Central Sleep Apnea Treatment Options, Symptoms and Causes
Having been trapped in the fog of low focus and daytime drowsiness in the past, I understand how frustrating it is to be afflicted by constant poor sleep. Good sleep is essential to living a well-rested, and happy life. Poor sleep, on the other hand, ruins personal productivity, upsets health and ultimately affects our happiness.
The good news is that there are usually solutions to our poor sleep; especially when the lack of sleep is due to sleep apnea.
In past posts, we’ve focused on obstructive sleep apnea causes, symptoms, and treatments. Today we’ll be talking about a different but similar type of sleep disorder; central sleep apnea.
In the next few quick moments, you will learn the following information:
– Central sleep apnea’s operating mechanism
– What causes central sleep apnea
– The seven main symptoms and risk factors of central sleep apnea
– The seven main central sleep apnea treatment options
As you can see, we’ve got a lot to cover, so let’s get started!
What is Central Sleep Apnea?
Central Sleep Apnea (CSA) occurs due to a miscommunication between the brain and the respiratory system. The brain “forgets” to signal the body to breathe, which leads to a pause in breathing. These pauses, when long and/or frequent enough, lead to involuntary awakening during the night.
Similar to obstructive sleep apnea, the patient usually does not realize that they have woken up. These sleep interruptions greatly affect sleep quality and lead to tiredness, drowsiness and other symptoms that most sleep apnea patients report.
It’s rather common to see cases where patients have both central and obstructive sleep apnea episodes while sleeping at night. When both classes of apneas are present, the patient has what’s called complex or mixed sleep apnea. Note that many people with sleep apnea esperience the occasional central sleep apnea episode during sleep. You need a certain number of central sleep apnea episodes per hour in order to be diagnosed with central or mixed sleep apnea.
Because of its neurological nature, some treatment options that effectively treat obstructive sleep apnea are not as effective when treating central sleep apnea. Still, many treatment options can treat both breeds of sleep apnea, even when they occur simultaneously.
What Causes Central Sleep Apnea?
Though the cause of central sleep apnea is sometimes unknown, there are several triggers that have been proven to cause central sleep apnea. In many of these instances, removing the causes will resolve central sleep apnea.
Air has less oxygen as you go increase atmospheric elevation. To compensate, your body usually breathes more rapidly while asleep. This can trigger Cheyne Stokes respiration, in which you alternate between rapid breathes and pauses in breathing. This breathing pattern ultimately produces central sleep apnea. Upon exiting high altitudes, CSA stops.
Consuming opioids, whether prescribed or not, can cause central sleep apnea. A few examples of common opioid medications include, Oxycodone, OxyContin, Vicodin, and morphine. Decreasing the dose or reducing the use of opioids all together can resolve CSA.
A small proportion of people using CPAP to treat their obstructive sleep apnea develop central sleep apnea.
Some of these cases occur due to excessively high CPAP pressures and can be resolved by properly adjusting the pressure delivered by the machine.
Underlying Medical Conditions
Medical conditions that affect the brainstem can ultimately alter the brains ability to communicate with the respiratory system. Examples of these conditions include strokes, heart attacks, congestive heart failure, encephalitis and Parkinson’s disease. However, keep in mind that having these conditions do not guarantee that central sleep apnea will be developed.
The Seven Main Central Sleep Apnea Symptoms
How do I know if I should get checked?
If you believe you might have central sleep apnea, check out the following list of symptoms. If you answer yes to two or more of these, contact your physician to schedule a sleep study.
1. Irregular breathing or breathing pauses while sleeping
2. Sudden awakening during the night accompanied by shortness in breathing
3. Excessive daytime sleepiness
4. Daytime fatigue
5. Morning headaches or chest pain
6. Difficulty concentrating
Some of these symptoms are indistinguishable from those caused by obstructive sleep apnea. A sleep study can reveal the presence of either category of sleep apnea.
Central Sleep Apnea Risk Factors
What can put me to at risk for CSA?
Some people may have a predisposition towards central sleep apnea depending on whether they meet certain risk factors.
The following risk factors do not guarantee the presence of central sleep apnea, but they have been correlated with a higher propensity toward having central sleep apnea:
1. People over the age of 60
2. Male gender
3. Presence of heart disorders
4. Past strokes or brain tumors
5. Sleeping at higher altitudes
6. Using opioid medications
The Top 7 Central Sleep Apnea Treatment Options
How do I treat central sleep apnea?
1. Continuous Positive Airway Pressure
CPAP is the number one option for treating all categories of sleep apnea. CPAP works by delivering room air through a mask to your mouth or nose at a constant pressure. The air delivered to the breathing airways help regulate breathing and compensate for the lack of oxygen during breathing pauses.
A CPAP machine can be purchased with an air humidifier and/or heater to prevent the symptoms that arise from inhaling cold dry air. Most insurance companies will cover the price of CPAP, though in some cases, you might save more money by purchasing the medical equipment online after obtaining a prescription from your doctor.
2. Bi-level Positive Airway Pressure
BiPAP operates very similarly to CPAP. The only difference between the former and the latter is that BiPAP alternates pressure setting depending on whether the patient is inhaling or exhaling. This helps maintain a regular breathing rhythm by delivering more air at specific intervals.
The effectiveness of both CPAP and BiPAP is around 95% for treating both sleep apneas. However, they have relatively poor compliance levels, around 54%, due to lack of mobility while sleeping and other factors.
3. Adaptive Servo-Ventilation
Adaptive Servo-Ventilation (ASV) stabilizes your breathing by delivering air to your airways through a mask. It calculates things like when the patient should be taking a breath and how much air should be taken in to deliver the correct amount of air to the patient at the right moment.
ASV makes breathing half as physically demanding, which helps with treating CSA. It can also help treat obstructive sleep apnea indirectly by delivering small amounts of air and keeping the airways open enough to avoid obstruction. That being said, this treatment may be harmful to patients with chronic heart failure. Consult with your doctor about using ASV if you fall in this group.
Some studies have shown that acetazolamide and theophylline have been used to successfully stimulate breathing in central sleep apnea patients. Ask your doctor to see if one of these medications can help heal your symptoms.
5. Addressing the underlying medical conditions
Central sleep apnea can be caused by underlying health problems. Finding the medical condition responsible for CSA and treating it will cause your apnea symptoms to disappear.
6. Reduce or stop opioid use and medications
Opioids have been shown to produce central sleep apnea. Working with your doctor to reduce opioid medication consumption when it is safe to do so can remove CSA.
7. The Remedē® System
The Remedē® system is new way of treating central sleep apnea. It consists of an implanted device that, through neural stimulation, helps regulate breathing while sleeping. It delivers electrical pulses while sleeping at night to restore regular sleeping patterns. It was created originally to improve cardiovascular health in CSA patients and alleviate the symptoms.
This treatment option allows for easy monitoring of its efficiency and effectiveness. That being said, this technology is not as popular as other treatment options. Ask your doctor to see if it would be appropriate for you.
I hope this helps clear up some of the questions or concerns you may have had about Central Sleep Apnea. If you have any questions about any other risk factors, symptoms, or treatment options that you might want to discuss, I encourage you to comment below!