What Causes Central Sleep Apnea (CSA)?

medica-seed-editor · November 5, 2026, 3:15pm

Central sleep apnea (CSA) is a breathing disorder occurring when the brain fails to signal the muscles to breathe, leading to repeated pauses in respiration during sleep.

Understanding Central Sleep Apnea (CSA) vs Obstructive Sleep Apnea

Both conditions involve interrupted breathing, but their origins differ. Obstructive sleep apnea happens when throat muscles relax and physically block the airway. Central sleep apnea (CSA) occurs because the brain “forgets” to trigger the breathing process; there is no physical blockage, but the signal to breathe is missing. Mixed or complex sleep apnea combines both issues.

Common Central Sleep Apnea Causes

In many instances, the exact reason for this condition is unknown, which doctors refer to as idiopathic. However, several known factors can trigger these missed signals:

Medical Conditions: Heart failure, kidney failure, and stroke can lead to this disorder. Heart and kidney issues may cause Cheyne-Stokes respiration, a specific pattern characterized by alternating fast, shallow breaths and slow, deep breaths followed by a pause.
Neurological Factors: Stroke or neurodegenerative diseases like ALS can damage the brain’s breathing centers and disrupt breathing patterns.
Medications: Certain drugs, particularly opiates such as fentanyl or hydrocodone, can interfere with brain signals.
Environmental Factors: Sleeping at high altitudes (typically above 8,000 feet) can disrupt the normal breathing rhythm, though this usually resolves once the person returns to lower elevations.

In children, causes are often unknown, but risks include premature birth, brain tumors, cerebral palsy, or head injuries.

Other Risk Factors for Sleep Apnea

While central sleep apnea (CSA) is linked to brain signals, other types of the disorder are influenced by different factors:

Weight and Anatomy: Obesity is a primary driver for obstructive types, as extra tissue around the neck can collapse the airway. A narrow throat, large tonsils, or a small lower jaw also increase risk.
Demographics: Men are two to three times more likely to be affected than women. Risk also increases with age, particularly for those over 60.
Lifestyle: Smoking and alcohol use can worsen symptoms by causing inflammation or relaxing throat muscles.

Complications and Warning Signs

Untreated breathing pauses can lead to severe health problems, including high blood pressure, heart attack, stroke, and type 2 diabetes. The heart and blood vessels face extra strain because the body releases stress hormones in response to low oxygen.

Warning signs include:

Loud snoring or gasping for air during the night.
Waking up frequently or with a dry mouth.
Morning headaches.
Excessive daytime sleepiness, irritability, or difficulty concentrating.

FAQ

What is central sleep apnea (CSA)?

It is a sleep disorder where the brain does not send the correct signals to the muscles that control breathing, causing temporary pauses in airflow.

What causes central sleep apnea (CSA)?

Causes can include stroke, heart failure, kidney failure, high altitude, or the use of certain medications like opiates. In some cases, the cause is idiopathic (unknown).

How is it treated?

Treatment depends on the cause. For central types, doctors focus on treating the underlying medical condition. For obstructive types, options include CPAP machines, oral appliances, lifestyle changes, or surgery.

Can children grow out of it?

Some children with obstructive sleep apnea may outgrow the condition as their airways stiffen and their throats grow larger.

When to See a Doctor

Consult a healthcare provider if you or your child experience the following:

Frequent waking during the night accompanied by gasping or choking.
Excessive sweating during sleep.
Extreme daytime fatigue that interferes with work or school.
Loud, chronic snoring.

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