Buspirone is an anti-anxiety medication that has shown promise as an off-label treatment for central sleep apnea (CSA). It works by modulating serotonin receptors, which may help stabilize respiratory drive and reduce the frequency of central apneas. Small clinical studies have suggested that buspirone can lower the central apnea index, particularly in patients with heart failure or treatment-emergent CSA. It is generally well-tolerated and has a favorable safety profile compared to other pharmacologic options like theophylline. While not a first-line therapy, buspirone may be considered as an adjunct in select patients when standard treatments are ineffective or poorly tolerated.