Central sleep apnea (CSA) is a sleep disorder characterized by repeated interruptions in breathing during sleep due to a failure of the brain to send appropriate signals to the muscles responsible for breathing. Unlike obstructive sleep apnea, which is caused by a physical blockage of the airway, CSA arises from neurological issues. In some cases, individuals may experience both types simultaneously, a condition referred to as mixed sleep apnea.
What Causes Central Sleep Apnea?
Central sleep apnea typically results from serious medical conditions affecting the lower brainstem, which plays a crucial role in regulating breathing. In infants, CSA can lead to breathing pauses lasting up to 20 seconds.
Symptoms of Central Sleep Apnea
The primary symptom of CSA is the cessation of breathing during sleep, which is usually not associated with snoring—a common symptom of obstructive sleep apnea. Other symptoms may include:
- Excessive daytime fatigue
- Frequent nighttime awakenings
- Morning headaches
- Difficulty concentrating
- Memory and mood disturbances
- Shortness of breath upon waking
Types of Central Sleep Apnea
Central sleep apnea can manifest in several forms, each linked to distinct causes:
- Cheyne-Stokes breathing: Characterized by cycles of rapid breathing followed by periods of apnea, often seen in individuals with heart failure or stroke.
- Narcotic-induced central sleep apnea: Opioid medications like morphine and oxycodone can disrupt normal breathing patterns.
- High-altitude periodic breathing: This occurs at elevations above 2,500 meters (8,000 feet).
- Treatment-emergent apnea: Some individuals receiving positive airway pressure treatment for obstructive sleep apnea may develop CSA.
- Medical condition-induced apnea: Conditions like heart failure, Parkinson’s disease, or severe kidney issues can trigger CSA.
- Idiopathic central sleep apnea: This form occurs without a clear underlying cause.
Congenital central hypoventilation syndrome (CCHS), often linked to genetic factors, affects approximately 1 in 200,000 children worldwide.
Risk Factors for Central Sleep Apnea
While anyone can develop sleep apnea, CSA is more prevalent in older adults, particularly those over 65, due to various health conditions and sleep patterns. Men are also at a higher risk. Contributing health issues may include:
- Congestive heart failure
- Hypothyroidism
- Kidney failure
- Neurological diseases (e.g., Parkinson’s disease, Alzheimer’s disease, ALS)
- Brainstem damage from injury, stroke, or infections
Diagnosing Central Sleep Apnea
Often, a partner or family member will first notice the breathing interruptions during sleep. Diagnosis typically involves:
- A comprehensive physical examination and medical history review.
- A sleep study, known as polysomnography, conducted overnight in a specialized lab to monitor various physiological parameters, including brain activity, heart rate, oxygen levels, and breathing patterns.
While home sleep studies can diagnose obstructive sleep apnea, they may not be as effective for CSA.
Treatment Options for Central Sleep Apnea
Treatment is tailored to the underlying cause and may involve medications for heart failure or discontinuing opioid medications. General recommendations include:
- Maintaining a healthy weight
- Avoiding alcohol and sedatives that may relax the airway
- Sleeping on one’s side rather than on the back
- Using nasal sprays or strips to alleviate congestion
Continuous positive airway pressure (CPAP) therapy is effective for many individuals with CSA, especially those with heart failure. CPAP machines deliver a steady stream of air through a mask to keep airways open. Alternative devices, such as adaptive servo-ventilation (ASV) and bilevel positive airway pressure (BPAP), can also be beneficial. Additionally, the Remede System, a small implantable device, can assist in regulating breathing patterns during sleep.
Medications like acetazolamide and theophylline may also stimulate breathing.
Complications Associated with Central Sleep Apnea
Untreated sleep apnea can lead to severe health issues, including an increased risk of:
- Stroke
- Obesity
- Diabetes
- Heart attack or heart failure
- Irregular heartbeat
- High blood pressure
Furthermore, sleep apnea can elevate the risk of workplace or vehicular accidents due to fatigue.
For more insights on sleep apnea, you might find it helpful to explore our other blog post on inter-scorer reliability, which complements this topic. Additionally, for authoritative information on sleep apnea, you can refer to resources from reputable health organizations.
To Summarize:
Central sleep apnea is a significant sleep disorder with various causes and symptoms. Understanding the risk factors, diagnosis methods, and treatment options is crucial for effective management. If you suspect you or a loved one may be experiencing symptoms of CSA, consulting a healthcare professional is essential for proper guidance and intervention. For those seeking immediate solutions, consider exploring this anti-snoring mouthpiece, which has proven effective for many users.