Central Sleep Apnea: What It Is, Causes, Symptoms and Treatment

Though the precise prevalence of central sleep apnea is not known, it is a type of sleep apnea that happens when the brain temporarily ceases to send breathing signals to the muscles responsible for breathing. This results in recurrent stoppages in breathing during sleep.

What causes central sleep apnea? 

This type of sleep apnea mostly happens to people who have certain medical conditions. It is also a fact that a form of central sleep apnea is present in people with congestive heart failure. Medical conditions that can cause or lead to the condition are:

–          Any life-threatening problem affecting the brainstem, which controls breathing.

–          Arthritis and degenerative changes in the cervical spine

–          Bulbar poliomyelitis

–          Complications after cervical spine surgery

–          Encephalitis or stroke  affecting the brainstem

–          Parkinson’s disease and similar other neurodegenerative conditions

–          Obesity

–          Radiation of the cervical spine

–          Primary hypoventilation syndrome

–          Certain medications including narcotic-containing painkillers; opioids like morphine, oxycodone or codeine

–          Cheyne-Stokes breathing (associated with congestive heart failure)

–          High-altitude (more than 15,000 feet) periodic breathing

What are the symptoms of central sleep apnea? 

Symptoms vary according to the causes of onset and which part of the nervous system is affected by the condition.

–          Fatigue

–          Excessive daytime sleepiness

–          Headaches in the morning

–          Restlessness during sleep

–          Swallowing problems

–          Chance of voice

–          Numbness throughout the body.

How is the condition diagnosed? 

When diagnosing central sleep apnea, the treating doctor usually makes an evaluation based on the symptoms. The patient could also be referred to a sleep clinic for thorough evaluation of the condition with the help of polysomnography, an overnight sleep study during which several biological and physiological parameters are tested that reveal the type of illness as well as severity. This test can be done either at home or at an accredited sleep center.

Help from cardiologist (heart specialist) and a neurologist (specializes in nervous system) can also be sought to locate the cause behind the condition.

Other tests during diagnosis may include:

–          Echocardiogram

–          Lung function studies

–          MRI of the spine or neck

How is central sleep apnea treated? 

The primary aim is to treat the underlying medical condition that is causing this type of sleep apnea. For example, treating heart failure could provide relief to the condition. Other treatment options include:

–          Decreasing opioid medications if this is the cause.

–          CPAP or Continuous positive airway pressure. This therapy provides artificial ventilation for allowing the patient to experience obstruction-free breathing during sleep.

–          Bilevel positive airway pressure or BPAP. This is different from CPAP which supplies pressurized air on a continuous basis. BPAP provides higher pressure during inhalation and lower pressure during exhalation. The aim is to boost the weak breathing pattern.

–          Adaptive servo-ventilation (ASV). Considered to be better than CPAP and BPAP, this device monitors normal breathing and stores information in a computer that is part of the equipment. During sleep, it regulates air pressure to ensure pause-free breathing.

–          Supplemental oxygen

–          Drugs include acetazolamide to prevent high altitude sleep apnea.

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