Central Sleep Apnea: Symptoms, Causes, and Treatments

medica-seed-editor · October 16, 2026, 10:30am

Central Sleep Apnea is a condition where the brain fails to signal breathing muscles, causing repeated pauses in airflow during sleep.

Understanding Central Sleep Apnea

Unlike other breathing disorders, this condition occurs because the brain does not consistently tell the body to breathe. It is estimated that 0.9% of people over age 40 are affected. While some brief pauses in breathing are normal during sleep transitions, those with this disorder experience frequent, abnormal interruptions that can lead to fragmented sleep and low blood oxygen.

Central Sleep Apnea vs Obstructive Sleep Apnea

It is common to confuse these two conditions, but the cause is different. In obstructive sleep apnea, the airway is physically blocked despite the person’s effort to breathe, often resulting in snoring. In contrast, the issue in central sleep apnea is a communication failure between the brain and the muscles. Some individuals may experience a combination of both, known as mixed sleep apnea.

Common Symptoms of Central Sleep Apnea

Many people are unaware they have the condition until a partner notices their breathing or they are hospitalized for another reason. Common signs include:

Waking up frequently or feeling short of breath upon waking.
Excessive daytime sleepiness and falling asleep during dull activities.
Morning headaches and nighttime chest discomfort.
Difficulty concentrating, memory lapses, or mood changes.
Irregular breathing patterns, such as rapid or shallow breaths.

Central Sleep Apnea Causes and Types

The causes vary depending on the specific type of the disorder:

Cheyne-Stokes breathing: The most frequent form, often linked to stroke or heart failure. It involves a cycle of small and large breaths followed by long pauses lasting 30 seconds to 2 minutes.
Medical conditions: Damage to the brain stem from injury or diseases like Parkinson’s, Alzheimer’s, or ALS can trigger the condition. Kidney failure and hypothyroid disease are also risk factors.
Substances and medications: Opioids (such as methadone, morphine, or codeine), benzodiazepines, and some antidepressants can diminish the brain’s ability to regulate breathing.
High altitude: Breathing may become faster and deeper with pauses when ascending to elevations above 8,000 feet (2,500 meters).
Treatment-emergent: Between 5% and 15% of people treated for obstructive sleep apnea with pressure therapy may develop this form.
Idiopathic: A rare primary form with no identifiable cause.

Risk Factors

Certain factors increase the likelihood of developing this disorder:

Age and Sex: It is more common in men and adults over 65.
Health History: A history of congestive heart failure, stroke, or metabolic disorders.
Medications: Use of muscle relaxants, anticonvulsants, or antiplatelet drugs.

Diagnosis and Sleep Studies

A doctor typically begins with a physical exam and a review of medical history. To confirm a diagnosis, a polysomnogram (overnight sleep study) is used. During this study, sensors monitor:

Heart rate and rhythm.
Blood oxygen levels and airflow.
Brain electrical activity and eye movements.
Respiratory effort and muscle activity.

While home studies exist for obstructive apnea, they may be less effective for diagnosing this specific central type.

Treatments for Central Sleep Apnea

The primary goal is to address the underlying health issue or adjust medications. Depending on the severity, doctors may suggest:

Positive Airway Pressure (PAP): Machines like CPAP, BiPAP, or adaptive servo-ventilation (ASV) pump air into the airway to stabilize breathing.
Oxygen Therapy: Supplemental oxygen may be used alone or alongside PAP therapy.
Medications: Certain drugs, such as theophylline or acetazolamide, may be used to stimulate breathing under medical supervision.
Nerve Stimulation: For severe cases, a device like the Remede System can be surgically implanted in the chest to trigger the diaphragm.

Living With Central Sleep Apnea

Managing the condition involves a combination of medical treatment and lifestyle adjustments. To improve sleep quality, consider:

Avoiding alcohol and sedatives, which can worsen breathing pauses.
Sleeping on your side rather than your back.
Maintaining a healthy weight and getting adequate rest.
Using nasal strips or sprays for congestion.

FAQ

What is central sleep apnea?

It is a sleep disorder where the brain fails to send the correct signals to the muscles that control breathing, leading to repeated pauses in airflow.

What causes central sleep apnea in adults?

Common causes include heart failure, stroke, neurological disorders, high altitude, or the use of certain medications like opioids.

What does central sleep apnea feel like?

While some have no symptoms, others may experience nighttime awakenings, morning headaches, shortness of breath, and extreme daytime fatigue.

What helps central sleep apnea?

Treatment typically involves addressing the underlying medical cause, using PAP machines (like CPAP), supplemental oxygen, or implanted nerve stimulators.

When to See a Doctor

Consult a healthcare provider if you or a partner notice the following warning signs:

Frequent pauses in breathing during sleep.
Waking up gasping for air or feeling breathless.
Severe daytime drowsiness that interferes with work or driving.
Persistent morning headaches.

Medical Disclaimer: This content is for informational purposes only and does not constitute medical advice. Always seek the guidance of a qualified healthcare provider regarding a medical condition.