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What Is The Best Treatment For Central Sleep Apnea

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Weight Gain Or Obesity

Managing Central Sleep Apnea With Advancements In Treatment of Obstructive Sleep Apnea

Your body weight is a major contributing factor to your sleep apnea symptoms in fact, approximately 70 percent of OSA patients are obese.

Obesity puts you at a higher risk of obstructive sleep apnea, as well as other conditions like hypertension, heart disease, and diabetes. This is because increased fat deposits around your neck can block your upper airway as you rest, and additional pressure on your abdomen can make it difficult to breathe at night.

Sleep apnea can also worsen weight gain because your body regulates your hormones as you sleep. One of these hormones, leptin, helps regulate your body weight as well as your breathing control as you sleep.

Leptin deficiency may actually disrupt your sleep architecture and impact your upper airway resistance if you have sleep apnea, as well as contribute to weight gain.

Animal studies have shown a strong correlation between sleep apnea and leptin deficiency, and the correlation appears in humans as well.

Thankfully, losing weight can reduce your sleep apnea severity or even significantly reduce your risk of the disorder. Even 10 to 15 percent weight loss if youre overweight or obese can reduce severity by 50 percent.

The healthiest ways to lose extra weight are through a healthy, balanced diet as well as regular moderate exercise.

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The Latest Sleep Apnea Devices Everything You Need To Know

While CPAP is one of the most effective treatments for sleep apnea, many patients stop using their machines within a year. Good news, theyre now plenty of alternatives you can try.

The latest sleep apnea devices include more comfortable air pressure systems, body positioners, innovative nerve stimulators, and surgically implanted suspension lines.

What Causes Central Sleep Apnea In Children

Central sleep apnea can occur for a variety of reasons in children. It is important to note that a few central apnea events during sleep is considered normal. Central sleep apnea has been associated with rare genetic disorders in children, such as congenital central hypoventilation syndrome. It may also be present when children have health conditions that interfere with parts of the central nervous system that controls breathing.

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What Are The Effects Of Sleep Apnea

If left untreated, sleep apnea can result in a number of health problems including hypertension, stroke, arrhythmias, cardiomyopathy , heart failure, diabetes, obesity and heart attacks.

Its likely that sleep apnea can cause arrhythmias and heart failure because if you have sleep apnea, you tend to have higher blood pressure. In fact, sleep apnea occurs in about 50% of people with heart failure or atrial fibrillation.

This is because sleep apnea can cause:

  • Repeated episodes of oxygen lowering .
  • Changes in carbon dioxide levels.
  • Direct effects on the heart due to pressure changes within the chest.
  • Increased levels of markers of inflammation.

With the high prevalence of sleep apnea in cardiac arrhythmias and heart failure , experts recommend that you dont delay in seeking the advice of your physician.

Last reviewed by a Cleveland Clinic medical professional on 03/03/2020.

References

What Are The Treatment Options For Central Sleep Apnea

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Treatment options for CSA can be complex, especially for those who also suffer from heart conditions. It is important that your sleep expert coordinate with your cardiologist for treatment options. In most CSA cases, continuous positive airway pressure, or CPAP, is ineffective. You may be given adaptive-servo-ventilation, or ASV, which is a more complex positive airway pressure device designed to normalize breathing pattern. However, ASV can increase the risk of death in patients with heart failure and reduced ejection fraction.

Additionally, we now offer another breakthrough option — a U.S. Food and Drug Administration-approved phrenic nerve stimulation treatment called the RemedÄ System. The implantable device, which was approved in 2017, stimulates a nerve in the chest that is responsible for sending signals to the diaphragm to stimulate breathing.

UChicago Medicine was the first hospital in Chicago to offer this latest, implantable treatment option for patients with CSA. The system is the newest addition to UChicago Medicine’s Sleep Disorders Center, which offers a number of noninvasive and minimally invasive sleep disorder treatments.

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Central Sleep Apnea Happens When The Brain Is Involved

Central sleep apnea is less common than obstructive sleep apnea. It can also be trickier to diagnose and treat. Unlike obstructive sleep apnea, which is caused by a mechanical problem that blocks the airway, central sleep apnea occurs because the brain is not sending the proper messages to the muscles that control breathing. Central sleep apnea is caused by a neurological reason, explains Dr. Capasso.

