Sleep Apnea: How Neurology Can Play a Role

Are you one of the many people who suffer from sleep apnea? If you have recently been diagnosed with this condition, there are some important pieces of information to take into account if you hope to alleviate the associated symptoms. 

One common misconception is that there is only a single form of sleep apnea (commonly referred to as obstructive sleep apnea or by the abbreviation OSA). 

On the contrary, neurology can also play an important role. This often comes in the form of a slightly different condition known as central sleep apnea (CSA). 

What exactly is CSA, what are its specific causes and how does it compare to OSA? These are some of the questions which this article will address in detail.

Sleep Apnea from a Broad Perspective

What factors serve to define this type of sleep disorder? Regardless of whether you have been diagnosed with OSA or CSA, the main takeaway point here is that breathing becomes difficult during sleep. As a result, you may awaken frequently during the night – and not even realize it – as your body struggles to get oxygen. 

While these are two common symptoms of sleep-related breathing disorders, the causes themselves can vary from individual to individual. This brings us to the next two sections.

Obstructive Sleep Apnea

OSA is caused by a narrowing of the airways which makes it more challenging for your lungs (and your body) to obtain the required levels of oxygen while asleep. When the airway narrows, you will wake up gasping for breath. Snoring is also very common. These conditions can increase the chances of developing OSA:

  • Obesity
  • Large neck circumference
  • Genetics (some individuals are born with narrower airways)
  • Smoking
  • Use of alcohol or sedatives to fall asleep

As the symptoms associated with this type of sleep apnea are primarily caused by physical issues, there are a handful of effective treatment options including PAP therapy.  

Central Sleep Apnea and Neurology

Central sleep apnea is slightly different when compared to OSA. As mentioned earlier, CSA is caused by neurological factors. Studies have found that this condition may occur after an illness that affects certain portions of the brain; particularly the brain stem (this portion controls autonomic actions such as breathing). Other factors may involve stroke, congestive heart failure and even sleeping at high altitudes. 

In other words, CSA is caused by a lack of communication between your brain and the muscles that control breathing while asleep. This leads to many of the same sensations associated with OSA and yet, physical blockages to the airway are not the primary factor. Neurology instead plays a crucial role.

What are the Symptoms of Each Condition?

We can now see that OSA and CSA are rather different in terms of the root causes. So, might it be possible to also base a diagnosis upon the symptoms themselves? Let's now take a look at each type of illness in more detail.

What are the Symptoms of Obstructive Sleep Apnea?

Do you suspect that you might be suffering from obstructive sleep apnea? If so, be on the lookout for these common symptoms:

  • Being extremely tired throughout the day
  • Snoring (a very common symptom)
  • Awakening throughout the night due to choking or coughing.
  • Experiencing a sore throat or dry mouth in the morning.
  • Irritability, anxiety, difficulty concentrating, and similar mood changes.

Note that not everyone will experience these symptoms. This ultimately depends on the severity of the OSA.

Central Sleep Apnea Symptoms

Although the causes of central sleep apnea are quite different, this condition shares many of the same symptoms in common. Some examples include:

  • Waking up out of breath.
  • Discomfort in the chest during the overnight hours.
  • Difficulty concentrating throughout the day.
  • Insomnia.
  • Morning headaches.
  • Reports of abnormal breathing during the overnight hours.

Note that snoring was not included within this list. Snoring is not often associated with CSA. Sleep specialists will make a diagnosis based on the symptoms -- and will also perform certain neurological tests to narrow down treatment options. 

How Is Central Sleep Apnea Treated?

The first step involves an evaluation of the symptoms. An overnight sleep study within controlled conditions may also be recommended. In the event that CSA is found to be the diagnosis, there are a handful of options.

Treating mild cases of central sleep apnea often involves alleviating the underlying medical condition. The theory here is that rectifying any related problems will help to eliminate the symptoms. 

In severe instances of CSA, additional measures may need to be taken such as:

  • a more sophisticated device that requires a backup rate to control central sleep apneic events.  There are two devices for this purpose: 1. a BiPAP S/T and 2. an Auto Servo Ventilator.  Your sleep specialist will determine which of these two devices is best for your breathing abnormality.
  • A device may be necessary to provide supplemental oxygen.
  • Certain types of medication that help to stimulate the autonomic breathing process while asleep.

While all of these options above can be highly effective, it is just as important to develop positive lifestyle habits. Learning about the symptoms of this condition and avoiding situations that may trigger an episode (such as drinking alcohol or taking sedatives) is likewise a powerful strategy to adopt. 

Thankfully, science has come a long way over the past few years. There is no doubt that even more effective solutions will be available in the near future. 

Sources:

https://www.mayoclinic.org/diseases-conditions/central-sleep-apnea/symptoms-causes/syc-20352109#:~:text=Central%20sleep%20apnea%20is%20a,muscles%20that%20control%20your%20breathing.

https://www.webmd.com/sleep-disorders/sleep-apnea/central-sleep-apnea

https://www.sleepfoundation.org/sleep-apnea/central-sleep-apnea