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Central Sleep Apnea: Causes, Symptoms and Treatments

Central sleep apnea is a medical condition in which a person stops breathing for short periods while sleeping. It differs from obstructive sleep apnea in the fact that the breathing ceases not due to an obstruction of the airways in the nose and the throat, but because of an issue with brain where it stops sending messages to the body to tell it to breathe.



There can be many different medical conditions that can cause the brain to fail to send the correct messages to the body to tell it to breathe. Generally speaking, males over the age of forty are most likely to develop some form of sleep apnea, especially if they are overweight. 

However, central sleep apnea can be caused by a variety of different factors, and is normally seen in individuals who are suffering from some other serious medical condition or disease. It if it unrelated to any other disease, it is referred to as idiopathic sleep apnea. Some of the most common causes are listed below:

  • Damage to the cervical spine or brainstem

This is one of the most common causes, although the damage itself can be caused by a number of different conditions, including arthritis, encephalitis, degenerative bone conditions, injury, stroke, radiation of the spine, or even complications following cervical surgery. Neurodegenerative disorders such as Alzheimer’s, Parkinson’s, and ALS (Lou Gehrig’s disease) are also common causes. 

central sleep apneaSince the brainstem is what controls breathing functions, any damage to this area can cause the nerves to stop firing correctly, resulting in a cessation of breath while sleeping. The damage normally only causes breathing problems when a person is sleeping, because while awake they can still manually control their breathing if necessary.

  • Congestive Heart Failure

Patients who have suffered from some form of congestive heart failure are often at risk of developing central apnea. In this case, it is necessary to treat the heart conditions in order to have any hope of curing the apnea. 

  • Obesity

Just like with obstructive sleep apnea, obesity is one of the major causes of all types of sleep apnea. Being overweight or obese can cause many problems in the body and sometimes can lead to issues with the brain stem not being able to function properly. Although this is normally only in very rare cases, as obesity causes obstructive sleep apnea much more commonly.

  • Bulbar Poliomyelitis

This is a type of the polio virus that affects the bulbar region. Polio often affects the brain stem and can cause many breathing issues, and patients with severe cases often need to spend the rest of their lives connected to a respirator to breathe for them.

  • Medications

Central sleep apnea can be brought on by taking certain medications, especially any type of sedative or hypnotic, such as painkillers which contain narcotics. In these cases, if a person simply stops taking the medication then the apnea should also stop, however this is not that easy for many people who have prescription medications that they must take daily. When medications are causing sleep apnea, the doctors normally try to put the patient on a different form of medication without the sedating narcotics which are causing the breathing problems.

  • Cheyne-Stokes Breathing

This is a sleeping disorder very closely related to central sleep apnea which is often brought on by a stroke or congestive heart failure. In patients suffering from this condition, the breathing effort gradually increases and decreases throughout the night, and occasionally ceases completely for short periods of time. Because the breathing rises and falls throughout the night, the instance of apneas is much lower so this is not considered as serious of a condition, although that is still up for debate.

Symptoms and Diagnosis

central sleep apneaThe first step to curing any type of sleeping disorder is to first understand the symptoms so your doctor can make a correct diagnosis. 

Of course, the most noticeable symptoms will be interrupted breathing throughout the night, although the person suffering from sleep apnea will be blissfully unaware of this and will normally only become aware when their partner tells them so. 

Some of the other common symptoms are:

  • Feeling fatigued, lethargic, and constantly tired, even after a full night’s sleep
  • Extremely restless sleep- tossing and turning in bed all through the night
  • Frequently waking up in the morning with a headache
  • Being grumpy or irritable for no reason

While these symptoms are signs of some form of sleeping disorder, it may be difficult to understand which type of disorder it is and what the underlying cause is. If the sleep apnea is caused by another medical condition, then the individual may present more specific symptoms of the underlying disease or condition, such as:

  • Numbness in the whole body or extremities when waking up
  • Having difficulties breathing and swallowing, especially after waking up
  • Night sweats
  • Changes in a person’s voice

If you or your partner is showing signs of displaying any of the above symptoms, you should immediately consult your physician. They may in turn recommend that you see a sleep specialist or possibly an ear, nose, and throat doctor who can help further diagnose the type of sleep apnea you are suffering from and hopefully the underlying causes as well. 

 

While it used to be necessary to spend the night in a sleep clinic to have a sleep test (polysomnography) performed, now many clinics are able to offer tests that can be done in the comfort of your own bed, which is very important for achieving accurate results as most people sleep best in an environment that they are comfortable in. In some cases, an MRI may also be done to check for damage to the spine and neck. 

 

Treatment

The treatment options available depend on the cause. Normally the doctor will try to treat the underlying cause; however a CPAP machine, which blows a continuous stream of air into the lungs, is also commonly prescribed for patients.


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