What is Central Sleep Apnea (CSA)

Central sleep apnea (CSA) is a group of conditions in which you repeatedly stop breathing throughout the night because your body ceases to try and breathe (i.e., brain doesn’t send proper signals to muscles that control breathing).

When this happens, you repeatedly stop breathing and then come awake to regain breathing (called an “apnea” or “apnea event”). Due to CSA, you may have anywhere from 40 to 100+ apnea events per night. The most common scale used to measure the severity of sleep apnea is number of apneas per hour:

• Mild sleep apnea: 5-14 apneas per hour of sleep
• Moderate sleep apnea: 15-30 apneas per hour of sleep
• Severe apnea: 30+ apneas per hour of sleep

Both mild and severe CSA can lead to a high degree of sleep deprivation and all of the associated health problems therein. CSA is relatively uncommon compares to obstructive sleep apnea (OSA).

Forms/Risk Factors of Central Sleep Apnea

Central sleep apnea can be broken down into several forms:

• Primary Central Sleep Apnea: cause is not known
• Cheyne-Stokes Breathing Pattern: an irregular breathing pattern that results in a temporary stop in breathing, and mainly occurs in men aged 60 years or older
• Narcotic-Induced CSA: this type of CSA occurs in people who are on chronic narcotic therapy (i.e., chronic pain, or drug abuse)
• Medical Condition: medical conditions such as heart or kidney problems and abnormalities of the base of the brain where breathing is regulated (rare)

Risk factors include [Mayo Clinic]:

• Being older
• Being male
• Heart disorders
• Using narcotics
• Stroke

Central Sleep Apnea vs. Obstructive Sleep Apnea

The primary difference between sleep apnea is this:

• Obstructive sleep apnea: you try to breathe bust can’t
• Central sleep apnea: you don’t try and breathe at all

On paper this seems pretty clear cut, but in actual, clinical practice it is often harder to diagnose this difference.

Another difference is that OSA is much more common and has a much greater number of possible causes.

Beyond this, OSA and CSA have a lot of overlap, such as with potential consequences and symptoms.

Symptoms and Diagnoses of Central Sleep Apnea

Symptoms of CSA include [WebMD]:

• Frequent pauses in breathing at night (reported by another person)
• Gasping for air during sleep
• Morning headaches
• Excessive daytime sleepiness
• General, chronic irritability
• Difficulty staying asleep
• Chronic dry mouth at night
• Snoring (though more common in OSA)

The main tipoff is frequent pauses for sleep, but this entails having a bed partner to report this. Otherwise, your symptoms may make you or your doctor suspicious that a sleep study would be a good idea for further prognoses. Formal diagnoses of CSA is done through a sleep study.

Side Effects of Central Sleep Apnea

Untreated sleep apnea generally results in:

• Lower quality of life
• Lower life expectancy
• Risks of medical conditions such as:
  • Heart disease
  • High blood pressure
  • Diabetes
  • Depression
  • Mood disorders

These risks stem from chronic sleep deprivation.

Treatment Options for Central Sleep Apnea

Fortunately, treatment options for CSA are generally very successful, and often includes some forms of positive airway pressure therapy, such as CPAP therapy (continuous-PAP) or lifestyle changes.

If you live in Alaska, and are concerned that you or a loved one has sleep apnea or has already been diagnosed, please consult with our sleep specialists about any questions you have.