Description

Central sleep Apnea is a disorder in which breathing repeatedly stops and starts during sleep.

Central sleep Apnea occurs because your brain doesn't send proper signals to the muscles that control breathing. This condition is different from obstructive sleep apnea, in which breathing stops because the throat muscles relax and block the airway. Central sleep Apnea is less common than obstructive sleep apnea.

Central sleep Apnea may be the result of other conditions, such as heart failure and stroke. Another possible cause is sleeping on altitude.

Treatments for central sleep apnea may involve the management of the existing conditions, the use of a device to assist breathing or the use of supplemental oxygen.

Symptoms

The common symptoms of central sleep apnea include:

  • Observed episodes of shortness of breath during sleep.
  • Abrupt awakenings with shortness of breath.
  • Not be able to fall asleep, known as insomnia.
  • Excessive sleepiness during the day, known as hypersomnia.
  • Difficulty focusing.
  • Changes of mood.
  • Morning headaches.
  • Snoring.

Despite the snoring suggests some degree of airway obstruction, snoring can also occur in people with central sleep apnea. However, snoring may not be so prominent with central sleep apnea as it is with the obstructive sleep apnea.

When to see a doctor

Consult with a medical professional if you have or if your partner notices — any symptom of central sleep apnea, in particular:

  • The shortness of breath that wakes out of his sleep.
  • Pauses in breathing during sleep.
  • The difficulty to stay asleep.
  • Excessive sleepiness during the day, which can cause you to fall asleep while you're working, watching television or even driving.

Ask a member of your health care team about any sleep problem that leaves regularly, fatigue, drowsiness, and irritability. Excessive daytime sleepiness may be due to other disorders, so it is important to obtain an accurate diagnosis. Drowsiness during the day may be caused by obstructive sleep apnea, and not allowing time to get enough sleep at night or sudden attacks of sleep, known as narcolepsy.

Causes

Central sleep Apnea occurs when the brain does not transmit signals to your breathing muscles.

The brain stem connects the brain to the spinal cord. Controls many functions, including heart rate and breathing. Central sleep Apnea can be caused by a number of conditions that affect the brain's ability to control the breath.

The cause varies with the type of central sleep apnea you have. The types include:

  • Cheyne-Stokes respiration.This type of central sleep apnea is most commonly associated with congestive heart failure or a stroke. During the Cheyne-Stokes breathing, the breathing effort and airflow to increase gradually and then decrease. During the weak efforts to breathe, a total lack of air flow can occur.
  • Drug-induced apnea. Taking certain medications, such as opioids can cause breathing to become irregular or stop completely for a short period of time. These medications can be taken orally or by injection, also called injection. They include morphine (MS Contin, Mitigo, others), oxycodone (Roxicodone, Oxycontin, others), and codeine.
  • High-altitude periodic breathing. A Cheyne-Stokes pattern of behavior can occur if you are at a very high altitude. The change in oxygen at a high altitude can cause rapid breathing, known as hyperventilation, followed by taking in very little air.
  • Treatment-emergent central sleep apnea. Some people with obstructive sleep apnea develop central sleep apnea, while the use of continuous positive airway pressure (CPAP) for the treatment. This condition is known as an emergency treatment central sleep apnea. It is a combination of obstructive and central sleep apnoea.
  • Medical condition-induced central sleep apnea. Several medical conditions, including end-stage renal disease, and stroke, which can lead to central sleep apnea. This type of sleep apnea does not imply Cheyne-Stokes respiration.
  • Primary central sleep Apnea, also known as idiopathic sleep apnea. The cause of this rare type of central sleep apnea is not known.

Cheyne-Stokes respiration. This type of central sleep apnea is most commonly associated with congestive heart failure or a stroke.

During the Cheyne-Stokes breathing, the breathing effort and airflow to increase gradually and then decrease. During the weak efforts to breathe, a total lack of air flow can occur.

