Central sleep apnea

Definition

Central sleep apnea is when you stop breathing during sleep. It is caused by problems with how the brain controls breathing.

This is not the more common obstructive sleep apnea, which is caused by obesity or other problems and involves loud snoring.

Alternative Names

Causes

Central sleep apnea usually occurs in people who are seriously ill. For example, it can occur in people with a variety of severe and life-threatening lower brain stem lesions. The brainstem controls breathing. As a result, any disease or injury affecting this area may result in problems with normal breathing during sleep or when awake.

Conditions that can cause central sleep apnea include:

• Bulbar poliomyelitis
• Encephalitis affecting the brainstem
• Neurodegenerative illnesses
• Stroke affecting the brainstem

Other causes include complications of cervical spine surgery, secondary radiation in the region of the cervical spine, severe arthritis and degenerative changes in the cervical spine or the base of the skull, or primary hypoventilation syndrome.

There is a form of central sleep apnea that commonly occurs in people with congestive heart failure. Finally, idiopathic central sleep apnea is when the apnea is not associated with another disease.

Symptoms

The primary symptom is when you temporarily stop breathing, especially during sleep. People with apnea of unknown cause may awaken frequently and complain of insomnia.

If a neurological condition is causing the apnea, it may also produce other symptoms. These include difficulty swallowing, change in voice, weakness, or numbness throughout the body, depending on the underlying disease and what parts of the nervous system it has affected.

Exams and Tests

• Lung and breathing studies
• All-night polygraphic sleep monitoring
• MRI
• Tests to diagnose an underlying medical condition

Treatment

If central sleep apnea is due to heart failure, the goal is to treat the heart failure itself. In the case of idiopathic apnea or brainstem problems, nasal CPAP may be used to allow breathing.

Outlook (Prognosis)

For idiopathic apnea, the outlook is usually favorable. In congestive heart failure, an aggressive treatment of the heart may improve the outlook. If the cause is a brainstem injury, the outlook tends to be worse.

Possible Complications

Complications may result from prolonged mechanical ventilation and from the underlying disease causing the syndrome.

When to Contact a Medical Professional

Call your health care provider if you have symptoms that might indicate sleep apnea. Central sleep apnea is usually diagnosed in patients who are already severely ill.

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