Central Sleep Apnea: The Less Common Apnea Type That is Difficult to Diagnose

Types of Sleep Apnea

Central Sleep Apnea is far less common than Obstructive Sleep Apnea. Because the syndrome is rarer, it is not as easy to spot or to treat effectively. CSA may not be as commonly understood as OSA, but it is just as dangerous, if not more. Central apneas are negative products of the body’s most important organ- the brain.

What Exactly is Central Sleep Apnea?

Patients who suffer from the less common form of Sleep Apnea, Central Sleep Apnea, stop breathing while they are sleep because of malfunctions in the brain. There are centers in the brain that control respiratory functions. These neurological centers respond to changes in blood and carbon dioxide levels in the body, and are meant to keep them balanced.

What Causes Central Sleep Apnea? 

CSA is often considered more dangerous than OSA because the root of the problem is in the brain. Patients with CSA have no control over their brain functions and responses, so this type of apnea is much more complicated. Central apneas occur when the brain fails to adequately support the body’s respiratory system; it doesn’t respond to the system’s needs.

  • Poor Brain-Breath Communication:
    • Brain Malfunction: During an episode of CSA, the brain does not respond to carbon dioxide and blood level changes in the body quickly enough. Essentially, the centers of the brain that help us to breathe are not working to keep blood and carbon dioxide levels balanced and the body stops breathing.
    • Respiratory Response: The respiratory system only breathes when it receives messages from the brain telling it to do so. If the brain is not registering unhealthy levels of blood and carbon dioxide in the body, it is not telling the body to breathe and balance out the levels. Patients with OSA attempt to breathe but are not successful. Patients with CSA, however, make no attempt to breathe because they have not received instructions from the brain. During CSA, the entire respiratory system stops functioning.

How Can I Identify Central Sleep Apnea?

Because CSA is caused by deeply internal malfunctions, it is not easy to recognize. Very close attention must be paid in order to spot someone with Central Sleep Apnea. Oxygen deprivation is the easiest way to cause the brain and body damage, so it is important to be aware of CSA symptoms and how to recognize them. Some of the most important CSA symptoms to be aware of are impossible to recognize yourself, and are usually identified by the people or person you sleep nearest.

  • Silence: Snoring occurs in OSA when air is being pushed and pulled through an obstructed airway; the obstruction causes friction and vibrations that result in snoring. Breathing also creates sounds that are much quieter than snoring. Sound is one of the most useful identifiers for OSA sufferers, but silence is the key to identifying CSA. If you notice that someone is snoring, then they immediately stop snoring, and there are no accompanying noises, they may be having a CSA episode. Also, the sudden silence of breath can be an identifier of CSA.
  • Body’s Response: When breathing is interrupted, or it stops completely, the body naturally responds to its need for oxygen. After significant oxygen deprivation, the muscles of the lungs and chest will start to work harder in an effort to resume inspiration. Patients with CSA do not show a physical response to breath interruption; there is no struggle to resume the breathing process because the respiratory system is not receiving messages from the brain.
  • Trouble Swallowing: When a patient has a neurological disorder like CSA, it is likely that they experience other neurological disorders. Malfunctions in the brain affect all of the body’s muscle control, not just in the respiratory system. Problems that affect CSA can also affect a patient’s ability to swallow correctly because there are no messages from the brain that are telling the body to swallow.
  • Voice Changes: Nervous system functioning, or lack thereof, also controls the vocal muscles of the throat. Sudden changes in the sound or quality of your voice can be an indicator of CSA.
  • Other Common Symptoms:
    • Same as OSA: Many Sleep Apnea symptoms are experienced by people who suffer with all three forms of apnea. As well as OSA and CompSA, CSA sleep apnea sufferers can experience daytime sleepiness, general fatigue, a lack of concentration and focus, headaches in the morning, frequent nightly arousals, and changes in their mood.

What Kind of People Get Central Sleep Apnea?

CSA is relatively rare compared to OSA. People who suffer from CSA are extremely likely to have underlying problems that have caused them to develop CSA. Idiopathic Central Sleep Apnea is a form of CSA that is not caused by, or associated with, another disease.

  • Neurological Disorders: Neurodegenerative diseases often cause the development of Central Sleep Apnea. These diseases cause deterioration of the brain and nervous system and inhibit their ability to function correctly. Neurological disorders like CSA are often caused by neurodegenerative diseases like Parkinson’s disease, Alzheimer’s disease, and Amyotrophic Lateral Sclerosis which is also known as ALS and Lou Gehrig’s disease.
  • Brain Damage: Damage to the brainstem can cause CSA also. The brainstem controls breathing, and problems with this area of the brain can cause serious problems with breathing in persons both sleeping and awake. The brainstem can be damaged by stroke, injury, and encephalitis.
  • Spinal Complications: Damage done to the cervical spine, the base of the skull, can cause CSA. Degenerative bone disorders like arthritis can damage the cervical spine. Complications during surgery or radiation exposure can also cause the spine to degenerate.
  • Heart Problems: There is a form of CSA that most commonly occurs in people who experience problems with their heart, especially congestive heart failure. The heart experiences great stress with both CSA and congestive heart failure; people who suffer one are at risk for the other.
  • Other Factors:
    • Stress: Cortisol, also known as the stress hormone, is released in the body during intense situations; this hormone causes the feeling of stress and it also raises blood pressure. Hypertension, high blood pressure, is common among people who develop CSA.
    • Medications: Sedative medications can affect the brain’s ability to respond promptly to changes in the body. They can also affect the functioning and response of the respiratory system.
    • Age: Medical research shows that people over forty years of age are more likely to develop CSA.