Central sleep apnea is a disorder that affects the pattern of breathing during sleep, so that breathing stops altogether on repeated occasions throughout the night. There are a number of causes, mostly involving problems in the area of the brain that controls respiration or weakness in the respiratory muscles. The most common central sleep apnea treatments involve using one or more of a range of options including: treating any underlying disease, medication to stimulate breathing, and devices that pump air into the respiratory passages during sleep. Central sleep apnea should not be confused with the more common disorder obstructive sleep apnea, which is caused by blockage of the airways.
As a number of diseases such as heart failure and kidney failure are associated with the problem, treatment of central sleep apnea often involves attending to these associated conditions. Treating heart failure with appropriate medication and kidney failure with dialysis may mean that normal nighttime breathing is restored and no further central sleep apnea treatment is required. Some causes are reversible; for example, traveling to areas at high altitude or taking opiates such as heroin can cause central sleep apnea. The treatment for central sleep apnea in the first case would involve descending to lower altitude and for the second case a gradual withdrawal of opiates would be implemented.
Continuous positive airway pressure, or CPAP, where pressurized air is pumped into the airways through a face mask, can be an effective central sleep apnea treatment. It may help to keep the airway open overnight and its use has been found to lead to better heart function in people with cardiac failure. CPAP is also used to treat obstructive sleep apnea.
Bilevel positive airway pressure, or BIPAP, is different from CPAP in that it varies the pressure of the air being pumped in. This type of central sleep apnea treatment is especially useful for people who repeatedly stop breathing for long periods of time. In such cases the machine can be set to deliver an additional breath after a specified length of time has elapsed without respiration. Adaptive servo ventilation, or ASV, is a more complex ventilation technique which is able to adapt constantly to respiratory needs, and which is proving more effective than conventional methods.
A common central sleep apnea treatment is the use of medications such as acetazolamide and theophylline. These may be taken as a preventive measure before visiting places at high altitude. The drugs work by stimulating breathing and are also used as a central sleep apnea treatment for patients with heart failure.