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A.D.A.M. Medical Encyclopedia. Atlanta (GA): A.D.A.M.; 2011.

A.D.A.M. Medical Encyclopedia.

Central sleep apnea

Last reviewed: August 5, 2011.

Central sleep apnea is when you repeatedly stop breathing during sleep because the brain temporarily stops sending signals to the muscles that control breathing.

See also:

• Obstructive sleep apnea

• Sleep disorders

Causes, incidence, and risk factors

Central sleep apnea often occurs in people who have certain medical conditions. For example, it can develop in persons who have life-threatening problems with the brainstem, which controls breathing.

Conditions that can cause or lead to central sleep apnea include:

• Arthritis and degenerative changes in the cervical spine or the base of the skull

• Bulbar poliomyelitis

• Complications of cervical spine surgery

• Encephalitis affecting the brainstem

• Neurodegenerative illnesses such as Parkinson's disease

• Obesity

• Radiation of the cervical spine

• Stroke affecting the brainstem

• Primary hypoventilation syndrome

• Use of certain medications such as narcotic-containing painkillers

A form of central sleep apnea commonly occurs in people with congestive heart failure.

If the apnea is not associated with another disease, it is called idiopathic central sleep apnea.

Central sleep apnea is not the same as obstructive sleep apnea, which is due to a blockage in the airway.

A condition called Cheyne-Stokes respiration can mimic central sleep apnea. This involves breathing to a variable depth, usually while sleeping.

Symptoms

Persons with central sleep apnea have episodes of disrupted breathing during sleep.

Other symptoms may include:

• Chronic fatigue

• Daytime sleepiness

• Morning headaches

• Restless sleep

Other symptoms may occur if the apnea is due to a neurological condition. Symptoms depend on the underlying disease and what parts of the nervous system it has affected, but may include:

• Difficulty swallowing

• Voice changes

• Weakness or numbness throughout the body

Signs and tests

The health care provider will perform a physical exam. Tests will be done to diagnose an underlying medical condition. A sleep study (polysomnogram) can confirm sleep apnea.

Other tests that may be done include:

• Echocardiogram

• Lung function studies

• MRI of the spine or neck

Treatment

Oxygen, nasal CPAP, or bilevel positive airway pressure (BiPAP) may be used for some types of central sleep apnea.

Some types of central sleep apnea are treated with drugs that stimulate breathing.

Patients should avoid the use of any sedative medications.

If central sleep apnea is due to heart failure, the goal is to treat the heart failure itself. See: Heart failure

Expectations (prognosis)

How well a patient does depends on the medical condition causing the central sleep apnea.

The outlook is usually favorable in those with idiopathic central sleep apnea.

Complications

Complications may result from the underlying disease causing the central sleep apnea.

Calling your health care provider

Call your health care provider if you have symptoms of sleep apnea. Central sleep apnea is usually diagnosed in patients who are already severely ill.

References

1. Eckert DJ, Jordan AS, Merchia P, Malhotra A. Central sleep apnea: pathophysiology and treatment. Chest. 2007;131:595-607.
2. Malhotra A. Disorders of ventilatory control. In: Goldman L, Schafer AI, eds. Cecil Medicine. 24th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 86.
3. Pien GW, Pack AI. Sleep disordered breathing. In: Mason RJ, Broaddus VC, Martin TR, et al, eds. Murray and Nadel’s Textbook of Respiratory Medicine. 5th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 79.

Review Date: 8/5/2011.

Reviewed by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Denis Hadjiliadis, MD, Assistant Professor of Medicine, Division of Pulmonary, Allergy and Critical Care, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

What works?

• Treating Sleep Apnea: A Review of the Research for Adults A doctor said you have mild, moderate, or severe “obstructive sleep apnea," or OSA. People with OSA may snore and stop (or “pause") their breathing a few or many times when they sleep.

Learn about...

• Making smart health choices Develop the skills to assess health advice and make better-informed decisions about your health and managing illness.

Read More

• Obstructive sleep apnea
• Encephalitis
• Stroke

• Sleep Apnea

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