Central sleep apnea is a sleep disorder in which your brain’s signaling to your body that controls your breathing is disrupted.
Central sleep apnea is a sleep disorder in which you briefly stop breathing during sleep. Moments of apnea can occur repeatedly throughout the night as you sleep. The interruption of your breathing may indicate a problem with your brain’s signaling.
It’s less common than obstructive sleep apnea, which occurs due to physical blockages of the airways.
People who have central sleep apnea don’t have blockages in their airways. The problem is in the connection between the brain and the muscles that control your breathing.
Underlying health conditions cause most cases of central sleep apnea. During a central sleep apnea episode, your brainstem doesn’t tell your breathing muscles to function properly. Your brainstem is the section of your brain that connects to your spinal cord.
Medical conditions that affect your brainstem, spinal cord, or heart can cause you to develop central sleep apnea. These
- stroke
- heart attack
- congestive heart failure
- a weak breathing pattern called Cheyne-Stokes breathing
- encephalitis (inflammation of the brain)
- arthritis in the cervical spine
- Parkinson’s disease (an age-related deterioration of certain nerve systems that affects movement, balance, and muscle control)
- surgery or radiation treatments in the spine
- certain medications, including opioids
Other risk factors for central sleep apnea
- premature birth
- smoking cigarettes
- drinking too much alccohol
- older age
- family history of CSA
If your doctor can’t identify the cause of your central sleep apnea, you will receive a diagnosis of idiopathic central sleep apnea
Even though they have different causes, central and obstructive sleep apnea share
The most common symptom of any type of sleep apnea is short periods during sleep when breathing stops. Some people exhibit very shallow breathing instead of actually stopping breathing. You may wake up feeling short of breath. The lack of oxygen can cause you to wake up frequently throughout the night, and can lead to insomnia.
Other symptoms associated with central sleep apnea occur during the day as a result of an interrupted night’s sleep. You may feel very sleepy during the day, have trouble concentrating or focusing on tasks, or have a headache when you wake up.
Central sleep apnea caused by Parkinson’s disease or other neurological conditions can be characterized by additional symptoms, including:
- difficulty swallowing
- changes in speech patterns
- changes in voice
- generalized weakness
A doctor will first ask about your symptoms and perform a physical exam to see if you have any signs of nasal passage blockage. If they suspect you may have a sleep disorder, they will order a sleep study test called a polysomnography to determine the specific cause. The test occurs overnight as you sleep in a sleep center or medial facility. During a polysomnography, you’ll wear electrodes on your head and body to measure your:
- oxygen levels
- brain activity
- breathing pattern
- heart rate
- lung function
A sleep study can sometimes be done at home.
The results can help determine the underlying cause of your apnea.
A head or spinal MRI scan may also help doctors diagnose CSA. MRI uses radio waves to generate images of your organs. The test may reveal that structural abnormalities in your brainstem or spine are causing central sleep apnea.
Managing underlying medical conditions is the first line of treatment for central sleep apnea. Medications can help control congestive heart failure, Parkinson’s disease, and other heart or nervous system conditions.
You may need to stop using medications if these drugs are causing your breathing to stop during sleep. Your doctor may also prescribe medications such as the diuretic acetazolamide (Diamox) to stimulate your breathing mechanism.
Oxygen supplementation and the regulation of air pressure during sleep are effective treatments for many people with central sleep apnea.
Positive air pressure (PAP) devices
Continuous positive air pressure (CPAP) machines provide a steady source of pressure in your airways as you sleep. You wear a mask over your nose and sometimes your mouth that delivers pressurized air throughout the night.
Bi-level positive air pressure (BPAP) machines adjust the air pressure to a higher level when you inhale and a lower level when you exhale. BPAP also uses a face mask.
Auto-adjustable positive air pressure (APAP) devices increase or decrease the level of positive airway pressure in response to a change in airflow.
Adaptive servo-ventilation (ASV)
ASV monitors your breathing as you sleep. The computerized system “remembers” your breathing pattern. A pressurized system regulates the breathing pattern to prevent apnea episodes. It’s more specialized than a PAP machine.
People with idiopathic central sleep apnea most often respond well to treatment. The overall benefits of treatment for central sleep apnea vary according to the exact cause of the condition.
If you receive a central sleep apnea diagnosis, it’s important to follow your treatment plan and to see your doctor for regular checkups to see how well treatment is working. Regular tests can also help detect complications.