What Is Central Sleep Apnea?

CSA is when your body stops breathing during sleep for prolonged periods. Most often, the body stops breathing because the brain isn’t sending signals to tell it to breathe. The brain doesn’t resume sending these signals until it experiences oxygen deprivation. Your brain has to wake up slightly to do this, interrupting sleep. It also causes the heart to beat faster and harder, spiking blood pressure.

This is similar but different from Obstructive Sleep Apnea (OSA). In OSA, breathing stops because your airway closes. This might be because tissues sag into your airway, such as your tongue, soft palate, or the throat tissues themselves. However, like CSA, the brain must awaken slightly to reopen the airway, so you experience similar sleep interruptions.

Central Sleep Apnea Symptoms

The symptoms of sleep apnea are similar, no matter the type. People with CSA might experience:

  • Daytime sleepiness
  • Waking up at night
  • Maintenance insomnia (difficulty staying asleep)
  • Problems with focus, thinking, or memory
  • Mood disorders, including irritability and depression
  • Morning headaches

If you have a sleeping partner, they may notice that you stop breathing at night. You might snore, but snoring is not strongly associated with CSA.

How Central Sleep Apnea Is Diagnosed

CSA diagnosis uses the same sleep study as for OSA. A home sleep study can detect both types, and, normally, it can distinguish between the types.

This means that for most people you can get tested for CSA in the comfort of your own bed. However, it might be necessary to refer you for a polysomnography in some cases.

Central Sleep Apnea Causes

adult woman suffering from Central Sleep Apnea morning headacheWhat makes your brain stop sending breathing signals to the body? Most often this is due to something affecting the brainstem, the part of the brain that controls many body functions, including breathing.

Understanding the cause of CSA can help treat it, and sometimes CSA is classified according to its cause. Some of these cause categories are:

  • Cheyne-Stokes breathing: A type of CSA linked to an irregular breathing pattern. Your body intermittently works very hard to breathe, then intermittently doesn’t work very hard to breathe. Sometimes the breathing effort stops altogether. Most often, this type of breathing is linked to heart failure or stroke, but it can be associated with other medical conditions, including traumatic brain injury (TBI).
  • High-altitude periodic breathing: If you go to high altitudes, your body may struggle to get enough oxygen. When this happens, it can create a breathing pattern similar to Cheyne-Stokes breathing that sometimes leads you to stop breathing.
  • Drug-induced CSA: Some prescription medications and illegal drugs can hamper brainstem function. Opioids are the drug that most often causes this type of CSA, but barbiturates, antihistamines, and benzodiazepines can also cause CSA.
  • Treatment-emergent CSA (TECSA): Sometimes called complex sleep apnea, TECSA occurs when OSA treatment causes CSA. Continuous positive airway pressure (CPAP) is most often linked to TECSA, but TECSA can sometimes occur with oral appliance therapy (OAT) or even sleep apnea surgery.

All these types of CSA are treatable, with various degrees of success.

Treating Central Sleep Apnea

Central sleep apnea doesn’t respond to the types of OAT and surgery that treats OSA. Instead, your options for treating sleep apnea include:

  • Treating medical conditions: If your CSA is linked to a medical condition, you might be able to resolve it by treating that medical condition.
  • Adjusting medications: If your prescription medication causes CSA, talk to your doctor about adjusting your prescription. A lower dosage or a different medication might reduce or eliminate your CSA.
  • Returning to normal altitude: if you experience a Cheyne-Stokes breathing pattern at high altitudes, your breathing may return to normal when you go back to lower altitudes. This may take several weeks. If it doesn’t improve after a month, talk to your doctor.
  • CPAP: CPAP forces air into your lungs, which can ensure that your body is getting enough air. Sometimes, though CPAP can cause or worsen CSA, and might not supply your body with enough oxygen.
  • CPAP variations: Since standard CPAP doesn’t always treat CSA, your doctor might prescribe other types of CPAP. The two types shown to help with CSA are bilevel positive airway pressure (BPAP or BiPAP) and adaptive servo-ventilation (ASV). BiPAP uses two different pressure levels intermittently to simulate and encourage your body’s normal breathing pattern. ASV uses a more complex variation in air pressure to achieve the same effect. There is slight evidence that ASV might work better, but it’s not conclusive.
  • Phrenic nerve stimulation: This is an experimental treatment in which a device stimulates the nerve that carries signals to your breathing muscles. This is not the same as Inspire, which treats OSA by stimulating the muscles that support your airway. While preliminary data is encouraging, this is still considered an investigational treatment, and most insurance will not cover it.
  • Supplemental oxygen: A doctor may recommend supplemental oxygen in addition to other treatments to ensure your body is getting enough oxygen.

It’s not easy to treat CSA, and it may take several tries before you find the right treatment for your condition.

Sleep Apnea Relief in Detroit

Successful sleep apnea treatment starts with a diagnosis. At the Michigan Head & Neck Institute, we can help you get a home sleep test to determine if you have sleep apnea, and what type it might be. Then we can either recommend a treatment or refer  you to someone who can.

Please call (586) 573-0438 or use our online form to request an appointment with a sleep dentist at the Michigan Head & Neck Institute, serving the Detroit area from Warren, MI.