Central sleep apnea (CSA) is a relatively uncommon condition. It occurs when your body stops breathing. Although the condition differs from obstructive sleep apnea and doesn’t respond to the same treatments, it can have similar health effects and needs treatment.
At the Advanced Dental Sleep Treatment Center in Omaha, sleep dentist Dr. Melissa Sheets leads an elite team of sleep care providers and can help you get care for all types of sleep apnea. Contact us today to learn how we can help you.
What Is Central Sleep Apnea?
In central sleep apnea, your body stops breathing for prolonged periods, frequently at night. It isn’t like obstructive sleep apnea, where your airway collapses, cutting off your access to air. Instead, your body just stops breathing. Typically, this is because your brain stops sending the signals telling your body to breathe. The brain doesn’t resume sending these signals until it experiences the resulting oxygen shortage.
Repeated oxygen deprivation and fragmentary sleep account for the serious health effects that link central and obstructive sleep apnea.
It is possible to have both central and obstructive sleep apnea. Sometimes this is described as complex sleep apnea, especially if it does not respond to typical treatment.
Symptoms of Central Sleep Apnea
People with CSA often experience similar symptoms to obstructive sleep apnea, including:
- Daytime sleepiness
- Difficulty concentrating, thinking, or remembering
- Waking up at night
- Difficulty staying asleep
- Mood changes
- Morning headaches
Sleep partners may notice that your breathing stops during sleep. People with CSA sometimes snore, but snoring is not as common with central sleep apnea as with obstructive sleep apnea.
Diagnosing Sleep Apnea
As with obstructive sleep apnea, a sleep test is the only way to diagnose CSA. Fortunately, the same sleep study equipment used for obstructive sleep apnea can detect CSA and distinguish between the two types.
However, it may sometimes be necessary to schedule a polysomnography to successfully detect central sleep apnea or distinguish it from obstructive sleep apnea.
Causes of Central Sleep Apnea
In CSA, your brain stops sending signals to your breathing muscles. This occurs when something affects your brainstem, the part of your brain that controls your breathing and many other basic bodily functions.
Often, the cause of your central sleep apnea helps define your type of sleep apnea. Some of the more common types and their respective causes are:
- Cheyne-Stokes breathing: This type of CSA occurs most often after an individual experiences congestive heart failure or a stroke. In this breathing pattern, your body goes through intermittent periods of working very hard to breathe and not breathing at all. Sometimes breathing stops altogether during the low-effort part of the cycle. Sometimes other medical conditions lead to a similar breathing pattern.
- Drug-induced central sleep apnea: This occurs when the use of medications or illegal drugs hampers your brainstem function. Opioids are the most common culprit, but antihistamines, benzodiazepines, and barbiturates can also cause this problem.
- Treatment-emergent central sleep apnea: For some people, treating obstructive sleep apnea with continuous positive airway pressure (CPAP) can lead to central sleep apnea.
- High-altitude periodic breathing: If you sleep in an unaccustomed high-altitude location, your body may struggle to get enough oxygen. Sometimes this leads to a breathing pattern similar to Cheyne-Stokes breathing.
The cause of your central sleep apnea will influence the best treatment option for you.
Treating Central Sleep Apnea
The type of treatment that’s best for your CSA depends on the cause of your condition. Treatments for CSA include:
- CPAP: CPAP forces air into your lungs, ensuring you always have the oxygen you need, even if your body stops breathing. However, under some conditions, CPAP can worsen central sleep apnea and may not ensure you are getting enough air.
- CPAP variations: When standard CPAP is not giving good results for your CSA, variations in the treatment might work better for you. A basic variation is BiPAP (bilevel positive airway pressure), which uses two pressure levels to mimic and encourage normal breathing patterns. Adaptive servo-ventilation (ASV) uses an even more advanced method to constantly vary the air pressure to encourage more consistent breathing. In addition, your doctor might recommend supplemental oxygen.
- Treatment of medical conditions: When CSA is linked to medical conditions, sometimes treating those conditions can improve your sleep apnea.
- Adjusting medications: If medications are causing your central sleep apnea, your doctor might adjust your prescription. Changing the type of medication or the dosage might reduce the severity of your CSA.
- Returning to a lower altitude: If your CSA occurred because of high-altitude sleeping, it would normally resolve after returning to a lower altitude, though it may take several weeks.
- Phrenic nerve stimulation: This treatment stimulates the nerve that carries the signals to your breathing muscles. Phrenic nerve stimulation is not the same as Inspire, which treats obstructive sleep apnea by stimulating the muscles that hold your airway open. Phrenic nerve stimulation is considered an investigational treatment. While preliminary data is promising, most insurance will not cover this treatment approach.
Central sleep apnea can be more difficult to treat than obstructive sleep apnea, and it may take several tries before you find a treatment that works for you.
Relief from Central Sleep Apnea in Omaha
At the Advanced Dental Sleep Treatment Center in Omaha, Dr. Melissa Sheets helps patients get the sleep they need to live a healthy, long life. If we cannot treat your condition, we can refer you to someone who can. Please call (402) 493-4175 or use our online form today to request an appointment at the Advanced Dental Sleep Treatment Center in Omaha.
