Primary central sleep apnea (PCSA) is a sleep disorder characterized by the repetitive cessation or reduction in breathing during sleep, lasting for at least 10 seconds. Unlike obstructive sleep apnea, where the breathing difficulties are typically caused by a physical blockage of the airway, in primary central sleep apnea, the interruptions in breathing occur due to a failure of the brain to control the respiratory muscles.
In PCSA, there is a temporary absence or decrease in the brain's signals to the muscles responsible for breathing, resulting in the individual experiencing pauses in their breathing throughout the night. This can lead to a significant decrease in the oxygen levels in the bloodstream and fragmented sleep patterns.
PCSA is considered primary when it occurs independently, without a clearly identifiable underlying medical condition such as heart failure, central nervous system disorders, or the use of certain medications. It is more commonly observed in older adults and those with certain medical conditions, such as stroke, brainstem lesions, or narcotic use.
Symptoms of PCSA may include excessive daytime sleepiness, fatigue, morning headaches, difficulties in concentration, and frequent awakenings during the night. The diagnosis of PCSA is usually made through a thorough evaluation and assessment of the individual's medical history, physical examination, and sleep studies.
Treatment options for PCSA may include addressing any underlying medical conditions, continuous positive airway pressure (CPAP) therapy to help maintain an open airway during sleep, adaptive servo-ventilation (ASV) therapy to assist breathing, or medication to stabilize respiratory control. Management of any contributing factors, such as medications that may exacerbate the condition, is also important in the management of PCSA.