Risk factors

Certain factors put you at increased risk of central sleep apnea:

  • Sex. Males are more likely to develop central sleep apnea than women.
  • Age. Central sleep Apnea is more common among older adults, especially those over 60 years of age. This could be due to the fact that people over 60 years of age are likely to have other medical conditions or sleep patterns that are linked to the central sleep apnea.
  • The disorders of the heart. Heart problems that put people at greater risk of central sleep apnea. An irregular heartbeat, known as atrial fibrillation, can increase the risk. Muscles of the heart that does not pump enough blood to meet the needs of the body, known as congestive heart failure, may also increase the risk.
  • Stroke, a brain tumor or a structural problem with the brain stem. These brain conditions can affect the ability of the brain to regulate the breathing.
  • High altitude. Sleeping in an altitude higher than you're used to it can increase your risk of sleep apnea. High-altitude sleep apnea was resolved a few weeks after returning to a lower altitude.
  • Consumption of opiates. Opioid medications may increase the risk of central sleep apnea.
  • The CPAP.Some people with obstructive sleep apnea develop central sleep apnea, while the use of continuous positive airway pressure (CPAP). This condition is known as an emergency treatment central sleep apnea. It is a combination of obstructive and central sleep apnoea. For some people, the complex of sleep apnea go away with continued use of theirCPAPdevice. Other people can be treated with a different type of treatment with positive pressure in the airways.

The CPAP. Some people with obstructive sleep apnea develop central sleep apnea, while the use of continuous positive airway pressure (CPAP). This condition is known as an emergency treatment central sleep apnea. It is a combination of obstructive and central sleep apnoea.

For some people, the complex of sleep apnea go away with continued use of your CPAP device. Other people can be treated with a different type of treatment with positive pressure in the airways.

Complications

Central sleep Apnea is a serious medical condition. Some of the complications include:

  • Fatigue.Awakenings repeated associated with sleep apnea make a good night's sleep impossible. People with central sleep apnea often have severe fatigue, daytime sleepiness, and irritability. You may have difficulty to focus. You can also find falling asleep at work, while watching tv, or even while driving.
  • Cardiovascular problems.Abrupt in blood oxygen levels that occur during central sleep apnea can affect the health of the heart. If you have heart disease, repeated episodes of low oxygen levels in the blood increase the risk of irregular heart rhythms.

Fatigue. Awakenings repeated associated with sleep apnea make a good night's sleep impossible. People with central sleep apnea often have severe fatigue, daytime sleepiness, and irritability.

You may have difficulty to focus. You can also find falling asleep at work, while watching tv, or even while driving.

Cardiovascular problems. Abrupt in blood oxygen levels that occur during central sleep apnea can affect the health of the heart.

If you have heart disease, repeated episodes of low oxygen levels in the blood increase the risk of irregular heart rhythms.

Diagnosis

A primary care professional can evaluate your condition based on your symptoms. Or you may be referred to a sleep specialist in a sleep disorders center.

A sleep specialist can help you decide on your need for further evaluation. That could imply the night of monitoring of breathing and other body functions during a sleep study called polysomnography.

During polysomnography, which is connected to equipment that monitors your heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels during sleep. You can have a full-night or split-night sleep study.

In a split night study, follow-up during the first half of the night. If you are diagnosed with central sleep apnea, the staff can wake up to the start of therapy to the second half of the night. The therapy could be positive airway pressure or supplemental oxygen.

Polysomnography can help to diagnose central sleep apnea. You can also help rule out other sleep disorders, such as obstructive sleep apnea, repetitive movements during sleep and narcolepsy. These other disorders that can cause excessive sleepiness during the day, but require different treatment.

Physicians trained in diseases of the nervous system, known as neurologists, and in diseases of the heart, known as cardiologists, and others may be involved in the evaluation of your condition. You might need images of your head or the heart to search for contributing conditions.

Treatment

Treatments for central sleep apnea may include:

