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Wednesday, November 9, 2011

Central Sleep Apnea: ABC of the Disabling Disorder

By Douglas Kidder

If you have been diagnosed with central sleep apnea, chances are that you are both surprised and confused. First of all, you know nothing about sleep apnea. Obviously chances of knowing other variants of the illness, the features and cure options are remote.

Sleep apnea is one of the worst types of sleep disorders that arise mainly out of neglected snoring. It is caused by narrowing of the airways that result in major breathing distress during sleep.

Know the variants

The three types of this condition are: obstructive, central and mixed. Obstructive sleep apnea is most the common. It happens when there is a complete collapse or blockage in the upper respiratory tract.

What actually happens?

The brain, the controller of all muscular activities, sends out relevant signal to breathing muscles as to when to breathe. In case of any miscommunication or lack of synchronization between the two, the result is breathing distress.

For instance, the obstructive type happens when the breathing muscles are incapable of following the brain's command to breathe, because of obstructions in the airway. It can be caused by collapse and blockage in the upper respiratory tract.

Central type on the other hand is a condition marked by complete lack of coordination and synchronization between the brain and the breathing muscles. It can be fallout of some heart ailments, cerebrovascular disease or any congenital disease.

Some health conditions are common triggers for this condition:

- Bulbar poliomyelitis

- Complications arising from cervical spine surgery

- Encephalitis involving the brainstem

- Neurodegenerative conditions like Parkinson's disease

- Radiation of the cervical spine
Sleep apnea symptoms: what are they?
The reason why this illness remains undiagnosed for a long time is because its important features appear during sleep. The bed partner usually notices the repeated choking and gasps for air during sleep, pauses in breathing, loud and persistent snoring and call for medical assistance. What the patient notices are rapid and irrational weight gain, excessive daytime sleepiness, mood disorders like depression, etc.

Typical signs of central type of this disorder are excessive daytime tiredness, morning headaches and restless sleep.

This is done with help of a overnight sleep study, known as polysomnogram examination. Such a test is the only objective and reliable diagnostic tool that provides the following information: type of disorder; severity of the condition; site of obstruction in the airway tract. The several physical and physiological parameters studied in this diagnostic examination include eye, abdomen and limb movement; brain waves, heart rate, loudness of snoring; oxygen levels in the blood and more.

Sleep apnea treatment: depends on how serious the condition is

CPAP therapy along with simultaneous deployment of several lifestyle modifications and self-help strategies are considered to be the best options for managing mild to moderate conditions.

Despite its high rate of success, a large section of patients feel unhappy with therapy that involves use of the use of device, mask, etc. For such patients some viable CPAP alternatives are recommended including steroid nasal sprays; nasal decongestants containing oxymetazoline and neosynephrine; drugs like modanifil or armodanifil or using dental sleep apnea devices like mouth guards, etc .are also considered to be effective options.

Serious conditions however demand surgical intervention.

What if the signs appear confusing?
At times diagnostic confusion is created by overlapping signs that are common to several sleep disorders. For example, excessive daytime sleepiness is one of the leading signs of hypersomnia as well as narcolepsy.
But what is narcolepsy? It is a sleep disorder characterized by sudden sleep attacks - typical only to this illness. While sleep apnea sets in around 50 years of age, other disorders usually set in earlier. Of course of cause of onset of central sleep apnea puts this illness in a class of its own.
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