Central Sleep Apnea – Diagnosis & Treatment
Sleep specialists have training and expertise in this area. The doctor will review your medical history and symptoms. In the case of high-altitude periodic breathing, the detailed history alone should be enough to detect the problem. If needed, the doctor will schedule you for an overnight sleep study. This kind of study is called a polysomnogram. The sleep study will help the doctor to evaluate your problem.
Most of the causes of CSA are serious conditions that should be evaluated and treated. A sleep specialist can put together a treatment plan just for you. First, he or she must evaluate the causes of CSA and look for other conditions that create similar problems with sleeping. These include the following:
- Another sleep disorder
- A medical condition
- Medication use
- A mental health disorder
- Substance abuse
The doctor will need to know your symptoms and how long you have had them. He or she will also want to know if your symptoms began at the same time as other medical problems or when you slept at a high altitude.
Get information from those who sleep with you or have seen you sleep. This includes spouses, relatives, friends, teammates and roommates. You will also need to provide a complete medical history.
Keep a sleep diary for two weeks. Include the following information:
- What time you went to bed each night
- What time you got up in the morning
- How many times you awoke during the night
- Whether you felt rested when you woke up
- If you took naps during the day
- Whether you felt sleepy or rested throughout the day
The sleep diary will help the doctor see your sleeping patterns. This information gives the doctor clues about what is causing your problem and how to correct it.
If your doctor thinks that you have a problem with breathing during sleep, you will need to do an overnight sleep study. This study is called a polysomnogram. It will chart your brain waves, heart beat, and breathing as you sleep. It will also record how your arms and legs move. This will reveal if you have CSA. It will also show how bad the problem is.
If you have CSA, you may be asked to return to the sleep center for a second polysomnogram. This visit will include a CPAP study. You will be given positive airway pressure (PAP) treatment as you sleep.
Positive airway pressure (PAP) is the treatment most often used for CSA. It is delivered through a mask that you wear over the nose or face. The air gently blows into the back of the throat. This keeps the airway open so you are able to keep breathing as you sleep.
The amount of air pressure needed is different for each person. A CPAP study will show what level is right for you. Often a variation of PAP, called BPAP, is used.
A thorough evaluation and treatment of underlying medical conditions needs to be done. Heart failure or kidney failure needs specific treatment. Stroke may require special care such as rehabilitation.
In the case of high-altitude periodic breathing, no specific treatment may be needed. But other problems that occur at high altitude may need to be addressed. Some of these may respond to medication. Others require avoiding high altitudes.
In the case of CSA due to drug or substance, a change of medication may be needed.