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Causes

By Mayo Clinic staff

Central sleep apnea occurs when your brain fails to transmit signals to your breathing muscles.

Central sleep apnea can be caused by a number of conditions that affect the ability of your brainstem — which links your brain to your spinal cord and controls many functions such as heart rate and breathing — to control your breathing. The cause varies with the type of central sleep apnea you have. Types include:

  • Cheyne-Stokes breathing. This type of central sleep apnea is most commonly associated with congestive heart failure or stroke. This condition is characterized by a gradual increase and then decrease in breathing effort and airflow. During the weakest breathing effort, a total lack of airflow (central sleep apnea) can occur.
  • Drug-induced apnea. Taking certain medications such as opioids — including morphine sulfate (Ms Contin, Avinza, others), oxycodone (Oxycodone HCL, Oxycontin, others) or codeine sulfate — may cause your breathing to become irregular, to increase and decrease in a regular pattern, or to temporarily stop completely.
  • High-altitude periodic breathing. A Cheyne-Stokes breathing pattern may occur if you're exposed to a very high altitude. The change in oxygen at this altitude is the reason for the alternating rapid breathing (hyperventilation) and under breathing.
  • Complex sleep apnea. Some people with obstructive sleep apnea develop central sleep apnea while using continuous positive airway pressure (CPAP) for their sleep apnea treatment. This condition is known as complex sleep apnea because it's a combination of obstructive and central sleep apneas.
  • Medical condition-induced central sleep apnea. Several medical conditions may give rise to central sleep apnea of the non-Cheyne-Stokes variety.
  • Idiopathic (primary) central sleep apnea. The cause of this uncommon type of central sleep apnea isn't known. It results in repeated pauses in breathing effort and airflow.
Risk factors Symptoms
References
  1. NINDS sleep apnea information page. National Institute of Neurological Diseases and Stroke. http://www.ninds.nih.gov/disorders/sleep_apnea/sleep_apnea.htm. Accessed April 18, 2013.
  2. Badr MS. Central sleep apnea: Risk factors, clinical presentation, and diagnosis. http://www.uptodate.com/home. Accessed April 4, 2013.
  3. Javaheri S. Central sleep apnea. Clinics in Chest Medicine. 2010;31:235.
  4. Central sleep apnea. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/pulmonary_disorders/sleep_apnea/central_sleep_apnea.html?qt=central%20sleep%20apnea&alt=sh. Accessed April 18, 2013.
  5. What is sleep apnea? National Heart, Lung, and Blood Institute. http://www.nhlbi.nih.gov/health/health-topics/topics/sleepapnea/. Accessed April 17, 2013.
  6. Malhotra A, et al. What is central sleep apnea? Respiratory Care. 2010;55:1168.
  7. Badr MS. Central sleep apnea: Pathogenesis. http://www.uptodate.com/home. Accessed April 18, 2013.
  8. Malhotra A, et al. Cheyne-Stokes breathing and obstructive sleep apnea in heart failure. http://www.uptodate.com/home. Accessed April 19, 2013.
  9. Leung RS, et al. Mechanisms of sleep-disordered breathing: Causes and consequences. Pflugers Archiv. 2012;463:213.
  10. Millman RP, et al. Polysomnography in obstructive sleep apnea in adults. http://www.uptodate.com/home. Accessed April 16, 2013.
  11. Badr MS. Central sleep apnea: Treatment. http://www.uptodate.com/home. Accessed April 4, 2013.
  12. Dave NB. Initiation of positive airway pressure therapy for obstructive sleep apnea in adults. http://www.uptodate.com/home. Accessed April 12, 2013.
  13. Find a sleep center near you. American Academy of Sleep Medicine. http://www.sleepcenters.org/. Accessed April 4, 2013.
  14. U.S. News best hospitals 2012-2013. U.S. News & World Report. http://health.usnews.com/best-hospitals/rankings. Accessed April 4, 2013.
  15. Olson EJ (expert opinion). Mayo Clinic, Rochester, Minn. April 29, 2013.
DS00995 June 28, 2013

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