Central Sleep Apnea

Causes

	With Central Sleep Apnea, the person stops breathing not because of a mechanical blockage, but because of neurological dysfunction.
	During an episode, a person may just not take a breath for an unusually long time, then suddenly inhale rapidly
	the person may inhale at regular intervals, but exhaling becomes troublesome

Symptoms

	snoring
	holding your breath while sleeping
	waking up gasping for air
	headaches in the morning
	excessive grogginess
	desire to sleep during the day
	fall asleep at work or while driving

Treatment

The objective of treatment is to keep the airway open to prevent apneic episodes during sleep.

Behavioral Therapy

	Behavioral changes are an important part of the treatment program, and in mild cases behavioral therapy may be all that is needed.
	The individual should avoid the use of alcohol, tobacco, and sleeping pills, which make the airway more likely to collapse during sleep and prolong the apneic periods.
	Overweight persons can benefit from losing weight. Even a 10 percent weight loss can reduce the number of apneic events for most patients.
	In some patients with mild sleep apnea, breathing pauses occur only when they sleep on their backs. In such cases, using pillows and other devices that help them sleep in a side position is often helpful.

Physical or Mechanical Therapy

Nasal continuous positive airway pressure (CPAP)

	It is the most common effective treatment for sleep apnea.
	In this procedure, the patient wears a mask over the nose during sleep, and pressure from an air blower forces air through the nasal passages.
	The air pressure is adjusted so that it is just enough to prevent the throat from collapsing during sleep.
	The pressure is constant and continuous. Nasal CPAP prevents airway closure while in use, but apnea episodes return when CPAP is stopped or it is used improperly.
	Variations of the CPAP device attempt to minimize side effects that sometimes occur, such as nasal irritation and drying, facial skin irritation, abdominal bloating, mask leaks, sore eyes, and headaches.
	Some versions of CPAP vary the pressure to coincide with the person's breathing pattern, and other CPAPs start with low pressure, slowly increasing it to allow the person to fall asleep before the full prescribed pressure is applied.

Dental appliances

	It repositions the lower jaw and the tongue have been helpful to some patients with mild sleep apnea or who snore but do not have apnea.
	Possible side effects include damage to teeth, soft tissues, and the jaw joint. A dentist or orthodontist is often the one to fit the patient with such a device.

Surgery

	Several surgical procedures are used to increase the size of the airway, none of them is completely successful or without risks.
	More than one procedure may need to be tried before the patient realizes any benefits.
	Some of the more common procedures include removal of adenoids and tonsils (especially in children), nasal polyps or other growths, or other tissue in the airway and correction of structural deformities.
	Younger patients seem to benefit from these surgical procedures more than older patients.

Uvulopalatopharyngoplasty (UPPP)

	It is a procedure used to remove excess tissue at the back of the throat (tonsils, uvula, and part of the soft palate).
	The success of this technique may range from 30 to 60 percent.
	The long-term side effects and benefits are not known, and it is difficult to predict which patients will do well with this procedure.
	Laser-assisted uvulopalatoplasty (LAUP) is done to eliminate snoring but has not been shown to be effective in treating sleep apnea.
	This procedure involves using a laser device to eliminate tissue in the back of the throat.
	Like UPPP, LAUP may decrease or eliminate snoring but not eliminate sleep apnea itself.
	Elimination of snoring, the primary symptom of sleep apnea, without influencing the condition may carry the risk of delaying the diagnosis and possible treatment of sleep apnea in patients who elect to have LAUP.
	To identify possible underlying sleep apnea, sleep studies are usually required before LAUP is performed.

Somnoplasty

	It is a procedure that uses radiowaves to reduce the size of some airway structures such as the uvula and the back of the tongue.
	This technique is being investigated as a treatment for apnea.

Tracheostomy

	It is used in persons with severe, life-threatening sleep apnea.
	In this procedure, a small hole is made in the windpipe and a tube is inserted into the opening.
	This tube stays closed during waking hours, and the person breathes and speaks normally.
	It is opened for sleep so that air flows directly into the lungs, bypassing any upper airway obstruction.
	Although this procedure is highly effective, it is an extreme measure that is rarely used

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