  • To address the associated medical problems. Possible causes of central sleep apnea include other disorders. The treatment of these conditions can help your central sleep apnea. For example, therapy for heart failure may improve central sleep apnea.
  • The reduction of the opioid drug. If opioid medications are the cause of your central sleep apnea, your health care team may reduce your dose of the medication over time.
  • Continuous positive airway pressure (CPAP).This method is also used to treat obstructive sleep apnea, involves the use of a mask over the nose or around the nose and mouth during sleep. The mask is connected to a small pump that supplies a constant flow of air pressure to maintain an open upper airway.CPAPmay to prevent the closure of the airways that can cause central sleep apnea. As with obstructive sleep apnea, in the center of the sleep apnea is important that you use theCPAPdevice only as directed. If the mask is uncomfortable or the pressure that it feels too strong, talk to your health care team. Several types of masks are available. The air pressure can also be adjusted.
  • Adaptive servo-ventilation (ASV).IfCPAPdoesn not effectively treat your condition, you could be givenASV. LikeCPAP,ASValso supplied air pressure. UnlikeCPAP,ASVadjusts the amount of pressure of the breath-by-breath when you take a breath. This softens your breathing pattern. The device could automatically provide a breath if you have not taken a break within a certain number of seconds. ASVisn is not recommended for people with symptomatic heart failure.
  • Bilevel positive airway pressure (BPAP). As a ASV , BPAP delivery of a fixed amount of pressure when you inhale and a different amount of pressure when you exhale. Unlike the ASV , the amount of pressure that is delivered to the breathing set in place of the variable. BPAP can also be configured to offer a respite if you have not taken a break within a certain number of seconds.
  • Supplemental oxygen. The use of supplemental oxygen during sleep can help if you have central sleep apnea. Various devices are available to deliver the oxygen to his lungs.
  • Drugs. Medications such as acetazolamide have been used to stimulate breathing in people with central sleep apnea. These medications may be prescribed to help your breathing while you sleep if you can't tolerate positive pressure in the airways.

Continuous positive airway pressure (CPAP). This method is also used to treat obstructive sleep apnea, involves the use of a mask over the nose or around the nose and mouth during sleep.

The mask is connected to a small pump that supplies a constant flow of air pressure to maintain an open upper airway. CPAP can prevent the closure of the airways that can cause central sleep apnea.

As with obstructive sleep apnea, in the center of the sleep apnea is important that you use the CPAP device only as directed. If the mask is uncomfortable or the pressure that it feels too strong, talk to your health care team. Several types of masks are available. The air pressure can also be adjusted.

Adaptive servo-ventilation (ASV). If the CPAP is not effective for the treatment of your condition, you may be given ASV . As CPAP , ASV also supplies air pressure.

Unlike CPAP , ASV adjusts the amount of pressure of the breath-by-breath when you take a breath. This softens your breathing pattern. The device could automatically provide a breath if you have not taken a break within a certain number of seconds.

ASV is not recommended for people with symptomatic heart failure.

Surgery or other procedures

A new therapy for central sleep apnea is transvenous stimulation of the phrenic nerve. A device approved by the Food and Drug Administration, known as the Remede System sends an electrical pulse to the nerve that controls the diaphragm during sleep. This causes it to take a breather. The system includes a battery, pulse generator that is implanted under the skin in the upper chest.

It is used for moderate to severe central sleep apnea, this system produces a steady breathing pattern. More studies are needed.

Preparing for your appointment

It is likely to start by seeing a member of your primary health care team. You may then be referred to a sleep specialist.

Here's some information to help you prepare for your appointment.

What you can do

  • The results of previous sleep studies or other tests or ask that they be sent to your sleep specialist.
  • Ask someone, such as a spouse or partner, who has seen you sleep to come with you to your appointment. This person will likely be able to provide your doctor with additional information.
  • Write down your symptoms, including any that may seem unrelated to the reason for which you scheduled the appointment, and when they began.
  • Write down key personal information, including major stresses or recent life changes.
  • Make a list of all medications, vitamins or supplements that you take, including over-dose.
  • Write questions to ask their health care team.

For central sleep apnea, some basic questions to ask include:

  • What is the most likely cause of my symptoms?
  • There are other possible causes of the symptoms?
  • What tests do I need? Do these tests require special preparation?
  • Is this condition temporary or long-term?
  • What treatments are available, and which do you recommend?
  • How are you going to treat or not to treat my central sleep apnea affect my health now and in the future?
  • I have other health conditions. How can I best manage these conditions?
  • Are there brochures or other printed material I can have? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Your health care team is likely to ask a series of questions, such as:

  • The symptoms been continuous or come and go?
  • Can you describe the typical hours of sleep?
  • How much sleep time and sleep well? How many times you wake up during the night?
  • You know if you snore?
  • How do you feel when you wake up? Are you short of breath?
  • Do you fall asleep easily during the day?
  • Has anyone ever told you that you stop breathing while you sleep?
  • You're short of breath when you wake up in the night?
  • Do you have any heart problems? Have had a stroke?
Symptoms and treatment of Central sleep apnea