central sleep apnea

[beckyperillo]

I was wondering if you could tell me more about central sleep apnea..there is very limited information about it online. I wake up gasping for air as I'm falling asleep, almost as if I stopped breathing. I'm no doctor, but from what I read central sleep apnea occurs several times during the course of a night, but it happens in stages 1&2 of sleep which is when it occurs in my situation. This has only happened to me 3 times in the course of a month or so. I made the mistake of reading these articles about apnea and am now scared that I have some brainstem tumor or something. I'm under terrible stress and don't sleep very well to begin with and now that this started I really can't sleep at all. I have no insurance to go to the Dr. to get a proper diagnosis. I have read a lot of information about other people having the same problem as me on different websites and a lot of information comes back to it being stress related. I am 40 years old and have had major problems with stress my whole life, but nothing like this has ever happened to me before. I am not a typical obstructive apnea case..I'm not overweight, male and  I don't smoke or drink which is why I think it would have to be central if anything. Also, I had an isolated episode like this 9 years ago while I was in Tennessee, but I was on meds for gastritis and thought maybe that had something to do with it, but now I don't know. Your help would be greatly appreciated. Thanks in advance.

[Lama Chahine, MD]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the cause of your breathing difficulties while falling asleep are. However, I will try to provide you with some useful information.

First, while you are correct that obstructive sleep apnea occurs in over-weight individuals, males, smokers etc., it can in fact occur in even under weight people as well not uncommonly. In such people, the airway becomes obstructed due to a large tongue, small/narrow upper airway, small lower jaw (mandible) and several other causes. Obstructive sleep apnea is much much more common than central sleep apnea. They can also commonly occur together.

Central sleep apnea most often occurs in the setting of other neurologist disorders. It results from lack of appropriate signals from the brainstem, the area of the brain that is involved in regulating the breathing cycle. Central sleep apnea also commonly occurs in the setting of heart disease, particularly heart failure.

Other causes of difficulty breathing when lying down (the medical term for this is orthopnea) include fluid in the lungs (pulmonary edema), heart failure, and other heart and lung problems. Parosymal nocturnal dyspnea, or sudden episodes in which you are woken up out of sleep unable to breathe, could be related to heart problems as well. Another possibility is asthma. If you are otherwise healthy and do not have other symptoms, it is unlikely that these are the cause of your symptoms. Yet another cause of difficulty with breathing out of sleep are panic attacks.

I recommend that when ever possible you be evaluated by a general practioner/family physician regarding your symptoms. After he/she examines you, he/she will be able to determine whether or not you have signs suggesting specific causes to your symptoms such as heart disease etc. Unfortunately, polysomnograms, or sleep studies, which are used to diagnose sleep apneas and other sleep-related breathing disorders, are expensive, but one may be indicated for you depending on the physician's evaluation.

Thank you for using the forum, I hope you find this information useful, good luck.