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Central sleep apnoea

Central sleep apnoea (CSA) disrupts a person's breathing because of problems in the brain or lung muscles.

Central sleep apnoea is a separate condition to the more common obstructive sleep apnoea where the walls of the throat narrow during sleep.

The main type of central sleep apnoea is Cheyne Stokes respiration (CSR) and this is usually linked to the person having heart failure.

What are the symptoms of central sleep apnoea?

A person with central sleep apnoea has a pattern of stopping breathing for 10 seconds or more at a time.

Unlike obstructive sleep apnoea, the person doesn't usually snore. That's because rather than being blocked, their airways are clear - it is the brain that hasn't sent the signals needed to breathe.

Other symptoms and side-effects of central sleep apnoea include:

  • Disrupted sleep
  • Daytime tiredness and fatigue
  • Chest pain
  • Mood changes
  • Waking up with headaches
  • Concentration problems
  • Shortness of breath when lying down
  • Heart health problems from having less oxygen in the blood

Seek medical advice about central sleep apnoea symptoms.

Who gets central sleep apnoea?

It is not always clear why someone develops central sleep apnoea, but it is more common with:

  • Heart failure
  • Stroke
  • Brain tumours
  • Brain infection (viral)
  • Long-term respiratory disease
  • Neurological conditions
  • Obesity
  • Older age
  • Being male
  • Some opioid painkillers, including codeine
  • Being at high altitudes
  • Obstructive sleep apnoea continuous positive airway pressure (CPAP) treatment.


How is central sleep apnoea diagnosed?

A GP will ask about symptoms, and will first try to rule out other causes of these symptoms.

They may make a referral to a sleep specialist or sleep clinic to diagnose and treat central sleep apnoea.

A sleep study called polysomnography may be arranged.

This involves spending the night in a special sleep laboratory while monitoring is carried out of breathing, oxygen levels in the blood, heart, lung and brain activity.

After a diagnosis is made, other specialists may be involved in treatment, including heart and neurology doctors.

How is central sleep apnoea treated?

Treatment for central sleep apnoea will usually depend on what's found to be causing it - if this is known.

This could mean changes of medication, or managing other conditions, such as heart failure.

Lifestyle changes may be advised, such as losing weight if overweight or obese.

Specific treatments include:

  • Continuous positive airway pressure (CPAP) - a device delivers pressurised air through a face mask at night
  • Adaptive servo-ventilation (ASV) - similar to CPAP but delivers variable levels of pressured air to match the person's breathing
  • Bilevel positive airway pressure (BPAP) - like ASV but delivers fixed pressure at different levels for breathing in and out
  • Oxygen while sleeping
  • Medication to help stimulate breathing
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WebMD Medical Reference

Medically Reviewed by Dr Rob Hicks on August 15, 2016

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