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Causes
By Mayo Clinic staffCentral sleep apnea occurs when your brain fails to transmit signals to your breathing muscles. Central sleep apnea can be caused by a number of conditions that affect the ability of your brainstem — which links your brain to your spinal cord and controls many functions such as heart rate and breathing — to control your breathing. The cause varies with the type of central sleep apnea you have. Types include:
- Idiopathic central sleep apnea. The cause of this uncommon type of central sleep apnea isn't known. It results in repeated pauses in breathing effort and airflow.
- Cheyne-Stokes respiration. This type of central sleep apnea is most commonly associated with congestive heart failure or stroke, and it is characterized by a rhythmic, gradual increase and then decrease in breathing effort and airflow. During the weakest breathing effort, a total lack of airflow (central apneas) can occur.
- Medical condition induced apnea. In addition to congestive heart failure and stroke, several medical conditions may give rise to central apneas. Any damage to the part of the brain that controls breathing (the brainstem) may impair the normal breathing process.
- High-altitude periodic breathing. Periodic breathing occurs in most people if they're exposed to a high-enough altitude, such as an altitude greater than 15,000 feet (4,572 meters). The change in barometric pressure at this altitude can cause loss of breath as well as rapid breathing (hyperventilation). The breathing pattern can be similar to Cheyne-Stokes respiration.
- Drug or substance induced apnea. Taking certain medications such as opioids — for example, morphine, oxycodone or codeine — may cause your breathing to become irregular, to increase and decrease in a regular pattern, or to stop completely.
References
- Badr MS. Central sleep apnea syndrome: Risk factors, clinical presentation, and diagnosis. http://www.uptodate.com/home/index.html. Accessed April 17, 2009.
- Douglas NJ. Sleep apnea. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aID=2869549. Accessed April 17, 2009.
- Central sleep apnea. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merck.com/mmpe/print/sec05/ch061/ch061d.html. Accessed April 17, 2009.
- Eckert, DJ. Central sleep apnea: Pathophysiology and treatment. Chest. 2007;131:595.
- Ropper AH, et al. Sleep and its abnormalities. In: Ropper AH, et al. Adams and Victor's Principles of Neurology. 9th ed. New York, N.Y.: McGraw-Hill Medical; 2009. http://www.accessmedicine.com/content.aspx?aID=3633173. Accessed April 17, 2009.
- Weil JV. Sleep at high altitude. High Altitude Medicine and Biology. 2004;5:180.
- Eckert DJ, et al. Mechanisms of apnea. Progress in Cardiovascular Diseases. 2009;51:313.
- Leung RST. Sleep-disordered breathing: Autonomic mechanisms and arrhythmias. Progress in Cardiovascular Diseases. 2009;51:324.
- Badr MS. Central sleep apnea syndrome: Treatment. http://www.uptodate.com/home/index.html. Accessed April 17, 2009.
- Randerrath WJ. Combined adaptive servo-ventilation and automatic positive airway pressure (anticyclic modulated ventilation) in co-existing obstructive and central sleep apnea syndrome and periodic breathing. Sleep Medicine. 2009. In press. Accessed April 17, 2009.
- Hastings PC. Adaptive servo-ventilation in heart failure patients with sleep apnea: A real world study. International Journal of Cardiology. 2008. In press. Accessed April 17, 2009.
- Morgenthaler TI (expert opinion). Mayo Clinic, Rochester, Minn. May 22, 2009.
