Recently, in a study by Montesi et al3 regarding 310 patients with OSA who underwent either split-night or full-night CPAP titration, air leak during CPAP titration was associated with the development of acute CSA, particularly in subjects using a nasal mask. The authors postulated that air leak washing out anatomic dead space is a contributing factor in the development of CompSAS. The group with central apnea index < 5 had a median average leak of 45.5 L/min (interquartile range, 20.8 L/min) vs 51.0 L/min (interquartile range, 21.0 L/min) with central apnea index ≥ 5 (P = .056). These findings might have mechanistic and therapeutic implications as the physicians involved in the management of CompSAS should be aware of this potential iatrogenic and avoidable cause of the emergence of CSA during CPAP titration. The finding of a reemergence of apneas on increasing CPAP should alert the astute physician to conduct a diligent search for air leak in the appropriate clinical setting.