There isn't just one form of sleep apnea. The most commonly treated and encountered is that which forms as a result of the obstruction of the air passage, and which is therefore called obstructive sleep apnea (OSA). It accounts for more than 80% of cases. However, it is also possible to encounter a second form called central sleep apnea (CSA). The latter can be combined with its obstructive form or manifest itself alone, which then represents 0.9% of sleep apnea cases.
How does central sleep apnea differ from the more commonly seen form? Simply by the phenomenon that produces this cessation of breathing. In the case of ACS, there is no mechanical airway obstruction.
Causes of central sleep apnea
In reality, the problem is not in the throat or the nose, but directly in the brain. Concretely, this means that the brain is responsible for not sending the breathing signal to the diaphragm, and this for a minimum of ten seconds.
However, there is a link between the two types of apnea, because ACS is often associated with AOS, and sometimes even the consequence.
It is rare to be confronted with a case of central apnea dissociated from its obstructive form. Why ? Undoubtedly one can find an explanation in the origin of the ACS.
Central apnea can be caused by heart failure or chronic respiratory disease, and these kinds of problems can have their roots in…obstructive apnea. It is, in this case, a vicious circle between the two apneas, one generating the other. It is therefore necessary to be able to break this gear.
However, there are other causes for the occurrence of central sleep apnea. A stroke, the presence of a tumor, a neoplastic myelinating lesion, encephalitis or brainstem infarction are all possible reasons for the presence of an ACS. However, this is not the only cause. Cheyne-Stokes respiration (RCS) is the most widely encountered cause of central sleep apnea. RCS is often observed in patients with cardiac difficulties and consists of alternating episodes of hyperpnea and apnea.
Latest cases of ACS, the high altitude one, which can appear in some people at altitudes above 3000 to 4000 meters, as well as in consumers of products narcotics or those under treatment with morphine and other opioids.
Solutions against central sleep apnea
In these situations, the treatment is relatively simple: reoxygenation, either via a respirator or by descending from heights in the case of high altitude central apnea, and withdrawal or modification of treatment for situations of central apnea induced by taking drugs or opioid-based medications.
The difficulty with this type of apnea lies in the impossibility of applying the classic solutions, those adapted to obstructive apnea. During an apnea whose origin is in a sagging of the soft palate and the tongue, it is simply necessary to clear the passage to the lungs. In the context of central apnea, the absence of a mechanical blockage prevents the application of clearing techniques.
It is therefore necessary to be able to provide better stabilization of the respiratory function in order to fight against central sleep apnea.
The treatment applied in the ACS therefore consists of the use of a mask connected to a device allowing self-controlled ventilation. This type of ventilation provides inspiratory support during the inspiration phase, by being associated with positive pressure. It is an accompaniment of the breathing which is done naturally in order to counteract the appearance of apnea.
If CSA is a complication due to obstructive sleep apnea, then the latter should be treated as a priority. The use of Back2Sleep, in order to free the airways by creating an uninterrupted channel of air, allows resolve night time breathing difficulties and help sleep apnea.
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