While central and obstructive sleep apneas share many symptoms such as episodes of pauses in breathing, constant awakenings during the night, and extreme sleepiness during the day central sleep apnea often affects people who have underlying illnesses, too, such as a brain infection or other conditions that affect the brainstem. Common diseases associated with central sleep apnea include: severe obesity, Parkinsons disease, stroke, and chronic heart failure. Certain drugs, such as opioids or benzodiazepines, can also play a role in central sleep apnea. In patients who use opioids on a chronic basis, the breathing mechanisms can get numbed, Capasso explains.

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Your doctor may refer you to a sleep specialist for a diagnosis if he or she suspects central sleep apnea, which may involve an overnight sleep test to rule out obstructive sleep apnea or other sleep disorders. The sleep specialist may also work with your cardiologist or order scans of your head and heart to rule out other contributing illnesses.

Due To Drug Or Substance

This breathing pattern can vary from a regular increasing and decreasing respiratory effort to something that is quite irregular. Sometimes there are elements of obstruction such as the breathing that is seen in OSA. Medications most associated with this central sleep apnea pattern are in the opioid category such as prescription pain medications or illicit substances such as heroin.

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How Is Central Sleep Apnea Diagnosed

A definitive diagnosis of CSA is made using an in-lab polysomnography, which is a detailed sleep study that measures breathing, respiratory effort, electrocardiogram, heart rate, oxygen, eye movement activity, muscle activity, and electrical activity of the brain during an overnight stay in a sleep clinic.

Because central sleep apnea can be tied to several health problems, a healthcare provider may also recommend other tests, such as a brain scan or an echocardiogram of the heart to determine the underlying cause.

Anyone who has noticed potential symptoms of central sleep apnea should speak with a doctor who can review their situation and determine if any diagnostic testing is appropriate.

How Is Sleep Apnea Different Between Adults And Children

The remed® System for Central Sleep Apnea

Sleep apnea leads to poor-quality sleep in all affected people, but the daytime symptoms can be different between adults and children. Adults are more likely to exhibit daytime sleepiness and fatigue, while children are more likely to show behavior issues such as difficulty concentrating and hyperactivity.

Additionally, sleep apnea is treated differently in children. In adults, the most common treatment is CPAP, while the most common treatment for children is surgery. Certain orthodontic treatments are only helpful in actively growing children and are not an option for adults with sleep apnea.

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The Symptoms Of Severe Sleep Apnea

To give you a reference, the next symptoms describe a patient with severe apnea. So, do you have these signs?

Severe Sleep Apnea Symptoms

You can recognize a patient with severe sleep apnea if he has the following symptoms:

  • stop breathing in sleep more than 30 times per hour!
  • very loud and irregular snoring
  • choking during sleep
  • sitting up or fighting for breath
  • abnormal motor activities
  • excessive daytime sleepiness
  • increased blood pressure
  • increased risk of heart attack and stroke
  • pulmonary hypertension
  • nocturia
  • weight gain
  • diabetes mellitus
  • there is a also link to GERD, night sweats, depression, anxiety
  • Fibromyalgia-like symptoms
  • cardiac arrhythmias

What Are The Risk Factors

Certain factors can put some at a greater risk of developing central sleep apnea, as reported by the Mayo Clinic.

  • Sex

Men are more likely than women to have central sleep apnea.

  • Age

Adults over the age of 60 are at an increased risk. Experts say this is likely because of additional sleep or medical issues that could induce apnea.

  • Heart disorders

Those who have atrial fibrillation or congestive heart failure also have a higher risk of this sleep disorder. Atrial fibrillation is when someone has an irregular heartbeat, while congestive heart failure is when the heart does not pump enough blood.

  • Brain conditions

Brain issues such as a stroke, tumor, or structural brainstem lesion could impair breathing.

  • Sleeping at a high altitude

If you are not used to resting at higher altitudes, that could induce central sleep apnea.

  • Opioid use

We also mentioned earlier that people who take opioid medications could develop sleep apnea.

