Central sleep apnea

Diagnosis

Based on your symptoms, a doctor may evaluate your condition, or you might be referred to a sleep specialist at a sleep problem center. If necessary, you can discuss the need for further testing with the sleep expert. This may involve undergoing a sleep study, specifically a polysomnography, where various devices are attached to monitor your breathing patterns, blood oxygen levels, heart, lung, and brain activity while you sleep. Depending on the situation, you may undergo either a split-night or full-night sleep study.

In a split-night sleep study, the first half of your sleep are monitored. If central sleep apnea is detected, the staff may wake you up to initiate therapy for the second half of the night. Treatment options could include the use of positive airway pressure or supplemental oxygen to alleviate the condition.

Polysomnography is a valuable tool for diagnosing central sleep apnea, and it also helps in ruling out other sleep disorders like narcolepsy, sleep-related movement disorders, and obstructive sleep apnea. Proper diagnosis is essential because even though these conditions can all lead to excessive daytime sleepiness, they require different treatment approaches.

In evaluating your condition, it might be necessary to involve doctors specialized in heart illnesses, known as cardiologists, and experts in neurological disorders, known as neurologists. They may conduct further tests, including imaging of your heart or head, to identify any underlying issues that could be contributing to your sleep problems.

Treatment

The following are possible therapies for central sleep apnea:

• Decreasing opioid medicines. Your medical team may gradually lower the dose of your opioid medications if they are the root cause of your central sleep apnea.
• Addressing associated medical problems. Other illnesses may contribute to central sleep apnea. Your central sleep apnea might improve if those symptoms are treated. For instance, treatment for heart failure may make central sleep apnea better.
• Medicines. People with central sleep apnea have been treated with medications like acetazolamide to encourage breathing. If you are unable to tolerate positive airway pressure, these medications may be recommended to assist you breathe while you sleep.
• Supplemental oxygen. If you suffer central sleep apnea, you might benefit from using supplemental oxygen while you sleep. You can get oxygen into your lungs using a variety of devices.
• Continuous positive airway pressure (CPAP). This technique involves putting on a mask over the nose or a mask over the nose and mouth while you sleep. It is also used to treat obstructive sleep apnea.

The mask is connected to a tiny pump that continuously delivers compressed air to keep the upper airway open. The airway closure that can cause central sleep apnea may be avoided using CPAP.

It’s crucial that you use the CPAP machine solely as instructed if you have central sleep apnea, just like if you have obstructive sleep apnea. Speak with your medical staff if the pressure on your mask is too intense or if it is uncomfortable. There are various sorts of masks. Additionally, the air pressure can be changed.

• Adaptive Servo-ventilation (ASV). You might be prescribed ASV if CPAP is ineffective in treating your disease. ASV also provides pressured air, just like CPAP.

ASV, as opposed to CPAP, changes the pressure on each breath that is taken. This results in a smoother breathing pattern. Additionally, if a specific amount of time passes without you taking a breath, the gadget may give a breath for you automatically.

For those with symptomatic heart failure, ASV is not advised.

• Bilevel positive airway pressure (BPAP). Similar to ASV, BPAP applies a predetermined amount of pressure when you inhale and a different amount when you exhale. In contrast to ASV, the amount of pressure you inhale is fixed rather than changeable. Additionally, BPAP can be programmed to deliver a breath if you haven’t taken a breath for a predetermined period of time.

Surgery or other procedures

Transvenous phrenic nerve stimulation is a relatively novel treatment for central sleep apnea. The U.S. Food and Drug Administration has given the Remede System device approval. It sends an electrical pulse to the nerve that regulates the diaphragm while you sleep. You take a breath as a result of this. The system consists of an implanted, battery-operated pulse generator in the upper chest.

This technique generates a consistent breathing pattern and is used for moderate to severe central sleep apnea. More research is required.