Central Sleep Apnea

  • Central sleep apnea is much less common than obstructive sleep apnea, but is prevalent in premature babies and people with heart failure
  • The brain does not send the signals to continue the normal cycle of breathing resulting in apnea (pauses in breathing) and then rapid breathing to recover

Overview of Central Sleep Apnea

There are areas of the brain that monitor levels of carbon dioxide (waste gas) and oxygen in the blood and keep them at an appropriate level by changing the rate and depth of breathing. However, people with central sleep apnea have a problem with these signals and during sleep breathing slows or stops, allowing carbon dioxide to build up and oxygen levels to drop. Unlike obstructive sleep apnea there is no attempt to breathe or the gasping associated with the throat blockage. Eventually the person starts to breathe again, usually at an increased rate to clear the carbon dioxide and increase the oxygen content. The cycle then starts again. In severe central sleep apnea this occurs more than 30 times an hour.

Symptoms of Central Sleep Apnea

These include:

  • Frequent silences during sleep due to breaks in breathing (apnea) followed by rapid breathing
  • A lack of choking, gasping, or chest movements during pauses of breath (the opposite of obstructive sleep apnea)
  • Parts of the body with lots of blood flow near the surface can take on a bluish tinge as the blood changes color with the lack of oxygen

These symptoms are often noticed first by a parent or bed partner. The effects of central sleep apnea are similar to overdoses of respiratory depressants like heroin or even alcohol (in large enough quantities). Consequently, anybody with central sleep apnea should avoid these drugs – sudden death could occur as the stimulus to start breathing again may never be given.

Causes of Central Sleep Apnea

Breathing is controlled by the lower brain stem. Injury, disease, or structural abnormalities that affect this and surrounding areas can cause central sleep apnea. Examples include encephalitis and damage to the cervical spine. Premature babies are prone to central sleep apnea because they have not reached the developmental stage where breathing is normal. Heart failure has also been shown to cause central sleep apnea.

Treatment for Central Sleep Apnea

Treatment involves understanding the cause of the deficiency in the brain and treating that. If diagnosis or treatment of the problem is not possible, oxygen at night may be administered as well as drugs that stimulate breathing. If you believe you may suffer from any type of sleep apnea, talk to your doctor or sleep specialist.