal nerve stimulation, a tongue stabilizing device and nasal expiratory PAP device, and after three different types of surgical upper-airway treatments. The prevalence of TECSA in maxillomandibular advancement surgery was 1.8% and 3.3% with hypoglossal nerve stimulation. Some authors observed a spontaneous resolution as seen with CPAP while others reported persistence of TECSA over time. The clinical management usually necessitated an individualized approach.Conclusions: TECSA with non-PAP treatments seems to be rare, but potentially underreported. A systematic reassessment of the treatment efficacy in an appropriate timeframe with follow-up sleep studies should help to identify TECSA with non-PAP treatments.FootnotesCite this article as ERJ Open Research 2021; 7: Suppl. 7, 11.This is an ERS Lung Science Conference abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only). %U