Central Sleep Apnea, Factors, Symptoms, and Snoring

Central sleep apnea is a sleep disorder characterized by episodes of cessation of respiration while sleeping. The brain, being part of the central nervous system, fails to send the proper messages to the muscles involved in breathing, causing reduced respiratory effort. Central sleep apnea is not as common as other sleep apneas as is counted as less than five percent of all the sleep apneas combined.

Factors of Central sleep apnea include:

• Heart failure


• Stroke.


• Sleeping at a high altitudes

Treatments for this disorder focus on maintaining the airway, which may involve the use of a device or oxygen supplementation.

Symptoms may include:

• Observed episodes of stopped breathing or abnormal breathing patterns during sleep


• Suddenly awake with shortness of breath, relief brought on by sitting upright


• Insomnia- inability to go to sleep and staying asleep


• Hypersomnia - sleepy during the day


• Reduced concentration


• Snoring

Snoring indicates there is some type of obstruction present. This is usually caused by:

• Enlarged tonsils and/or adenoids


• Excessive tissue in the throat


• Loss of tone in the throat muscles


• Increased weight


• Use of alcohol


• Certain medications

Snoring may or may not be present with central sleep apnea as it is with obstructive sleep apnea. If you are always feeling overly tired during the day and irritable for no apparent reason,you should consult your physician as soon as possible. Any type of sleep apnea is a dangerous disorder that requires medial intervention.

Excessive daytime drowsiness (hypersomnia) an also be due to narcolepsy or obstructive sleep apnea syndrome (OSAS). Narcolepsy is marked by falling asleep anytime, anywhere, even in the middle of a sentence or while driving. The person who suffers from disorder has no control over it.

Causes of central sleep apnea:

Idiopathic central sleep apnea: Repeated pauses in breathing effort and airflow.

Cheyne-Stokes respiration: Seen mostly in with congestive heart failure or stroke, and is a rhythmic, gradual increase and then decrease in breathing effort and airflow. During the weakest breathing effort, resulting in a total lack of airflow.

Medical condition induced apnea: Brain stem damage. The brain stem is responsible for controlling breathing.

Exposure to high altitudes: Altitude higher than 15,000 feet and accompanying changes in barometric pressure can cause respiratory difficulty, such as hyperventilation (rapid breathing).
Medications: Opioids such as morphine, oxycodone, or codeine can cause decreased respiration

Risks:

• Gender - Males more likely to develop this disorder than females.


• Heart disorders - Such as atrial fibrillation and congestive heart failure


• Stroke or brain tumor - Reduces the brain's ability to control breathing


• High altitudes


• Taking opioids

Complications:

Cardiovascular problems: Sudden drops in blood oxygen levels can put undue strain on the heart.

Daytime fatigue: Central sleep apnea can result in excessive sleepiness, fatigue, and irritability, as well as difficulty concentrating at work or at the wheel.

Testing for this sleep disorder includes:

• Nocturnal polysomnography - Monitors heart, lung and brain activity, breathing patterns, arm and leg movements, and blood oxygen levels.


• oximetry - monitors and records your blood oxygen level


• cardiorespiratory testing - Measures airflow and breathing patterns.


• Arterial blood gas testing (ABG) - Measures blood oxygen and carbon dioxide levels

Treatment:

• Treat other underlying medical problems


• Reduction of opioid medications.


• Supplemental oxygen


• Medications to stimulate respiration, such as acetazolamide


• Continuous positive airway pressure (CPAP).


• Bilevel positive airway pressure (bilevel PAP).


• Adaptive servo-ventilation (ASV)

by Barb Hicks, RN