Central sleep apnea

• Central sleep apnea is a breathing disorder that causes your breath to pause frequently while you’re asleep
• Central sleep apnea symptoms can include waking up abruptly with shortness of breath, daytime sleepiness, insomnia, and mood changes
• Treatment for central sleep apnea can include the use of a positive airway pressure device and treatment of underlying medical conditions. 

Central sleep apnea is a breathing condition that causes your breathing to pause frequently while you’re asleep. As this condition causes you to wake up abruptly from your sleep, daytime symptoms such as excessive sleepiness, mood changes, and concentration issues may occur. In this guide by Ada’s medical team, you’ll find more information on central sleep apnea, its symptoms, diagnosis, and treatment options.  

Central sleep apnea (CSA) and obstructive sleep apnea are two possible types of sleep apnea. Sleep apnea is a breathing disorder that causes your breathing to frequently stop and restart throughout your sleep. The difference between both forms of sleep apnea is the reason why this happens. Central sleep apnea occurs when there is an issue with the parts of your brain responsible for coordinating your breathing. This condition can have an effect on your quality of life, and can also lead to other medical conditions, which is why you should always see a healthcare provider if you’re experiencing any of the symptoms of central sleep apnea. 1

Central sleep apnea symptoms are mostly present throughout the night, which can make it more difficult to notice these symptoms yourself. However, a family member or bed partner will often observe and report these symptoms to the affected person. While you’re sleeping, you may: 2 3

• Experience pauses in your breathing
• Wake up abruptly
• Experience shortness of breath 
• Find it difficult to stay asleep 

The symptoms of central sleep apnea that you’re experiencing throughout the night can also have an impact on the moments that you are awake. During the day, you may: 2

• Feel very sleepy
• Have concentration issues
• Experience mood changes 
• Have headaches

Central sleep apnea causes can be found in certain centers in the brain responsible for your breathing. These centers can be affected by a number of medical conditions. Some possible causes of central sleep apnea are: 2 4 3

• Atrial fibrillation
• Heart failure
• Ischemic stroke
• Long-term use of opioid medication
• Spinal cord injury
• Anatomic deviations of the thorax
• Renal failure
• Congenital central hypoventilation syndrome
• Obesity hypoventilation syndrome
• Prader Willi syndrome 

Central sleep apnea can also occur in healthy individuals without any underlying medical conditions when they are at high altitudes.

If you’re experiencing any of the symptoms of central sleep apnea, then your healthcare provider will first perform tests to rule out other possible causes of your symptoms and to see whether you meet the central sleep apnea diagnosis criteria. These criteria will be assessed during a polysomnogram, which is also known as an overnight sleep study. 

While you’re asleep, certain vital parameters will be checked, such as your respiratory rate, heart rate, and your oxygen saturation. Other parameters such as your chest wall movement and your airflow will also be monitored. Your healthcare provider will then analyze these results to form a diagnosis. Various factors will be taken into account including your symptoms and how many times your breathing stops per hour of sleep. 2 4

Central sleep apnea treatment is primarily focused on stabilizing your sleep again and treating underlying medical conditions. The main form of treatment for central sleep apnea is positive airway pressure therapy. Some examples of this are: 2

• Continuous positive airway pressure (CPAP)
• Bi-level positive airway pressure (BPAP)
• Adaptive servo-ventilation (ASV)

The type of positive airway pressure therapy you need depends on your underlying medical conditions and the severity of your central sleep apnea. Your healthcare provider will discuss the options to treat your central sleep apnea. 

Other forms of treatment for central sleep apnea can include supplemental oxygen and medication. 3

Central sleep apnea can increase the risk of developing other complications. Some examples are: 

• Hypertension
• Atrial fibrillation
• Sleep disturbances
• Mood disorders
• Chronic respiratory failure
• Narcolepsy
• Hypercapnic respiratory failure

Central sleep apnea is a breathing disorder that causes your breathing to stop and restart frequently during your sleep. This condition is often the result of other underlying medical conditions, which affect the parts of your brain responsible for coordinating your breathing. In order to improve the symptoms of central sleep apnea and to reduce the possibility of complications from developing, it’s important to seek treatment for central sleep apnea and for the underlying medical conditions that cause it.

Q: What is the life expectancy of someone with central sleep apnea? 
A: Untreated sleep apnea can shorten someone’s life expectancy by several years, so it’s important to get diagnosed and seek treatment early on. 

Q: When does central sleep apnea typically occur? 
A: Central sleep apnea typically occurs during the night, while you’re asleep.

Q: What does central sleep apnea feel like? 
A: Central sleep apnea can wake you up abruptly with a feeling of shortness of breath. Due to the frequent interruptions of your sleep, it can also cause symptoms while you’re awake such as excessive sleepiness, concentration issues, and mood changes.

Q: Is central sleep apnea dangerous?
A: Untreated central sleep apnea can be dangerous as it has been associated with other medical conditions such as heart failure, stroke, arrhythmias, and a shortened life span. 

Q: How common is central sleep apnea? 
A: Central sleep apnea is much less common than obstructive sleep apnea. It only occurs in less than 1% of the population. 

Q: What can be mistaken for central sleep apnea? 
A: Some other conditions can cause symptoms that may resemble central sleep apnea. This is possible with people that suffer from obstructive sleep apnea, narcolepsy, neuromuscular diseases, or obstructive lung diseases.