types of “sleep-related breath ing disorders,” including primary central sleep apnea, ob-
structive sleep apnea, and sle ep-related hypoventilation.
Central Sleep Apnea
Diagnostic Criteria
A. Evidence by polysomnography of five or more central apneas per hour of sleep.
B. The disorder is not better explained by another current sleep disorder.
Specify whether:
327.21 (G47.31) Idiopathic central sleep apnea:  Characterized by repeated epi-
sodes of apneas and hypopneas during sleep caused by variability in respiratory effort
but without evidence of airway obstruction.
786.04 (R06.3) Cheyne-Stokes breathing: A pattern of periodic crescendo-
decrescendo variation in tidal volume that results in central apneas and hypopneas at
a frequency of at least five events per hour, accompanied by frequent arousal.
780.57 (G47.37) Central sleep apnea comorbid with opioid use:  The pathogenesis
of this subtype is attributed to the effects of opioids on the respiratory rhythm genera-
tors in the medulla as well as the differential effects on hypoxic versus hypercapnic re-
spiratory drive.
Coding note  (for 780.57 [G47.37] code only): When an op ioid use disorder is present, first
code the opioid use disorder: 305.50 (F11.10) m ild opioid use disorder or 304.00 (F11.20)
moderate or severe opioid use disorder; then code 780.57 (G47.37) central sleep apnea
comorbid with opioid use. When an opioid use disorder is not present (e.g., after a one-