Central Sleep Apnea

Overview


Plain-Language Overview

Central Sleep Apnea is a condition that affects the way the brain controls breathing during sleep. It involves repeated pauses in breathing because the brain temporarily stops sending signals to the muscles that control breathing. This condition primarily affects the respiratory system and can lead to poor oxygen levels and disrupted sleep. People with this disorder often experience daytime fatigue, difficulty concentrating, and may have episodes of waking up gasping for air. Unlike obstructive sleep apnea, the airway is not blocked; instead, the problem lies in the brain's control of breathing. This can impact overall health by causing sleep fragmentation and increasing the risk of heart problems.

Clinical Definition

Central Sleep Apnea (CSA) is characterized by recurrent episodes of apnea during sleep due to a failure of the central nervous system to generate appropriate respiratory effort. The core pathology involves impaired respiratory drive from the brainstem respiratory centers, often caused by conditions such as heart failure, stroke, or use of opioids. Unlike obstructive sleep apnea, CSA features absence of respiratory effort rather than airway obstruction. This leads to intermittent hypoxia and sleep fragmentation, contributing to symptoms like excessive daytime sleepiness and increased cardiovascular risk. CSA can be idiopathic or secondary to underlying neurologic or cardiac disorders. The condition is clinically significant because it disrupts normal sleep architecture and can worsen comorbidities such as atrial fibrillation and hypertension.

Clinical Presentation


Diagnostic Workup


Pathophysiology


Treatments


Prevention


Outcome & Complications


Differential Diagnoses


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