Central Sleep Apnea: Causes, Symptoms, Diagnosis, Treatment, and Prevention
A central sleep apnea is a sleep disorder in which breathing stops and starts repeatedly during sleep. Central sleep apnea occurs because the brain fails to send signals to the muscles that control breathing, as opposed to obstructive sleep apnea, which occurs when an obstruction blocks the airway. The heart and brain can suffer serious consequences from central sleep apnea, a condition that is less common than obstructive sleep apnea.
Causes of Central Sleep Apnea
Central sleep apnea can be caused by a number of conditions that affect the ability of the brainstem, the part of the brain that connects to the spinal cord, to control breathing. Some of these conditions include:
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Stroke
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Heart attack
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Congestive heart failure
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Brain infection or inflammation
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Brain tumor
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Spinal cord injury or disease
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Parkinson’s disease
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Alzheimer’s disease
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Surgery or radiation in the spine
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Certain medications, especially opioid painkillers
Sleeping at a high altitude can also affect oxygen levels in the blood and breathing patterns in people with central sleep apnea. The condition is called idiopathic central sleep apnea.
Symptoms of Central Sleep Apnea
A central sleep apnea occurs when a person stops breathing during sleep for a short period of time. The episodes can last from a few seconds to a few minutes and may occur numerous times throughout the night. A breathing interruption can also cause the following symptoms:
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Sudden awakenings with shortness of breath
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Difficulty staying asleep or falling back asleep
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Excessive daytime sleepiness or fatigue
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Trouble concentrating or remembering things
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Mood changes, such as irritability or depression
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Morning headaches
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Snoring, although less prominent than in obstructive sleep apnea
Diagnosis of Central Sleep Apnea
An individual diagnosed with central sleep apnea will be asked about their symptoms, medical history, and medications, as well as a physical exam to check for signs of heart or neurological problems. A sleep study, or polysomnography, is the most definitive method of diagnosing central sleep apnea. In this test, various parameters are recorded during sleep, including brain activity, eye movements, muscle tone, heart rate, blood pressure, oxygen levels, and breathing patterns. A sleep study can reveal whether breathing pauses are caused by obstructive or central causes, and how often and for how long they occur.
Treatment of Central Sleep Apnea
There are a number of possible treatment options for central sleep apnea, depending on the severity of the symptoms and the underlying cause. These options include:
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Treating the underlying condition, such as heart failure, stroke, or brain infection, with medications, surgery, or other interventions
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Adjusting or stopping the medications that may cause or worsen central sleep apnea, such as opioids, under the guidance of a doctor
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Using a device to assist breathing during sleep, such as a continuous positive airway pressure (CPAP) machine, a bilevel positive airway pressure (BiPAP) machine, or an adaptive servo-ventilation (ASV) machine. An air pressure mask keeps the airway open and regulates the breathing pattern using these devices.
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Using supplemental oxygen during sleep to increase the oxygen levels in the blood and reduce the breathing effort
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Changing the sleeping position to avoid lying on the back, which can worsen the breathing pauses
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Avoiding alcohol and sedatives before bedtime, as they can relax the muscles and interfere with the breathing signals
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Losing weight if overweight or obese, as excess weight can put pressure on the chest and affect the breathing
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Quitting smoking, as smoking can damage the lungs and reduce the oxygen levels in the blood
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Exercising regularly, as exercise can strengthen the heart and lungs and improve the blood circulation
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Following a healthy diet, as eating well can provide the nutrients needed for the proper functioning of the body and the brain
Prevention of Central Sleep Apnea
There are some cases of central sleep apnea that may not be preventable, especially if they are caused by genetic or congenital factors. However, lifestyle changes and preventive measures can help reduce the risk or severity.
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Controlling the blood pressure and cholesterol levels, as high blood pressure and high cholesterol can increase the risk of heart disease and stroke, which can cause central sleep apnea
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Managing the blood sugar levels, as diabetes can damage the nerves and blood vessels and affect the breathing signals
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Getting regular check-ups and screenings for heart and brain conditions, as early detection and treatment can prevent or delay the complications that can lead to central sleep apnea
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Avoiding or limiting the use of opioids and other medications that can cause or worsen central sleep apnea, and following the doctor’s instructions on how to use them safely
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Avoiding sleeping at high altitudes, or acclimatizing gradually to the altitude change, as high altitude can affect the oxygen levels in the blood and the breathing pattern
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Seeking help for any sleep problems, as poor sleep quality can impair the brain function and the breathing regulation
Sleep apnea can negatively affect the health and well-being of a person who suffers from it, but it can be managed with proper diagnosis and treatment. If you suspect that you or someone you know has central sleep apnea, do not hesitate to consult a doctor and get the help you need. For a healthy and happy life, it is essential to get a good night's sleep.
