CENTRAL SLEEP APNEA
Central sleep apnea is a sleep disorder in which a person stops and starts breathing as they sleep repeatedly. This occurs when the brain ceases sending signals to the muscles that control breathing temporarily.
This phenomenon can be caused by diseases like strokes or infections in the brainstem which is the part of the brain that controls breathing.
Other conditions that can cause central sleep apnea include Alzheimer’s disease, amyotrophic lateral sclerosis, congestive heart failure, hypothyroidism, kidney failure, obesity and Parkinson’s disease. Medications like narcotic painkillers can also cause this condition.
The main symptom of central sleep apnea is episodes of disrupted or abnormal breathing during sleep. Other symptoms include abrupt awakenings, shortness of breath, chronic fatigue, hypersomnia or daytime drowsiness, morning headaches, difficulty concentrating and restless sleep.
The polysomnogram (PSG) is a diagnostic test that is done on patients with central sleep apnea. This overnight sleep study takes continuous measurements while the patient is asleep to document abnormalities in the sleep cycle. It also records their heart rate, respiratory rate, electrical activity in the brain and nerve activity in muscles. Air flow, blood oxygen levels, eye movements and muscle activity are also measured. The polysomnography helps determine whether the breathing problems are due to airway blockage or irregular signals from the brain.
In some situations, a multiple sleep latency test (MSLT) is done the day after the overnight sleep test to measures how quickly an individual falls asleep. During this test the individual is asked to take four or five short naps which are usually 2 hours apart during the course of the day. The sleep latency or the time it takes for them to fall asleep is then measured. The normal is usually 12 minutes or longer and persons with a latency period of 8 minutes or less are diagnosed to have excessive daytime sleepiness.
Some sleep tests can also be done at home since they are more cost effective than studies done in sleep centers. In fact, they can cost as little as one third the expense of a sleep studies done in a clinic. They are also more comfortable and convenient. They do not provide as much information as the complete overnight studies performed in a sleep center. They are only able to diagnose obstructive and central sleep apnea. They cannot provide information on brain waves or heart rhythm.
Other tests that can be done include echocardiograms, lung function tests and MRIs of the neck or spine.
The treatment of central sleep apnea begins with treating the underlying condition or changing the medications that may be causing it.
Devices used during sleep to aid breathing are key to treating this condition. These include those which provide continuous positive airway pressure (CPAP) which is especially beneficial for people with central sleep apnea associated with heart failure. This therapy involves wearing a mask over the nose or mouth. An air blower pumps air through the nose or mouth to keep the airways patent when the patient is sleeping. The pressure is then continuously adjusted to ensure that the airway does not collapse and block breathing during sleep.
Bilevel positive airway pressure (BiPAP) devices are also used to pump air into the airways. These do so at a higher pressure during inhalation and a lower one during exhalation. Auto CPAP machines are also used to manage this condition. These adjust the pressure setting automatically throughout the night when they detect that more or less pressure is needed to stabilize the airway.
Behavioral modifications that can help individuals with central sleep apnea include avoiding alcoholic beverages before bedtime. Losing weight and maintaining a healthy body weight is also beneficial. Exercising for 20 minutes at least five hours before bedtime also improves sleep quality and can help prevent weight gain.
The treatment of sleep apnea is very important because if left untreated it can lead to chronic heart failure, high blood pressure, stroke and other cardiovascular problems.
The latest research reveals that the use of a bedside SleepMinder device at home can help diagnose the sleep disordered breathing that is associated with heart failure.
Support groups for central sleep apnea in Tennessee include the American Sleep Apnea Association affiliation under Rob Koehn who can be contacted by phone at 615 373 1550 or via email at firstname.lastname@example.org