Central sleep apnea
DEFINITION
Central sleep apnea is a disorder in which your breathing repeatedly stops and starts during sleep.
Central sleep apnea occurs because your brain doesn’t send proper signals to the muscles that control your breathing. This condition is different from obstructive sleep apnea, in which you can’t breathe normally because of upper airway obstruction.
Central sleep apnea is less common than obstructive sleep apnea.
Central sleep apnea may occur as a result of other conditions, such as heart failure and stroke. Sleeping at a high altitude also may cause central sleep apnea.
Treatments for central sleep apnea may involve treating existing conditions, using a device to assist breathing or using supplemental oxygen.
CAUSES
Central sleep apnea occurs when your brain fails to transmit signals to your breathing muscles.
Central sleep apnea can be caused by a number of conditions that affect the ability of your brainstem — which links your brain to your spinal cord and controls many functions such as heart rate and breathing — to control your breathing. The cause varies with the type of central sleep apnea you have. Types include:
- Cheyne-Stokes breathing. This type of central sleep apnea is most commonly associated with congestive heart failure or stroke. This condition is characterized by a gradual increase and then decrease in breathing effort and airflow. During the weakest breathing effort, a total lack of airflow (central sleep apnea) can occur.
- Drug-induced apnea. Taking certain medications such as opioids — including morphine sulfate (Ms Contin, Avinza, others), oxycodone (Oxycodone HCL, Oxycontin, others) or codeine sulfate — may cause your breathing to become irregular, to increase and decrease in a regular pattern, or to temporarily stop completely.
- High-altitude periodic breathing. A Cheyne-Stokes breathing pattern may occur if you’re exposed to a very high altitude. The change in oxygen at this altitude is the reason for the alternating rapid breathing (hyperventilation) and under breathing.
- Complex sleep apnea. Some people with obstructive sleep apnea develop central sleep apnea while using continuous positive airway pressure (CPAP) for their sleep apnea treatment. This condition is known as complex sleep apnea because it’s a combination of obstructive and central sleep apneas.
- Medical condition-induced central sleep apnea. Several medical conditions may give rise to central sleep apnea of the non-Cheyne-Stokes variety.
- Idiopathic (primary) central sleep apnea. The cause of this uncommon type of central sleep apnea isn’t known. It results in repeated pauses in breathing effort and airflow.
SYMPTOMS
Common signs and symptoms of central sleep apnea include:
- Observed episodes of stopped breathing or abnormal breathing patterns during sleep
- Abrupt awakenings accompanied by shortness of breath
- Shortness of breath that’s relieved by sitting up
- Difficulty staying asleep (insomnia)
- Excessive daytime sleepiness (hypersomnia)
- Difficulty concentrating
- Mood changes
- Morning headaches
- Snoring
Although snoring indicates some degree of increased obstruction to airflow, snoring also may be heard in the presence of central sleep apnea. However, snoring may not be as prominent with central sleep apnea as it is with obstructive sleep apnea.
When to see a doctor
Consult a medical professional if you experience, or if your partner observes, any signs or symptoms of central sleep apnea, particularly the following:
- Shortness of breath that awakens you from sleep
- Intermittent pauses in your breathing during sleep
- Difficulty staying asleep
- Excessive daytime drowsiness, which may cause you to fall asleep while you’re working, watching television or even driving
Ask your doctor about any sleep problem that leaves you chronically fatigued, sleepy and irritable. Excessive daytime drowsiness (hypersomnia) may be due to other disorders, such as narcolepsy or obstructive sleep apnea.
