Central sleep apnea (CSA) is a breathing disorder in which your body's effort to breath during sleep starts decreasing or ceases altogether. It usually arises due to an issue with the brain or heart, but can also be caused by certain medications such as pain killers. Unlike obstructive sleep apnea (OSA), this pattern of breathing results from something other than a blockage of the airway. CSA is less common than OSA.
In CSA, the brain fails to send proper signals to regulate breathing. This results in five distinct types of this syndrome among adults. These range from those with no identifiable cause to those related to triggers like sleep apnea and infections.
Primary CSA
This breathing pattern is characterized by periodic periods of apnea, leading to a marked reduction in airflow, though the cause remains unknown.
Cheyne-Stokes breathing pattern
This breathing pattern is marked by a gradual build-up (crescendo) of effort and airflow, followed by a reduction (decrescendo), sometimes with no activity. It is linked to heart failure, stroke, and possibly kidney disease.
Medical condition not Cheyne-Stokes
This is when central apnea occurs due to medical conditions without the typical pattern of Cheyne-Stokes breathing. It is caused by heart and kidney problems. It may also result from a problem in the base of the brain where breathing is controlled.
High-altitude periodic breathing
At higher heights around 15,000 feet, sleeping can result in a breathing pattern resembling Cheyne-Stokes. Unlike in these conditions due to history of heart failure, stroke or kidney failure, this phenomenon often improves with lower altitudes and has shorter cycle times between breaths.
Due to drug or substance
The respiratory pattern of this disorder may vary from a constant cycle to something that's quite irregular. Obstructive occurrences, such as the breathing seen in OSA, can occur too. Medications linked to this form of central sleep apnea include opioids like prescription pain meds or heroin.