Details of Central sleep apnea(CSA)
Central sleep apnea(CSA) occurs when the brain periodically fails to activate the breathing muscles in the chest. Central sleep apnea is a heterogeneous group of conditions characterized by changes in ventilatory drive without airway obstruction; most of these conditions cause asymptomatic changes in breathing pattern during sleep. This type of sleep apnea results from the brain not signaling the body to breathe. There is no airflow because there is no effort to breathe. This causes the same difficulties as Obstructive Sleep Apnea.
Patients with central sleep apnea (CSA) fall into 2 categories. One group presents with hypercapnia with decreased ventilatory drive. Causes include hypothyroidism and central lesions, such as brain stem infarctions, encephalitis, and Arnold-Chiari malformation. This type of central sleep apnea may also complicate neuromuscular diseases and chest wall abnormalities. The other group presents with eucapnia or hypocapnia with increased ventilatory drive but with sleep-induced apnea, periodic breathing, or both. Cheyne-Stokes breathing is a discrete pattern of this form of CSA thought to be caused by delays in circulation time that, in turn, cause a lag in recognition by respiratory centers of acidosis, hypoxia, or both and of alkalosis, hypocapnia, or both (causing apnea). High altitude is another cause of recurrent CSA presenting with hypocapnia. Use of opioids can cause either hypercapneic or hypocapneic CSA.
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