  • CPAP use

Those using continuous positive airway pressure to treat obstructive sleep apnea are at increased risk of contracting central sleep apnea.

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Exactly How Sleep Apnea Impacts Lifestyle Job And Also Partnerships

Sleep apnea can have a considerable impact on lifestyle. One of the most typical threat aspects associated with sleep apnea is excessive weight. Central Sleep Apnea Treatment Devices

Sleep apnea is a sleep problem that can influence job efficiency. It can trigger mishaps and lower concentration, which decreases the high quality of work. There are additionally connections in between sleep apnea and colleagues social communications, team interaction, and work-life equilibrium.

The impact of sleep apnea on partnerships is a subject that should have attention. Sleep apnea has been linked to depression, hormone imbalance, and also weight gain. Along with these, several various other signs might impact relationships, such as snoring, gasping for air, and also lack of energy.

The research study is out there with researches suggesting that sleep apnea may cause marital troubles as well as divorce rates in couples.

Sleep apnea could be affecting more connections than you believe.

When somebody is dealing with Sleep Apnea, they are denied of the deep sleep that is so crucial for us to function at our best. Their partner then needs to take care of the effects of their partners exhaustion, absence of focus on tasks handy, irritability, as well as mood swings. This can have a considerable effect on the partnership.

American Sleep Apnea Association

Treatment Options for Central Sleep Apnea

We envision a world in which most people suffering from sleep apnea are diagnosed, aware, educated and treated. This serious syndrome, when left untreated has a large influence on quality of life and multiple life-threatening implications. Yet it is highly treatable. Unfortunately it is estimated that more than 80% of people suffering from sleep apnea are undiagnosed. To help those living with sleep apnea, we work relentlessly to promote

  • better awareness in the general public and among health professionals and,
  • affordable, convenient and highly effective diagnoses and treatments.
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    Where And How Is The Remed System Implanted How Does It Work

    The RemedÄ System is usually implanted under the skin in the right upper chest, similar to a pacemaker, during an outpatient procedure with sedation. The generator sits over the pectoral muscle and is connected to two leads, or wires. The leads work in tandem to deliver the therapy and to sense breathing. The stimulating lead activates a nerve in the chest, called the phrenic nerve, to send signals to the large muscle in the chest and abdomen called the diaphragm, mimicking how the brain signals breathing.

    Complex Sleep Apnea Syndrome Is A Combination Of Osa And Central Sleep Apnea

    Doctors have recently identified a third type of sleep apnea called complex sleep apnea, which is a combination of obstructive sleep apnea and central sleep apnea. Patients with this type of sleep apnea may at first seem to have obstructive sleep apnea, but unlike typical patients with obstructive sleep apnea, these patients symptoms are not fully addressed with the use of CPAP.

    In patients with complex sleep apnea syndrome, breathing problems persist even after the airway obstruction is addressed and treated, which means something besides the collapsing throat muscles are also contributing to the apnea.

    The problem is that there is still a lot of debate among sleep medicine specialists about whatexactly is going on in complex sleep apnea, or what the key characteristics that define it are.

    In a study published in March 2014 in the journal Sleep Medicine Clinics, doctors conducted a review of 223 patients referred to the Mayo Clinic Sleep Disorders Center over one month, as well as 20 patients diagnosed with central sleep apnea. 00122-7/abstract” rel=”nofollow”> 11) They found that 15 percent of all sleep apnea patients had complex sleep apnea. As many as 84 percent were found to have obstructive sleep apnea, and 0.4 percent had central sleep apnea.

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    A Cpap Therapy Targeted To Normalize The Apnea Hypopnea Index Is Indicated For The Initial Treatment Of Csas Related To Chf

    Values and Trade-offs: The overall quality of evidence for the use of CPAP in the setting of CSAS related to CHF is moderate, but with a large effect size and consistent findings for reduction of AHI and improvement in LVEF. Post hoc analysis of the CANPAP data indicates that CPAP treatment targeted to an AHI < 15 has a positive effect on transplant-free survival in patients with CSAS and CHF. Given the relative ease of availability of this therapeutic intervention and overall familiarity with its use, a STANDARD level of recommendation was given. An alternate treatment option should be considered in the absence of adequate control of CSAS related to CHF with CPAP.

