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    Central sleep apnea

    Sleep apnea - central

    Central sleep apnea is a sleep disorder in which breathing stops over and over during sleep.

    Causes

    Central sleep apnea results when the brain temporarily stops sending signals to the muscles that control breathing.

    The condition often occurs in people who have certain medical problems. For example, it can develop insomeone who hasa problem with the brainstem, which controls breathing.

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

    • Problems that affect the brainstem (the brainstem controls breathing) including brain infection, stroke, or conditions of the cervical spine (neck)
    • Parkinson disease
    • Obesity
    • Certain medicines,such as narcotic painkillers
    • Heart failure

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

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

    Central sleep apnea is not the same as obstructive sleep apnea. With obstructive sleep apnea, breathing stops and starts because the airway is narrowed or blocked. But a person can have both conditions, such as with a medical problem called obesity hypoventilation syndrome.

    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 problem with the nervous system. Symptoms depend ontheparts of the nervous system that are affected,and may include:

    • Swallowing problems
    • Voice changes
    • Weakness or numbness throughout the body

    Exams and Tests

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

    Other tests that may be done include:

    • Echocardiogram
    • Lung function
    • MRI of the spine or neck

    Treatment

    Treating the condition that is causing central sleep apnea can help manage symptoms. For example, if central sleep apnea is due to heart failure, the goal is to treat the heart failure itself.

    Devices used during sleep to aid breathing may be recommended. These include nasal continuous positive airway pressure (CPAP), bilevel positive airway pressure (BiPAP) or adaptive servo-ventilation (ASV). Some types of central sleep apnea are treated with medicines that stimulate breathing.

    Oxygen treatment may help ensure the lungs get enough oxygen while sleeping.

    If narcotic medicine is causing the apnea, the dosage may need to be lowered or the medicine changed.

    Outlook (Prognosis)

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

    The outlook is usually favorablefor personswith idiopathic central sleep apnea.

    Possible Complications

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

    When to Contact a Medical Professional

    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

    Aurora RN, Chowdhuri S, Ramar K, et al. The treatment of central sleep apnea syndromes in adults: practice parameters with an evidence-based literature review and meta-analyses. SLEEP. 2012;35:17-40.

    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: Elsevier Saunders; 2010:chap 79.

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                Review Date: 7/20/2013

                Reviewed By: Denis Hadjiliadis, MD, Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

                The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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