Central sleep apnea (CSA)
DEFINITION: is when you repeatedly stop breathing during sleep because the brain temporarily stops sending signals to the muscles that control breathing. (vs OSA which is due to upper airway obstruction) SIGNS & SYMPTOMS: chronic fatigue, daytime sleepiness, morning headaches, restless sleep but not associated with snoring. ASSOCIATIONS: Any disease or injury affecting the brainstem may result in problems with normal breathing during sleep or when awake. Bulbar poliomyelitis, complications of cervical spine surgery, encephalitis affecting the brainstem, neurodegenerative illnesses such as Parkinson’s disease, radiation of the cervical spine, severe arthritis and degenerative changes in the cervical spine or the base of the skull, severe obesity leading to hypoventilation, stroke affecting the brainstem, primary hypoventilation syndrome and use of certain medications such as narcotic-containing painkillers. One form of central sleep apnea commonly occurs in people with congestive heart failure.
- Physical exam
- Sleep study (polysomnogram)
- Lung function studies
- MRI imaging of Brain.
- Nasal CPAP
- Drugs that stimulate breathing
Patients should avoid the use of any sedative medications.