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Understanding Central Sleep Apnea
Central Sleep Apnea: What is it?
As we sleep, we may experience pauses in breathing, which are called apneas. Normal adults may experience up to five brief apneas per hour. Individuals with central sleep apnea (CSA) suffer from more frequent and longer apneas. During these pauses, the body is not trying to breathe. The condition differs from the more common Obstructive Sleep Apnea (OSA). Patients with OSA struggle to breathe because their airways are blocked. In patients with CSA, the airway is not blocked; there is just a pause in breathing.
CSA affects about 10% of people with breathing problems during sleep. As a result, they experience poor sleep quality and can feel tired during the day. Insomnia or other sleep disorders are also possible. It is less common to snore loudly in CSA than in OSA.
How does central sleep apnea occur?
As breathing slows down, the brain may take a while to adjust to changes in blood oxygen and carbon dioxide levels. Those who have had sleep apnea for a long time may develop this condition. In essence, the breathing reflex becomes blunted. The breathing reflex pathway may be disrupted by a slow blood circulation associated with heart failure. This leads to a pattern of over-breathing followed by under-breathing (periodic breathing) or stopping breathing altogether. In addition to some drugs (such as morphine) and having a cerebrovascular disease (such as a stroke) may cause this pattern of CSA. Both of these affect the breathing control centres in the brain.
The cause of CSA may also be a weakness of the muscles that cause the lungs to expand and contract, such as can be found in some neurological disorders. Additionally, it can also be caused by an abnormality in the chest wall or by stiff lungs. Under-breathing, or hypoventilation, can result. CSA can affect your sleep. You may also retain carbon dioxide which might result in morning headaches or fogginess.
Central Sleep Apnea Assessment
To verify a diagnosis of central sleep apnea a consideration of all the possible causes as well as a sleep study needs to be undertaken. This is something our sleep professionals are able to work with you on and your GP can arrange a referral.
Available Treatments for Central Sleep Apnea
- If possible, reduce or stop using drugs that may cause CSA (e.g., narcotics). There are also some drugs that stimulate breathing. You may find these helpful.
- Many types of CSA can be helped by positive airway pressure therapies such as Continuous Positive Airway Pressure (CPAP). Periodic breathing can be helped with adaptive servo-ventilation. Hypoventilation during sleep responds well to bilevel ventilatory assistance.
- It may be beneficial to use oxygen at night.
- When heart failure is a factor, treating it with medications is crucial.
- Diaphragm pacemakers are rarely used, though spinal cord injury patients or those with congenital hypoventilation syndrome have benefitted from this therapy.
If you are always feeling tired and having ongoing sleep problems, you should certainly seek the advice of your doctor. Should they be concerned you may have central sleep apnea they’ll refer you to a sleep professional for further evaluation. If you’ve got any questions about what this might involve our sleep professionals are on hand to help and can be contacted on 1800 717 566
