Understanding and Treating Central Sleep Apnea: Types, Symptoms, and Treatments

central sleep apnea

sleep disorder with periods of interrupted breathing due to a disruption in signals sent from the brain that regulate breathing

Central sleep apnea is a sleep disorder characterized by brief interruptions in breathing during sleep that result from a lack of respiratory effort, as opposed to a physical obstruction in the airway. Unlike obstructive sleep apnea, in which airway obstruction is the underlying cause of breathing pauses, central sleep apnea is caused by a failure of the brainstem to initiate breathing.

Central sleep apnea can be divided into three types:

1. Cheyne-Stokes breathing pattern – a type of central sleep apnea that causes a periodic breathing pattern, meaning that breathing will gradually increase in depth and frequency, then gradually decrease until a breathing pause occurs. This cycle repeats every few minutes.

2. Treatment-emergent central sleep apnea (TECSA) – central sleep apnea that develops after treatment with positive airway pressure (PAP) therapy or other respiratory support, often in patients who have underlying health conditions that predispose them to central apnea events, such as congestive heart failure.

3. Idiopathic central sleep apnea (ICSA) – central sleep apnea that doesn’t have any obvious underlying cause.

The most common symptoms of central sleep apnea include excessive daytime sleepiness, difficulty maintaining sleep at night, restless sleep, morning headaches, and frequent nighttime awakenings.

Treatments for central sleep apnea depend on the cause and severity of the condition. For mild cases, lifestyle modifications such as losing weight, avoiding alcohol and sedatives, or changing sleep position may be helpful. In severe cases, Continuous positive airway pressure (CPAP) machines or adaptive servo-ventilation (ASV) machines may be used. Adaptive servo-ventilation machines use a computer algorithm to monitor the patient’s breathing and adjust the pressure of the machine to deliver a breath when needed. In some cases, supplemental oxygen therapy or medications, such as acetazolamide, may be used as well. In extreme cases, surgery to correct the underlying cause of the condition may be necessary.

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