Central sleep apnea can significantly impact your sleep quality and overall health. But what, exactly, is the condition, and how is it diagnosed? Read on to learn more about how central sleep apnea differs from obstructive sleep apnea and the current treatment options available for the disorder.
What is Central Sleep Apnea?
Unlike obstructive sleep apnea, which is caused by improperly-relaxed muscles in the throat and mouth that physically block your airway during sleep, central sleep apnea occurs when there is a problem with the brain signals that regulate the mechanical, muscular aspects of normal breathing during sleep.
According to a 2019 review published by Current Pulmonology Reports, the mechanical process of breathing may be disrupted in central sleep apnea by any of the following factors:
- Irregularities in your sleep cycle
- Intermittent decreases in the amount of carbon dioxide in your lungs and blood
- Instabilities in your ventilatory control system
- Problems with the reflexes of your upper airway
- A depressed rate of rhythm generation by the brain stem
The presence of other disorders can also make you more prone to developing central sleep apnea. “There are a few underlying conditions that can cause central sleep apnea, such as congestive heart failure (CHF), prescriptive or non-prescriptive opioid use or abuse, irregular heartbeat, stroke, or even living in high altitudes,” Alan Thomalla, PhD and psychologist, tells WebMD Connect to Care.
When your body’s mechanical process of breathing is disrupted, it develops a reduced drive to breathe. This causes periods of apnea, or the temporary stoppage of breathing, during sleep. These apneic periods are what central and obstructive sleep apnea have in common.
According to the 2019 Current Pulmonary Reports review, central sleep apnea can cause symptoms such as excessive daytime sleepiness, snoring, disrupted sleep, and morning headaches.
Polysomnography, or a sleep study, is the current standard for diagnosing central sleep apnea. This form of diagnostic testing measures the flow of your breathing, your blood oxygen levels, and the amount of effort it takes for you to breathe during sleep.
Next Steps After Diagnosis
Treating central sleep apnea will involve multiple factors. If there is an underlying cause like congestive heart failure that is contributing to your central sleep apnea, it must be treated first. Stopping chronic opioid use can also help manage central sleep apnea, since opioids can suppress your breathing rhythm.
Positive pressure therapy, most commonly achieved using a continuous positive airway pressure (CPAP) device, is a primary treatment option for central sleep apnea. This therapy increases the amount of oxygen that enters your airways by delivering a steady airstream through a mask that you wear while you sleep.
If you live in a high-altitude area, supplemental oxygen may be an alternative and more appropriate treatment method that helps increase your oxygen levels during sleep. Supplemental oxygen may also be recommended for cases of central sleep apnea that are associated with heart failure.
For severe cases of central sleep apnea that do not improve with a CPAP device, a nerve stimulator that helps the phrenic nerve function properly can be implanted in qualifying patients to improve breathing. The phrenic nerve controls the diaphragm, one of the central muscles involved in respiration. Proper stimulation of this nerve can therefore stabilize breathing during sleep.
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