What Is Central Sleep Apnea & How Is it Treated?
For many people, the fact that there are different types of sleep apnea is news. Obstructive sleep apnea is the type that people are most often familiar with; central sleep apnea is another type that presents the same dangerous health risks.
What Is Central Sleep Apnea?
Central sleep apnea (CSA) is a condition describing repeated interruptions in breathing during sleep because of irregular neurological signals that control respiration. When the brain does not send the right signals to the muscles, there is effort to breath is lessened or completely absent. This causes apneas that usually last 10 – 30 seconds. Disordered breathing can occur intermittently throughout the night or periodically in conjunction with sleep cycles.
Who Is at Risk for Central Sleep Apnea?
Sleep apnea, including CSA, can affect anyone although it is more common among men and people over the age of 65. It is linked to other medical conditions including obesity, stroke, high blood pressure, and cardiovascular problems.
What’s the Difference? – Obstructive Sleep Apnea vs. Central Sleep Apnea
Unlike obstructive sleep apnea, which is caused by something physically blocking respiration, central sleep apnea is usually caused by other health conditions. There is no physical barrier to breathing. Additionally, loud snoring is not a main sign or symptom associated with CSA, rather pauses in breathing while asleep are the noticeable sign of this disorder.
What Can Cause Central Sleep Apnea?
There are six different types of central sleep apnea that are differentiated by their cause.
- Medical Condition-Induced Apnea – CSA can be caused by brain damage from an injury or encephalitis affecting the lower brainstem, the area of the brain responsible for breathing. It can also be caused other serious illnesses, particularly Parkinson’s disease, Alzheimer’s, ALS, hypothyroidism, and chronic kidney disease.
- Cheyne-Stokes breathing – People affected by this type of CSA have an irregular breathing cycle in which respiration speeds up, slows down, then stops and restarts. The pattern can last between 30 seconds and two minutes. This kind of CSA and is often seen in patients who have had a stroke or heart failure.
- Treatment-Emergent Apnea – About 5% to 15% of people using CPAP therapy for obstructive sleep apnea develop CSA.
- Narcotic-Induced CSA – This refers to disordered breathing caused by opioid medications.
- High-Altitude Periodic Breathing – Many people at high elevations above 2,500 meters (8,000 feet).
- Idiopathic (Primary) CSA – Describes central sleep apnea that cannot be traced to a clear cause.
What Are the Symptoms of Central Sleep Apnea?
As stated before, snoring is not one of the main symptoms of CSA. In addition to sleep apneas, signs of this condition include:
- Morning headaches,
- Extreme daytime tiredness,
- Disrupted sleep and waking up throughout the night,
- Difficulty concentrating and remembering,
- Mood swings, and
- Difficulty doing regular exercise.
How Is Central Sleep Apnea Diagnosed?
Similar to OSA, people usually begin seeking a diagnosis for CSA because a bed partner has noticed the interruptions in breathing while asleep. Diagnosis of this sleep disorder requires a physical exam by your doctor and information about your medical and sleep history. A clinical sleep test, using a polysomnogram to monitor brain activity and breathing, can help confirm the diagnosis. CSA can be graded in terms of severity based on the number of apneas that occur during the test.
How is Central Sleep Apnea Treated?
Available treatment options will depend mostly on the cause of your CSA. In some cases, treating the underlying condition, or modifying medications, may also resolve the sleep apnea. There are also medications that can be prescribed to help manage the symptoms of CSA.
Lifestyle changes recommended to manage obstructive sleep apnea can also be helpful for those with CSA. These include:
- Losing weight,
- Avoiding alcohol, sleeping pills, and opioids,
- Quit smoking, and
- Change sleeping positions.
Continuous positive airway pressure (CPAP) therapy can help people with all types of sleep apnea. It works by pushing air into the respiratory tract through the moth or nose via tubing and a mask. The pressurized air helps keep the airway open and stimulate regular breathing.
Sometimes similar devices – adaptive servo-ventilation (ASV), automatic positive airway pressure (APAP), variable positive airway pressure (VPAP) or bilevel positive airway pressure (BPAP) – are more effective than standard CPAP for treating central sleep apnea.
Inspire Sleep Therapy
There is also an effective long-term solution available for adults with CSA. This involves having the Inspire Therapy device implanted just below the skin where it tracks the patient’s breathing. When necessary, the device sends mild electrical stimulation to the muscles and stimulate breathing.
Reliable Sleep Analysis – Sleep Health Solutions of Ohio
If you are having trouble sleeping, we can help. Sleep Health Solutions has a fully equipped sleep monitoring clinic to help confirm diagnosis and develop successful treatment plans for a wide variety of sleep disorders. Contact our office for more information.