What is central sleep apnea?

Updated: Oct 09, 2018
  • Author: Sufen Chiu, MD, PhD; Chief Editor: Caroly Pataki, MD  more...
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Central sleep apnea

Central sleep apnea is caused by variability in respiratory effort that results in repeated episodes of apneas and hypopneas during sleep. Central sleep apnea and obstructive sleep apnea hypopnea can coexist. DSM-5 defines central sleep apnea as PSG evidence of 5 or more central apneas per hour of sleep. The disorder is not better explained by another current sleep disorder.

There are 3 subtypes that can be diagnosed: idiopathic central sleep apnea, Cheyne-Stokes breathing, and central sleep apnea comorbid with opioid use. Idiopathic is characterized by variability in respiratory effort without evidence of airway obstruction. Cheyne-Stokes is a pattern of periodic crescendo-decrescendo variation in tidal volume of at least 5 events per hour, accompanied by frequent arousal. This pattern of breathing is associated with heart failure, stroke, or renal failure. Opioids affect the respiratory rhythm generators in the medulla (central area of brain) and the differential effects of hypoxic versus hypercapnic respiratory drive. This can occur even after only a one-time heavy use of the substance.

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