What You Need To Know About Central Sleep Apnea

What is central sleep apnea?

Central sleep apnea is a breathing problem that occurs while you're asleep. There are a few different types of sleep apnea, but central sleep apnea has a few distinct characteristics that set it apart from other similar disorders.

First, it's important to define central sleep apnea, so you know exactly what the disorder entails. From there, it will be easier to see how central sleep apnea is different from other types of sleep apnea.

Defining central sleep apnea

Sleep apnea occurs when your breathing repeatedly stops and starts while you are asleep. There are a few different causes for this in different types of sleep apnea. When someone has central sleep apnea, the patient stops breathing because their brain fails to send the proper signals to their muscles for them to breathe properly.

How is central sleep apnea different from other types of sleep apnea?

There are three different types of sleep apnea, each with their own defining characteristics. Here's a brief overview of each type and what makes each of them unique:

Obstructive sleep apnea

Obstructive sleep apnea happens when there's something physically blocking your airway. In most cases, your throat muscles and tongue relax too much during sleep, blocking the airflow to your lungs. 

Central sleep apnea

Central sleep apnea differs from obstructive sleep apnea because there is nothing that is actually blocking your breathing. Instead, it is a communication problem between your brain and your muscles. 

Treatment-emergent central sleep apnea (formerly known as complex sleep apnea)

In this disorder, the patient appears to have obstructive sleep apnea, but when the obstructive sleep apnea is treated, there is still a persistence or emergence of central sleep apnea.

Other related conditions

Symptoms

The first step towards knowing if you have central sleep apnea is understanding your symptoms and how they differ from the symptoms of other sleep problems. It's important to be able to spot symptoms early so you know when to see a doctor before it becomes a more serious problem.

It's also important to remember that the symptoms of central sleep apnea may look similar to the symptoms of other medical conditions. Getting a proper diagnosis is the only true way to know if you have this disorder.

Different cases of central sleep apnea can vary in severity. Some patients may only wake up occasionally, while other patients may wake up as much as 100 times throughout the night.

What are the physical and emotional symptoms?

Central sleep apnea has both physical and emotional symptoms that can have a serious impact on your daily life. Some of the most common symptoms include:

Daytime sleepiness

In many cases, the periods of wakefulness during the night are so brief, you don't realize they happen. But when you are waking up multiple times during the night, it's impossible for your brain to reach the deepest parts of your sleep cycle. This means that even though it seems like you may have gotten a full night of sleep, you are actually sleeping very poorly. Daytime sleepiness and excessive fatigue are classic symptoms of sleep apnea.

Waking up short of breath

During episodes of sleep apnea, you may wake up gasping for breath. However, some people fall right back to sleep without noticing anything.

Insomnia

Some people with central sleep apnea may have trouble staying asleep at night. You may wake in the middle of the night, unable to get back to sleep.

Difficulty concentrating during the day

When your brain doesn't get enough sleep at night, it can be difficult to focus on anything during the day, especially complex problems at work or school. If you are having issues concentrating on your job or schoolwork, it could be a symptom of central sleep apnea.

Mood changes

You know that when you miss out on sleep, you don’t wake up in the best mood. Now imagine losing sleep night after night. After a while, you may start feeling depressed, hopeless, or unhappy.

Snoring

Snoring is more commonly a symptom of obstructive sleep apnea than central sleep apnea. However, it can occur in some cases of central sleep apnea, although it’s usually not as prominent.

Headaches upon waking

A lack of oxygen upon waking can lead to headaches from the moment you wake up.

Remember, this is not an exhaustive list of the signs and symptoms of central sleep apnea. It’s important to see your doctor if you have any sleep concerns.

What are the complications of having central sleep apnea?

Getting plenty of sleep is one of the most important things you can do for your health because if you fail to get quality sleep, your health is likely to suffer. Due to this and other factors, central sleep apnea can have some serious complications, including a greater risk of certain health problems like:

  • High blood pressure

  • Heart problems like heart attacks, an irregular heartbeat, or heart failure

  • Strokes

  • Diabetes

  • Obesity

While not everyone who has central sleep apnea will have these complications, it's best to seek treatment right away to avoid the risk of these dangerous complications.

