Central Sleep Apnoea: Types, Symptoms, Causes, Diagnosis, & Treatment

Does your partner often complain about having to put up with your loud snoring?

Chances are you are suffering from central sleep apnoea or CSA. Notwithstanding how intimidating the term sounds, CSA is one of the several sleep disorders that are easily curable and should not be a cause for much headache.

How you can prevent it from becoming a literal headache, however, is by having a thorough knowledge of this sleep disorder and by opting for the necessary treatment.

Keep scrolling to know more!

Central sleep apnoea is a condition that comprises sleep-related breathing disorders. Individuals who are suffering from this sleep disorder experience periods of breathlessness throughout their sleep duration, disrupting their slumber and leading to sleep deprivation.

Often mistaken for obstructive sleep apnoea for the overlapping symptoms, CSA is different from the former in terms of the disorder’s root cause. While obstructive sleep apnoea is primarily a result of blockages in the respiratory passages, the latter results from poor neurotic coordination between the brain and the respiratory muscles.

In fact, central sleep apnoea is a lot less common than OSA.

CSA can manifest in different manners across individuals. The few of the CSAs are classified below based on their causes and features are -

1. Congenital Central Hypoventilation Syndrome (CCHS)

This constitutes a genetic condition that primarily onsets in newborns and infants, where the brain fails to signal effectively for breathing during sleep time.

2. Narcotic-Induced Central Sleep Apnoea

In this condition, the usage of narcotics like opioids disrupts the brain’s functioning in terms of breathing initiation and regulation.

3. Central Sleep Apnoea Related to Neuromuscular Disease

Weakness of the respiratory muscles due to conditions such as multiple sclerosis or amyotrophic lateral sclerosis (ALS) often results in this type of sleep disorder.

4. Central Sleep Apnoea Due to a Medical Condition

Conditions such as trauma, tumour, or stroke, affecting the brain stem responsible for breathing regulation, result in this category of sleep apnoea.

5. Altitude-Induced Periodic Breathing

Those travelling to places at higher altitudes, above 8000 feet, for instance, may face this type of sleep disorder due to reduced oxygen concentration in the air.

6. Cheyne-Stokes Breathing

The type of central sleep apnoea arising in patients with heart conditions, such as atrial fibrillation and heart failure, is called Cheyne-Stokes breathing. This sleep disorder involves a combination of rapid, deep and shallow breaths followed by long pauses.

7. Idiopathic Central Sleep Apnoea

When there is no identifiable cause behind CSA, it is classified as idiopathic central sleep apnoea.

8. Treatment-Emergent Central Sleep Apnoea

Individuals embarking on Continuous Positive Airway Pressure (CPAP) treatment to cure obstructive sleep apnoea often start experiencing this type of CSA sometime later. Previously distinguished as complex sleep apnoea, treatment-emergent CSA often goes away on its own.

Once you have a decent understanding of central sleep apnoea and its types, it is important to note its common symptoms to help identify this sleep disorder early on.

Some of the common signs and symptoms that most patients of CSA report observing are as follows:

• Abnormal breathing patterns or periods of breathlessness during sleep
• Snoring
• Waking up at sudden intervals, experiencing shortness of breath at the same time
• Difficulty swallowing
• Restlessness and mood swings
• Lack of focus
• Morning headaches
• A numbing sensation throughout the body
• Changes in voice and speech pattern
• Secondary sleep disorders, such as insomnia and hypersomnia

In case you have been observing one or several of these symptoms, you might be wondering about the causes of the same.

Worry not! We have got you covered on that front as well.

For those wondering what causes central sleep apnoea, this sleep disorder mainly occurs as a result of some other health conditions. These include:

• Heart attack
• Encephalitis
• Stroke
• Cervical spine arthritis
• Congestive heart failure
• Radiation treatment or surgery in the spine
• Parkinson’s disease

Now that you are fully aware of the causes of central sleep apnoea, let’s find out who is at risk of developing the same.

Besides knowing the reasons that can lead to the occurrence of CSA, you must also watch out for the factors that can put you at an increased risk of developing this condition. 

Some of these risk factors are listed below -

• Pre-existing health conditions such as heart disorders and conditions affecting the brain stem
• Consumption of specific medications, such as codeine, oxycodone, and morphine, among others
• Age; i.e., adults above 60 years of age are more prone to developing medical conditions that can interfere with their sleep.

If you find yourself in the above risk groups and are already suffering from sleep-related issues, it is important to get yourself diagnosed at the earliest.

Following are a few ways in which healthcare professionals perform a diagnosis of central sleep apnoea.

• Polysomnography

The primary in-lab test that is used to confirm a case of central sleep apnoea is polysomnography. This is an in-depth sleep study conducted overnight, during which an individual needs to wear electrodes on his or her body and head, aiding in measurements of lung function, oxygen levels, breathing pattern, brain activity, eye movement activity, heart rate, and muscle activity.

• Echocardiogram

This test uses sound waves to generate images of the heart, in which any issue related to this organ can be identified.

• MRI Scan

An MRI scan of the neck, spine, and brain involves the application of radio waves to generate these organs’ images. As a result, any structural abnormalities causing CSA can be identified from these tests.

Besides, doctors prescribe specific blood tests to determine other underlying causes leading to central sleep apnoea.

Once diagnosed with this sleep disorder, individuals must undertake the required treatment procedure to avoid developing further complications.

If you are wondering how to treat central sleep apnoea, addressing the underlying causes is the primary solution.

Some treatment procedures that doctors use to help regulate respiratory function are as follows:

• Continuous Positive Air Pressure (CPAP)

Although primarily employed as a method to treat obstructive sleep apnoea, CPAP also works wonders for those with CSA. In this method, individuals need to wear a mask covering their mouth and nose that will ensure a steady supply of pressurised air to their airways to regulate breathing.

• Adaptive Servo-ventilation (ASV)

Adaptive Servo-ventilation constitutes a digital system that monitors a patient’s breathing pattern during their sleep and feeds the data into a system of pressurised air to streamline the respiratory process during this time.

• Bi-level Positive Air Pressure (BPAP)

Like CPAP, this treatment procedure also requires a patient to wear a face mask, via which the system adjusts the air pressure to a lower level when you breathe out and to a higher level when you breathe in.

• Medication

Your healthcare professional may also prescribe you copulations of acetazolamide to bring your respiratory mechanism on track.

Not opting for any form of treatment for prolonged periods of CSA can lead to further complications, including cardiovascular problems. At the same time, you should not opt for any of the above treatment methods without properly consulting a medical professional.

Now that you know how to cure central sleep apnoea, you may be curious if there is any way to prevent this condition in the first place. However, there are no specific measures that you can take to keep yourself from developing this sleep disorder in the first place. An indirect way is to check the habits or conditions that might give rise to the underlying causes of CSA.

The previously discussed causes and symptoms of central sleep apnoea will, hopefully, help you identify this condition in its early stages, if present. Accordingly, you can proceed with getting a diagnosis and suitable treatment options to help yourself lead an overall better life.