the national institute of neurological disorders and stroke (ninds) and other institutes of the national institutes of health (nih) conduct research related to sleep apnea in laboratories at the nih, and also support additional research through grants to major medical institutions across the country. sleep apnea is a common sleep disorder characterized by brief interruptions of breathing during sleep. people with sleep apnea will partially awaken as they struggle to breathe, but in the morning they will not be aware of the disturbances in their sleep. central sleep apnea (csa) is caused by irregularities in the brain’s normal signals to breathe. additional symptoms of sleep apnea include restless sleep, loud snoring (with periods of silence followed by gasps), falling asleep during the day, morning headaches, trouble concentrating, irritability, forgetfulness, mood or behavior changes, anxiety, and depression. sleep apnea is more likely to occur in men than women, and in people who are overweight or obese.
there are a variety of treatments for sleep apnea, depending on an individual’s medical history and the severity of the disorder. some people are helped by special pillows or devices that keep them from sleeping on their backs, or oral appliances to keep the airway open during sleep. there are also surgical procedures that can be used to remove tissue and widen the airway. the u.s. food and drug administration has approved a surgically implantable device placed in the upper chest that monitors a person’s respiratory signals during sleep and stimulates a nerve to send signals to a muscle to stimulate and restore normal breathing. untreated, sleep apnea can be life threatening. although there is no cure for sleep apnea, recent studies show that successful treatment can reduce the risk of heart and blood pressure problems.
in patients with low central drive, this further loss of drive at sleep onset can lead to marked hypercapnia in some cases. any of these various gains can serve to elevate the overall loop gain and create a propensity for breathing instability. these data are consistent with the notion that csb per se may be problematic in chf, and not simply a marker of a “sicker” patient. on the one hand, some might argue that treatments that lead to resolution of apnea are likely to yield improved outcome in chf patients with csb.
among chf patients who also have a component of osa one could argue that treatment with cpap is justified, based on some improvements in hemodynamics that have been documented in prior studies.42,43 although some short-term studies have shown some improvements in breathing pattern with the use of newer positive pressure devices, outcome data are again lacking.44,45 because of the clinical overlap between osa and csb, and the potential improvement in morbidity with cpap therapy in osa plus chf, we frequently will give these patients a trial of nasal cpap with close clinical follow-up to document improvement in breathing pattern. frequently, transient arousals from sleep occur and are followed by resumption of sleep, but the associated augmentation in ventilation leads to central apnea upon resumption of sleep. these patients frequently have bradypnea (reduced respiratory rate), and thus a low respiratory frequency should alert the clinician to the possibility of narcotic therapy/use. thus, a careful clinical approach to the patient with hypoventilation can often be clinically important.64 many patients with daytime hypercapnia will experience worsening of their blood gases at sleep onset. a crescendo-decrescendo pattern of breathing with cessations in air flow in the absence of respiratory effort.
central sleep apnea results when the brain temporarily stops sending signals to the muscles that control breathing. central sleep apnea (csa) is a disorder in which breathing stops and starts repeatedly during sleep. in some cases, breathing is very shallow. central sleep apnea (csa) is a breathing disorder that causes your body to decrease or stop the effort of breathing during sleep. it is usually, .
central sleep apnea occurs because your brain doesn’t send proper signals to the muscles that control your breathing. this condition is different from obstructive sleep apnea, in which you can’t breathe normally because of upper airway obstruction. central sleep apnea is less common than obstructive sleep apnea. the term central sleep apnea encompasses a heterogeneous group of sleep-related breathing disorders in which respiratory effort is central sleep apnea (csa) is caused by irregularities in the brain’s normal signals to breathe. most people with sleep apnea will have a central sleep apnea (csa) is defined by the cessation of air flow without respiratory effort. this condition is in contrast to obstructive sleep apnea (osa),, . central sleep apnea symptomsbeing very tired during the day.waking up often during the night.having headaches in the early morning.trouble concentrating.memory and mood problems.not being able to exercise as much as usual.
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