Not sure if you have sleep apnea? Learn more about the signs and symptoms.

Causes

Getting diagnosed with sleep apnea can be life-changing. If you think you may be at risk for developing sleep apnea, knowing the risk factors and causes of the disorder can help you make smarter decisions about your health.

Certain people are more likely to develop central sleep apnea throughout the course of their lives. Keep on reading for potential causes of central sleep apnea, and the factors that may put you at risk in the future.

What are the known or suspected causes of central sleep apnea?

There are a few different types of central sleep apnea that are caused by different factors.  Here are a few things that may cause central sleep apnea:

Opioid use — opioid medications like codeine, morphine, and oxycodone can slow your breathing or affect your breathing patterns

High altitude — the air becomes thinner at higher altitudes. People may have trouble breathing at altitudes above 8000 feet, which can contribute to central sleep apnea.

Positive airway pressure — people with obstructive sleep apnea are often prescribed positive airway pressure in the form of CPAP or BIPAP machines. A small percentage of the people who use these treatments develop central sleep apnea.

Other medical conditions — conditions like heart failure, strokes, or Parkinson's can lead to central sleep apnea.

Cheyne-Stokes breathing — in around half of central sleep apnea cases, the patient will have cycles where breathing speeds up, slows, stops, and then restarts. These cycles can last between 30 seconds and two minutes.

Sometimes central sleep apnea may develop for no reason and no clear cause. This is often referred to as idiopathic central sleep apnea.

Keep reading to find everything you need to know about the causes of sleep apnea.

What are the risk factors for developing central sleep apnea?

There are a few medical conditions that theoretically may be linked with sleep apnea. If you have one of the below medical conditions, you may be at a greater risk of developing sleep apnea.

  • Congestive heart failure

  • Hypothyroidism

  • Kidney failure

  • Certain neurological conditions, like Parkinson's disease, Alzheimer's, and amyotrophic lateral sclerosis (ALS)

  • Brainstem damage due to brain injuries, strokes, or swelling.

There may be other unknown risk factors that are still not understood by medical professionals. If you have any concerns about your personal risk for central sleep apnea, talk to your doctor.

Statistically, who is most likely to develop central sleep apnea?

Anyone can develop any type of sleep apnea at any point in their lives. Statistically, however, people over the age of 65 are more likely to develop the condition, and men are more likely to be diagnosed than women.

With that in mind, it can be said that men over the age of 65 are statistically most likely to develop central sleep apnea.

Diagnosis

Sleep apnea is diagnosed by a doctor or other medical professional. To get a diagnosis, you'll likely need to go through testing. Your doctor will give you a physical exam, ask about your health history, and will probably recommend a sleep study.

Sleep apnea is diagnosed with a special sleep study called a polysomnogram (PSG). During this test, you'll usually have to spend the night in a lab where your sleep can be closely monitored.

A specialist will track your breathing, heart rate, airflow, oxygen rate, and more. After the study, you'll be able to learn if you have central sleep apnea and if you do receive a diagnosis, how severe your case is.

Treatments

A central sleep apnea diagnosis may be scary at first, but luckily, this disorder can be treated by a medical professional. Many people with central sleep apnea are able to live a normal life.

First, it's important to rule out any medical conditions that may be causing your central sleep apnea. Sometimes an underlying medical condition is at fault, and treating that condition will relieve your symptoms. Properly treating any underlying causes is the first step. Once those are ruled out, there are several other treatment options available.

How is central sleep apnea generally treated?

First, it's important to avoid using alcohol or any opioid medications before sleeping, as these drugs can slow your breathing to dangerous levels. If you're prescribed opioid medications, talk to your doctor about alternatives.

CPAP machine

A continuous positive airway pressure (CPAP) machine can help alleviate breathing problems for all types of sleep apnea. When using this machine, you wear a mask that forces a pressurized stream of air through your nose and mouth to ensure that you continue breathing throughout the night.

In some cases, adaptive servo-ventilation (ASV) machines and bilevel positive airway pressure (BPAP) machines are alternatives to CPAPs.

