Central Sleep Apnea due to Positive Airway Pressure Mask Leakage

Complex sleep apnea is the term used for central sleep apnea (CSA) events that arise during positive airway pressure (PAP) titration in a patient undergoing polysomnography (PSG).Multiple mechanisms have been used to explain the same including hypocapnia, loss of central drive, circulatory delay, or arousals.However, PAP mask leakage is an easily correctable cause of CSA during titration studies.We hereby present a case of a middle-aged female who was diagnosed with severe obstructive sleep apnea (OSA), and developed central events during titration, which were easily corrected by readjusting the oronasal mask.