Breathing is something most people never have to think about. While you sleep, your brain sends signals to your body to breathe in and out. Sometimes, these signals become irregular. Breathing may slow down, pause, or stop for a short time, not because the airway is blocked, but because the brain does not send the message in time. This is called central sleep apnea.
Unlike obstructive sleep apnea, which happens when the airway physically collapses, central sleep apnea begins in the brain and nervous system.
Identifying the brain-related causes of central sleep apnea helps explain why it’s often linked to other health conditions and why proper diagnosis matters. Read on to find out how the brain controls breathing during sleep and what can interfere with it.
How Does the Brain Control Breathing During Sleep?
The brainstem, found at the base of the brain, controls automatic body functions like breathing. Nerve centers in the brainstem check the levels of oxygen and carbon dioxide in the blood. When needed, the brain sends signals to the muscles that control breathing.
While you sleep, this system runs automatically. If the brainstem does not send signals as it should, your breathing may pause. In central sleep apnea, the airway remains open, but the urge to breathe stops for a short time.
What Neurological Conditions Cause Central Sleep Apnea?
Here’s a list of the neurological conditions that cause central sleep apnea:
1. Damage to the Brainstem
One of the most direct neurological causes of central sleep apnea involves damage to the brainstem itself. This can happen due to:
- Stroke
- Brain tumors
- Infection affecting the brain
- Traumatic brain injury
If the brainstem is injured, the nerves that control breathing may not function properly. This can cause repeated pauses in breathing during sleep, usually without loud snoring.
2. Neurodegenerative Conditions
Some neurological disorders gradually damage nerve function. These disorders can make it harder to control breathing during sleep, such as in the following cases:
Parkinson’s disease
Multiple system atrophy
Amyotrophic lateral sclerosis (ALS)
When nerve cells become weaker, the brain may have more trouble keeping a steady breathing rhythm. Central sleep apnea can develop as one of the changes that happen in the nervous system with these disorders.
3. Heart-Brain Signaling Problems
The brain keeps a close watch on blood flow and oxygen levels. For people with heart failure, the signals between the heart and brain may slow down or become less steady.
This can cause a breathing pattern called Cheyne-Stokes respiration, which is a type of central sleep apnea. It involves cycles of deep breaths followed by pauses.
While the heart is involved, the main issue is how the brain reacts to changes in blood chemistry. This breathing pattern reflects how the brain responds to changes caused by heart disease.
4. Medication Effects on the Nervous System
Certain medications can affect the parts of the brain that control breathing. Opioid pain medicines, for example, can slow down the nerves that help us breathe. Using these drugs for a long time or in high doses may make the brain less responsive to rising carbon dioxide levels during sleep.
When the brain’s response gets weaker, breathing pauses can happen more often. This type of central sleep apnea often gets better when a doctor adjusts the medication.
5. Congenital and Genetic Factors
In rare cases, central sleep apnea can be caused by conditions present from birth. One example is congenital central hypoventilation syndrome, where the brain does not control breathing well during sleep. Genes can also affect how the brain senses oxygen and carbon dioxide levels.
Why Central Sleep Apnea Often Goes Unnoticed?
Many people with central sleep apnea do not snore loudly. Symptoms may include frequent awakenings, daytime fatigue, morning headaches, or trouble staying asleep. Because the signs are subtle, the condition may remain undiagnosed without proper sleep testing.
The Bottom Line Is
Sleep apnea does more than just disrupt your sleep. It can put extra stress on your heart, lower your oxygen levels, and make daily activities harder.
Dentists with training in sleep medicine often work closely with other healthcare providers. Oral appliances are most often used for obstructive sleep apnea and may be helpful when obstructive and central sleep apnea occur together.
At John H. Krell DDS, we offer sleep apnea treatments based on thorough screening. Call us at to schedule your consultation and evaluation.