    The Causes Of Unchecked Sleep Apnea

    Effective Treatment for Sleep Apnea

    Snoring and also sleep apnea can interrupt your sleep as well as bring about other health problems. Central Sleep Apnea Treatment Devices

    Individuals with sleep apnea experience duplicated stops briefly in their breathing during the evening. This is called obstructive sleep apnea . When people with OSA do not get enough oxygen, they fall under a deep sleep and dont awaken as commonly as individuals that dont have it. This can make them feel like theyre not getting adequate remainder during the night.

    Snoring is another sort of breathing problem thats more common than OSA. Snoring occurs when the soft cells in a persons nose, mouth, or throat vibrates while theyre resting, making an audio that disturbs their partners sleep and has actually been recognized to lead to chronic sleep deprivation as well as severe illness.

    Concerning 18 million Americans have sleep apnea, a serious illness. Its a common condition that disrupts your breathing during sleep, causing several complications.

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    Obstructive Sleep Apnea Is The Most Common Subtype Of The Condition

    The most common type of sleep apnea is obstructive sleep apnea, sometimes referred to as OSA. With OSA, the throat muscles in the back of your throat, which naturally become more relaxed during sleep, collapse too much to allow for normal breathing.

    The throat muscles support the soft tissues in the back of the throat such as the soft palate, the uvula, the tonsils, and tongue so when those muscles collapse too much, those tissues can fall back into the throat, partially or completely blocking the normal flow of air in your airway. When the airway is blocked partially the person may start to snore, which is why this symptom is common in OSA.

    When your brain senses that you arent getting enough oxygen, it signals your body to wake up enough so that you can reopen your airway, and you may gasp for air during the night. Simply put, having obstructive sleep apnea means that not enough air can get into lungs at night, and your brain wakes you up to breathe, says Robson Capasso, MD, chief of sleep surgery and associate professor of otolaryngology and head and neck surgery at Stanford University School of Medicine in California.

    Doctors diagnose OSA using a sleep test that measures your body and brain activity during sleep, which is conducted either at home or at a sleep lab.

    Your doctor may also advise you to lose weight and to avoid sleeping on your back, to prevent gravity from further pushing your tongue, tonsils, and other soft tissues in your throat into your airway.

    Continuous Positive Airway Pressure

    CPAP improves cardiac function in patients with congestive heart failure and CSB-CSA.

    A study published in 2000 suggesting that CPAP may reduce the combined rate of mortality and cardiac transplantation in heart failure patients with CSB-CSA. This observation raised substantial interest and resulted in the institution of a large prospective study, the Canadian Prospective Continuous Positive Airway Pressure trial for congestive heart failure trial. While this latter study failed to confirm a mortality benefit, CPAP was associated with attenuation of central sleep apnea, improvement of nocturnal oxygenation, lowering of norepinephrine levels, improvement in ejection fraction, and the increased distance walked in six minutes.

    Another study demonstrated that despite lowering of the AHI, CPAP had no significant effect on the frequency of arousals, sleep efficiency, or the amounts of total, slow wave, or rapid eye movement sleep in heart failure patients with central sleep apnea.

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    Positive Airway Pressure Devices

    Positive airway pressure machines, used with a variety of breathing masks, are the most widely used treatment for moderate and severe sleep apnea.

    The mask, worn snugly over the nose, or sometimes nose and mouth, during sleep, supplies pressurized air that flows continuously or intermittently into the sleepers throat. The increased air pressure prevents the sleepers airway from collapsing.

    The pressurized air is supplied through a flexible tube from one of several types of machines: CPAP , BiPAP , VPAP , and so on. Studies of the effect of PAP therapy show that people with sleep apnea who consistently use their machines feel better and, as a result of the reduction of apnea and hypopnea episodes during sleep, encounter fewer complications of the disease. Theres more information about PAP therapy here.

    Although PAP devices are not used to treat snoring alone, they do eliminate snoring in addition to treating obstructive sleep apnea.

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