FIG. 17:  We do not know the clinical significance of Op-CSA and ataxic breathing or whether the hypoxemia or the arterial gas fluctuations during sleep are detrimental.  We do not even know if these changes are prognostic in any way.  So it is often difficult to know who, how, and when to treat, if at all.  There are insufficient data on long-term outcomes, but it is not unreasonable to suppose that there might be some protective effects of Op-CSA, especially in light of the results of the SERVE-HF study, which showed increased mortality with servoventilation therapy of CSR in patients with congestive heart failure (CHF).^[12]  Opioid-induced CSA may be countering potential adverse effects of chronic opioid treatment on sleep, metabolism, and PCO₂ or PO₂ processing.