Okay, we have gone over obstructive sleep apnea, OSA, time and time again. I think we have beaten that horse enough times and we have a pretty good understanding of that it is. At this point, are you able to explain what central sleep apnea is? I have touched on it briefly, but haven’t gone in to much detail. Do you remember what was discussed, and what the difference is between central and obstructive sleep apnea is? Let’s review, shall we?
According to Mayoclinic.com, OSA is when, “your throat muscles intermittently relax and block your airway during sleep” causing you to repeatedly stop and start breathing. CSA is a little scarier than OSA. “Central sleep apnea occurs because your brain doesn’t send proper signals to the muscles that control your breathing. This condition is different from obstructive sleep apnea, in which you can’t breathe normally because of upper airway obstruction.” It is often seen that patients who suffer form CSA suffer from OSA as well; while the OSA is being treated, it is throughout that time period that CSA is ‘discovered.’
Central sleep apnea pretty much has the same causes as OSA (like fatigue and snoring), and then some as well (cardiovascular or neurological problems). Mayo Clinic says, “Central sleep apnea can be caused by a number of conditions that affect the ability of your brain stem – which links your brain to your spinal cord and controls many functions such as heart rate and breathing – to control your breathing. The cause varies with the type of central sleep apnea you have.”
There are a few different types of CSA: Cheyne-Stokes breathing, drug –induced apnea, high-altitude periodic breathing, complex sleep apnea, and medical condition-induced central sleep apnea. Cheyne-Stokes breathing is a type of CSA that is usually caused by congestive heart failure or stroke. “There is a gradual increase and then decrease in breathing effort and airflow. During the weakest breathing effort, a total lack of airflow (CSA) can occur.” Drug-induced apneas are caused when the patient takes certain medications – something such as opioids of codeine sulfate. The drugs cause the patients breathing to become irregular, and can even lead to a complete stop in the breathing. High altitude affects the way you breathe, but this is the easiest CSA to ‘cure’ – once you return to a lower altitude, or an altitude that you are accustomed with, your breathing should also return to normal. Complex sleep apnea is a mixture of OSA and CSA; this particular type of sleep apnea develops while using a CPAP machine to treat OSA. Medical condition-induced central sleep apnea is basically how it sounds – some sort of medical condition increased the amount of CSA’s a patient experiences.
After a through sleep study to determine if a patient is indeed suffering from CSA, treatment is determined – usually it is determined by the cause. Some remedies include reducing opioid medication or using a CPAP or BiPAP machine. Another alternative is suing an adaptive servo-ventilation machine (ASV). Mayo Clinic says, “If CPAP hasn’t effectively treated your condition, you may be given ASV. Like CPAP, ASV also delivers pressurized air. Unlike CPAP, ASV adjusts the amount of pressure during inspiration on a breath-by-breath basis to smooth out the breathing pattern. The device may also automatically deliver a breath if you haven’t taken a breath within a certain number of seconds.” If CSA is caused by say a neurological problem, then treatment is a little harder to come by as there is an underlying cause. However, according to sleepapnea.org, if there is treatment available for the underlying cause then the CSA is usually treated as well.
There is so much information that encompasses CSA that it’s hard to cover it all in one posting, but it is good to be informed. These are just some of the basics that I learned myself while writing this post. It is pretty scary thinking that at one point in another we need assistance with something so natural like breathing, but with the right information we are able to learn about and how to accept the help that we need.
For more information on CSA, please see:
https://www.mayoclinic.org/diseases-conditions/central-sleep-apnea/symptoms-causes/syc-20352109
https://www.sleepapnea.org/learn/sleep-apnea/central-sleep-apnea/
For more information on OSA and CSA machines, supplies, etc., please see:
www.cpapoffice.com