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Central sleep apnea (CSA) is a type of sleep disorder that causes your breathing to repeatedly stop and start during sleep. It’s associated with significant complications, including frequent nighttime awakenings, excessive daytime sleepiness and an increased risk of problems associated with the heart and circulatory system. If you suspect you or a loved one has central sleep apnea, see your health care provider right away for diagnosis and next steps.
Breathing is controlled by the autonomic nervous system, a part of the nervous system that unconsciously controls bodily function such as breathing, heart rate and digestion. Under normal circumstances, when the brain senses the need for a breath, it sends signals to the diaphragm and intercostal muscles to contract and relax at regular intervals. With central sleep apnea, however, this process is disrupted because the brain fails to send those signals. CSA may be caused by a number of important factors including:
Many people with central sleep apnea have no idea that they have it, and partners identify it more often than it is self-identified. As such, it is important to be aware of the symptoms of CSA, just in case. The symptoms of central sleep apnea include:2
Keep in mind that, while snoring is more often associated with obstructive sleep apnea, snoring can be present with central sleep apnea, too. Look for other symptoms, in addition to snoring, to help assess your potential risk.
Central sleep apnea is a serious medical condition associated with potentially significant complications. These complications can put your health at further risk if your CSA continues untreated. Complications can include:
Though anyone can develop central sleep apnea, some populations are at a higher risk of developing CSA. The following factors may put you at risk for central sleep apnea:2
Central sleep apnea is diagnosed using a test called a polysomnography, commonly referred to as a sleep study.2 During a sleep study, you are connected to equipment that monitors your overnight breathing, your heart, your lung activity, your brain activity, your blood oxygen levels and your arm and leg movements. If you are diagnosed with central sleep apnea, you may also be asked to participate in a split-night sleep study, during which you are monitored for the first half of the night, then awakened so you can receive positive airway pressure for the remainder of the night.
Following the results of your polysomnography, you may receive other tests to identify problems with your heart or your brain, or to identify contributing conditions.
Treatment of central sleep apnea includes treating both the causes of the CSA to attempt to eliminate it. Treatments for CSA may include the following:2
Central sleep apnea is characterized by the breathing center in the brain failing to send a signal to the diaphragm and intercostal muscles to breathe. So how does CSA differ from OSA, and how does one wind up with both types of sleep apnea?
Obstructive sleep apnea – the most common type of sleep apnea, OSA occurs when the throat muscles sporadically relax during sleep causing a partial or complete blockage of the airway. This leads to episodes of hypopnea (abnormally slow/shallow breathing) and complete apnea (cessation of breathing). It differs from CSA because it’s caused by a physical obstruction of the airway and has nothing to do with brain activity and the autonomic nervous system.
Complex or mixed sleep apnea is a combination of both types of sleep apneas: OSA and CSA. It has been suggested that some OSA patients treated with CPAP also develop CSA. In fact, in 2006, researchers from the Mayo Clinic conducted a study using 223 OSA patients and found that 15% of them also had CSA. During CPAP treatment their airways were successfully “splinted open and free from obstruction,” but they continued to have difficulty breathing during sleep. The study revealed that their symptoms of OSA shifted to symptoms of CSA while undergoing CPAP treatment for OSA.
Talk to your health care provider about how to best treat your central sleep apnea. If you are prescribed supplemental oxygen therapy, Inogen may be able to help you with your CSA treatments. Contact our Inogen Oxygen Specialists to find out more today.
 Eckert, D. J., Jordan, A. S., Merchia, P., & Malhotra, A. (2007). Central Sleep Apnea: Pathophysiology and Treatment. Chest, 131(2), 595–607. http://doi.org/10.1378/chest.06.2287
 Mayo Clinic. Central Sleep Apnea. August 7, 2017.
 Mayo Clinic. Obstructive Sleep Apnea. August 2, 2017.
 Wang, J., Wang, Y., Feng, J., Chen, B., & Cao, J. (2013). Complex sleep apnea syndrome. Patient Preference and Adherence, 7, 633–641. http://doi.org/10.2147/PPA.S46626