What causes central sleep apnea?
Central sleep apnea is rare in people who are not seriously ill. It occurs in patients 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 sentral sleep
apnea include bulbar poliomyelitis, encephalitis affecting the brainstem, neurodegenerative illnesses, and stroke affecting the brainstem. Other causes include complications of surgery of the cervical spine, secondary radiation in the region of the cervical spine, severe arthritic and degenerative changes in the cervical spine and/or base of skull, or primary hypoventilation syndrome.
Central sleep apnea may result from disorders such as strokes, heart failure, and kidney failure, which can interfere with the brain's control of breathing. People with central sleep apnea experience repeated, prolonged periods of nonbreathing during sleep, often followed by periods of rapid breathing (Cheyne-Stokes breathing). This pattern occurs in cycles through the night. In central sleep apnea, the airway remains open, but the nerve signals controlling the respiratory muscles are not regulated properly. This can cause wide fluctuations in the level of carbon dioxide (CO2) in the blood. Normal activity in the body produces CO2, which is brought by the blood to the lungs for exhalation. When the blood level of CO2 rises, brain centers respond by increasing the rate of respiration, clearing the CO2. As blood levels fall again, respiration slows down. Normally, this interaction of CO2 and breathing rate maintains the CO2 level within very narrow limits. CSA can occur when the regulation system becomes insensitive to CO2 levels, allowing wide fluctuations in both CO2 levels and breathing rates. High CO2 levels cause very rapid breathing (hyperventilation), which then lowers CO2 so much that breathing becomes very slow or even stops. CSA occurs during sleep because when a person is awake, breathing is usually stimulated by other signals, including conscious awareness of breathing rate.
A combination of the two forms is also possible, and is called "mixed sleep apnea." Mixed sleep apnea episodes usually begin with a reduced central respiratory drive, followed by obstruction.
More information on sleep apnea
What is sleep apnea? - Sleep apnea is a disorder in which a person stops breathing during the night. Sleep apnea means cessation of breath characterized by repetitive episodes of upper airway obstruction.
What types of sleep apnea are there? - There are three types of sleep apnea, including obstructive sleep apnea (OSA), central sleep apnea, mixed sleep apnea.
What is obstructive sleep apnea? - Obstructive sleep apnea is a disorder in which complete or partial obstruction of the airway during sleep causes loud snoring, oxyhemoglobin desaturations and frequent arousals.
What causes obstructive sleep apnea? - Obstructive sleep apnea is caused by repetitive upper airway obstruction during sleep as a result of narrowing of the respiratory passages.
What're the symptoms of obstructive sleep apnea? - Symptoms of obstructive sleep apnea include loud snoring, Daytime sleepiness, memory changes, depression, and irritability.
What is central sleep apnea? - Central sleep apnea is a sleep breathing disorder that occurs when the brain fails to send the appropriate signals to the breathing muscles to initiate respirations.
What causes central sleep apnea? - Conditions that can cause sentral sleep apnea include bulbar poliomyelitis, encephalitis affecting the brainstem, neurodegenerative illnesses.
What're the symptoms of central sleep apnea? - Symptoms of central sleep apnea include extreme exhaustion and sleepiness during daylight hours, early morning headaches, lack of concentration, and memory loss.
What are the risk factors for sleep apnea? - There are several factors that may predispose a person towards sleep apnea, including gender, age, ethnicity, geography, obesity, immune abnormalities.
What are the complications of sleep apnea? - Sleep apnea is a potentially life-threatening condition because there are interruptions in breathing during sleep.
How is sleep apnea diagnosed? - A sleep test, called polysomnography is done to diagnose sleep apnea. Confirmation of the diagnosis requires making measurements while the person sleeps.
What's the treatment to stop sleep apnea? - Treatment for sleep apnea is determined based on the individual's specific circumstances and can include behavioral changes, physical therapy and surgery.
What surgeries are available to cure sleep apnea? - Surgeries to stop sleep apnea include uvulopalatopharyngoplasty, laser-assisted uvulopalatoplasty, tracheostomy, radiofrequency ablation.
What about the CPAP therapy for sleep apnea? - The most effective treatment for sleep apnea is nasal continuous positive airflow pressure (CPAP) therapy.