Many people don’t realize it, but there are two different forms of sleep apnea. The most common form and the one most people know about is obstructive sleep apnea (OSA), which is when something is blocking someone’s airway while they sleep, causing them to stop breathing for a few seconds.

The other form of sleep apnea is Central Sleep Apnea (CSA) which occurs when your body decreases your breathing or stops it altogether while you sleep. But what causes this to happen? This article will dive into CSA, its symptoms, risk factors, and treatment options.

What is CSA?

When you breathe, your brain sends signals to your diaphragm and the muscles in your rib cage to contract, causing you to inhale. If you have CSA, the muscles and the brain aren’t properly communicating. A problem in the heart or brain is typically the cause of CSA, but certain medications can also cause CSA.

There are five categories of CSA syndrome in adults.

  • Primary CSA occurs when there are multiple times per night when your body makes no effort to breathe. The cause of primary CSA is unknown. 
  • Cheyne-Stokes Breathing Pattern is rhythmic, and there is a steady increase in breathing followed by a decrease and sometimes no effort at all. Stroke, heart failure, and sometimes kidney disease can cause this type of CSA.
  • Medical conditions other than the heart or the kidneys can cause CSA. This can also be caused by a problem at the brain’s base, where your breathing is controlled.
  • Periodic breathing due to high altitudes occurs when one is sleeping at altitudes at or above 15,000 feet, and is similar to that of the Cheyne-Stokes breathing pattern. The difference is that if your CSA is caused by a high altitude, not a medical issue. The breathing issues typically resolve themselves as altitude decreases, and the time between breaths is usually shorter.
  • Drugs or other substances can cause someone’s breathing pattern to vary. For example, respirations can go from increasing to decreasing to completely irregular breathing. Opioids such as pain medications and illegal substances such as heroin are associated with CSA.

Symptoms of CSA

Your body wakes you up when you stop breathing while sleeping. It can happen so fast that you don’t even realize it, but you may stop breathing hundreds of times throughout the night. 

Here are some of the problems you may experience if you have CSA:

  • Waking up frequently throughout the night
  • Having problems falling asleep
  • Being sleepy throughout the day
  • Snoring
  • Pauses in your breathing
  • Being short of breath when waking up 

Not only can CSA affect your sleep, but so can any underlying medical conditions that cause CSA, so you may find yourself very sleepy throughout the day and even still feel tired after napping.

Risk Factors

Risk factors of CSA vary depending on the category.

  • Primary CSA – Risk factors are unknown. However, it is typically rare and is seen mainly in middle-aged people and the elderly. Men are also more affected than women, and it could be genetic. In addition, some neurological conditions, such as Parkinson’s disease and Multi-System Atrophy may increase your risk.
  • Cheyne-Stokes breathing pattern – Is seen mostly in men over 60, in men with chronic congestive heart failure, and men who have suffered a stroke. It doesn’t seem to be inherited, and women are rarely affected.
  • Medical conditions other than Cheyne-Stokes – A condition such as heart and kidney problems or abnormalities at the base of the brain (the part of the brain that regulates breathing) increases your risks.
  • Periodic breathing due to high altitudes – Men are more sensitive to changes in oxygen and carbon dioxide levels in their blood, making them more susceptible for problems. There is also a possibility that this category is hereditary. Sleeping at altitudes higher than 15,000 feet puts people at risk for this disorder, and anyone who sleeps above 25,000 feet will be affected.
  • Drugs or other substances – You are at risk if you take opioids and the longer you take opioids the greater your risk increases.

Treatment Options

PAP is the most common treatment for CSA. You will wear a mask over your nose or your mouth and nose. Air will blow gently into the back of your throat to keep your airways open while you sleep. You will likely need a CPAP study to determine the right level of air pressure for you.

If it’s determined that your CSA is due to an underlying medical condition, it’s crucial to be evaluated by your doctor. Treatments are specific to conditions such as heart or kidney failure. If you have had a stroke, you may need to seek rehabilitation services and be assessed to determine your risk of having another stroke.

Although there are no specific treatments for high-altitude periodic breathing, you may need to seek treatment for other problems that can occur at high altitudes. Sometimes they can be resolved using medication. Other times, you simply have to avoid high altitudes.

Drug and substance-induced CSA can be resolved by changing medication or discontinuing the use of the medication or substance.

Let DreamZz Sleep Center Help Get You the Sleep You Deserve

If you or your partner have noticed that you have signs of CSA, contact your doctor immediately. You must take care of the underlying condition causing CSA for the sake of your overall health. They will likely order a sleep study (polysomnogram) to monitor your sleep for an accurate diagnosis.

Trust DreamZz Sleep Center for all of your sleep testing needs. Our fellowship-trained, Sleep Medicine board-certified physician will provide detailed information about your symptoms and treatment options. When you put your care in our hands, the Dream Team will get you a diagnosis in as little as one month, so you can get back to the peaceful, restful sleep you deserve.

Contact us today to book your appointment.