Remede System

In severe cases of central sleep apnea, your doctor may recommend getting a Remede System implanted under your skin in your chest. This device functions similarly to a pacemaker, but instead of regulating your heartbeat, it regulates your breathing and will stimulate your diaphragm when your breathing stops.

Are there any proven natural remedies or lifestyle changes that can help?

The best way to treat central sleep apnea is to see your doctor, as there aren't currently any proven natural remedies to treat this condition. This is especially true if your condition is severe.

Sometimes, sleeping in a different position can help, though this is more likely to help those with obstructive sleep apnea. Making healthy lifestyle changes like losing weight and getting plenty of exercise can also make a difference for some people.

Find natural techniques and remedies to help manage sleep apnea here.

However, it's not a good idea to try to treat central sleep apnea by yourself. It's always recommended that you consult with a medical professional before trying any kind of treatment, both medical and natural.

Prevention

If you are at risk for developing central sleep apnea, you may be wondering if there's anything you can do to prevent a future diagnosis. There are many things that may increase your risk for developing central sleep apnea and it can be difficult to avoid them all, especially if you have a genetic predisposition for any of the risk factors.

Can central sleep apnea be prevented?

There is nothing you can do to totally eliminate your risk of central sleep apnea. However, it’s always a smart idea to live as healthy a lifestyle as possible by staying active, eating a healthy diet, and getting regular checkups from your doctors.

Maintaining a healthy lifestyle as you age is the best thing you can do to help prevent the most serious medical conditions that may develop over time, including central sleep apnea. Talk to your doctor about how to reduce your risk for disease as you get older.

Doctors & specialists

Only a doctor or medical professional can make a central sleep apnea diagnosis. If you display any of the symptoms of this disorder, it's best to seek medical treatment right away. There are a few different types of doctors and specialists who can best diagnose and treat central sleep apnea.

Start by seeing your primary care doctor. They will be able to give you more information and refer you to the right kind of specialist.

Which types of doctors and specialists diagnose central sleep apnea?

While your primary care physician is a great place to start, they may not be able to properly diagnose your central sleep apnea. Sleep specialists, neurologists, or even ear, nose, and throat doctors are more used to seeing sleep apnea cases and maybe your best bet for receiving a diagnosis.

Which doctors treat it?

You can receive treatment from your primary care physician or a board-certified sleep specialist. The preferred treatment is usually a CPAP machine, but some people find these uncomfortable or difficult to sleep with. Your doctor can help you find a solution that works for you and your current lifestyle.

FAQs

While there is a lot of helpful information on this page about central sleep apnea, it's normal to have questions. If you think you may be at risk for central sleep apnea or you think you may even have it, you may still be wondering about certain aspects of this disease.

We’ll take a look at some of the most commonly asked questions about central sleep apnea below.

What's the difference between central and obstructive sleep apnea?

Obstructive sleep apnea is the most common form of sleep apnea. When a person has obstructive sleep apnea, their tongue and muscles in their throat relax too much during sleep, blocking their airway, and causing their breathing to stop for short periods of time.

While the symptoms are similar to those of central sleep apnea, the cause is totally different. In central sleep apnea, breathing problems are caused by a lack of communication between the brain and the muscles that control your breathing.

Is central sleep apnea common?

Central sleep apnea is less common than obstructive sleep apnea. It’s pretty rare to be diagnosed with central sleep apnea. In fact, it occurs at a rate of less than one percent of adults who are at least 40 years old.

Still, thousands of people have received this diagnosis. Luckily, it can be treated, and people living with central sleep apnea can continue to live a healthy, productive life despite this condition.

What makes central sleep apnea worse?

Since central sleep apnea is less common and not as much research has been done compared to obstructive sleep apnea, it can be more difficult to diagnose and treat.

Clinical trials for central sleep apnea

Actively recruiting
Studying an Investigational Weight Loss Medication
Actively recruiting
Studying an Investigational Weight Management Treatment
Actively recruiting
A randomized controlled trial assessing the combined effect of acetazolamide and oxygen therapy as a novel treatment for sleep apnoea.

Medications for central sleep apnea