Central Sleep Apnea

Central sleep apnea is a sleep-related breathing disorder in which breathing repeatedly stops and starts during sleep due to the brain failing to send proper signals to the muscles that control breathing. Unlike obstructive sleep apnea, this condition is not caused by airway blockage but by a problem in the central nervous system’s regulation of respiration. It can lead to disrupted sleep, reduced oxygen levels, and long-term health complications if left untreated.

Symptoms

Symptoms often develop gradually and may be noticed by a bed partner before the affected individual becomes aware.

• Repeated episodes of breathing pauses during sleep

• Sudden awakenings with shortness of breath

• Difficulty staying asleep or frequent nighttime awakenings

• Excessive daytime sleepiness

• Morning headaches

• Poor concentration or memory problems

• Fatigue or low energy throughout the day

• Mood changes such as irritability or depression

Causes

Central sleep apnea occurs when the brain does not properly regulate breathing during sleep. Several underlying conditions can contribute to this disruption.

• Disorders affecting the brainstem, such as stroke or brain injury

• Heart conditions, particularly heart failure

• Use of opioid medications that suppress breathing

• Neurological diseases affecting respiratory control

• High-altitude exposure leading to temporary breathing instability

• Idiopathic causes, where no clear reason is identified

Risk Factors

Certain factors increase the likelihood of developing central sleep apnea.

• Older age

• Male sex

• History of stroke or neurological disease

• Heart failure or other significant heart conditions

• Chronic use of opioid pain medications

• Sleeping at high altitudes

• Previous diagnosis of sleep-disordered breathing

Complications

Untreated central sleep apnea can have serious health consequences due to repeated oxygen deprivation and sleep disruption.

• Chronic daytime fatigue and reduced quality of life

• Increased risk of cardiovascular disease

• Worsening of heart failure

• High blood pressure

• Irregular heart rhythms

• Impaired cognitive function

• Increased risk of accidents due to daytime sleepiness

Prevention

While not all cases can be prevented, certain measures may reduce risk or severity.

• Managing underlying heart or neurological conditions

• Avoiding or carefully monitoring opioid medication use

• Maintaining a regular sleep schedule

• Limiting alcohol intake, especially before bedtime

• Following medical advice when traveling or living at high altitudes

• Regular follow-up and sleep evaluations for high-risk individuals

Central sleep apnea is a complex condition that requires medical evaluation and ongoing management. Early recognition and appropriate treatment can significantly improve sleep quality and reduce long-term health risks.