Central Sleep Apnea is the result of signal loss by the brainstem to the muscles that control breathing during sleep. This is often found in people who suffer from certain medical conditions. Since the brainstem controls breathing, any injury or disease in this area can be the basis for problems with normal breathing when awake or during sleep.

Conditions that can be the basis of central sleep apnea:

• Encephalitis affecting the brainstem   
• Complications of cervical spine surgery   
• Bulbar poliomyelitis   
• Neurodegenerative illnesses   
• Primary hypoventilation syndrome   
• Radiation of the cervical spine   
• Use of certain medications containing narcotics   
• Severe arthritis   
• Degenerative changes to the base of the skull or cervical spine   
• Severe obesity   
• Stroke  affecting the brainstem   
• Congestive Heart Failure     

If the central sleep apnea does not refer to apnea associated with another disease it is called idiopathic central sleep apnea.

It is important to note that central sleep apnea is not the same as obstructive sleep apnea since this version is neurological in nature while obstructive sleep apnea is due to an airways blockage. Even though the symptoms might be similar their causation is extremely different.

Symptoms may include:

• Cessation of breathing   
• Chronic fatigue   
• Weakness or numbness throughout the body  
• Narcolepsy  
• Daytime sleepiness  
• Difficulty swallowing  
• Voice changes  
• Explosive Snoring  
• Morning headaches  

While obstructive sleep apnea is determined with a polysomnogram, central sleep apnea may require a Lung Function Study or an MRI. This is due to the fact that in pure central sleep apnea or Cheyne-Stokes respiration, the brain's respiratory control centers are imbalanced during sleep.

Carbon dioxide and oxygen fluctuate greatly since the neurological feedback mechanism that monitors them, does not react quickly enough to maintain an even respiratory rate. The body cycles between apnea and hyperpnea, even during wakefulness. Hyperpnea is increased breathing by the body to eliminate retained waste gases and absorb more oxygen In a healthy person breathing is regular during sleep, and both oxygen and carbon dioxide levels in the bloodstream stay relatively constant.

During central sleep apnea episodes the sleeper stops breathing and then starts again and there is no effort made to breathe during the pause in breathing: There are no chest movements and no struggling. That is due to the failure of the neurological controls to give the signal to inhale. This causes the person to miss one or more breathing cycles. When this happens the oxygen level will drop and the CO2 level increases. These changes have other effects on the body. If the oxygen level becomes too low and remains there for a prolonged period of time brain damage is a real possibility. In extreme case death is also a possibility. While this is rare it is a possibility. Since central sleep apnea is more often a chronic condition, there is more often an increase in the heart rate which can do damage to the heart muscle. If there is co-existing damage to the heart muscle or the autonomic system this compensatory increase is not possible.

Treatment consists of C-PAP or Bi-Pap to treat the symptoms, but it is more efficient to treat the underlying conditions if possible. It is also very important to avoid medications that would further depress these systems. Narcotics, tranquilizers and the like should be avoided if at all possible but it is essential that any prescriber be aware of the existing condition.

If you observe any of the above symptoms or suffer from any of the conditions listed it is advised that you let your treating physician know and have an overnight sleep study from a trained clinic. 

Franklin Harris is a personal coach and mentor. He has actively helped individuals to start and/or expand their business. In order to make the most of the traits and charcteristics that make a successful entrepreneur taking care of ones health is critical. When it comes to taking care of one's health, nothing is more important than a good night's sleep.