Introduction
A less common disorder in which the breathing is disturbed with episodes of breathlessness during sleep, as the signals from the brain towards the breathing muscles are disturbed. It is often misinterpreted with obstructive sleep apnoea in which upper airway obstruction is the cause. Central sleep apnoea is otherwise caused by sleeping at high altitudes, heart failure or stroke.
Types
Cheyne-Stokes breathing (related with congestive heart failure or stroke), drug-induced (morphine, codeine etc) apnoea, high-altitude periodic breathing which is characterised by alternating hyperventilation and under-ventilation, treatment-emergent central sleep apnoea often associated with obstructive sleep apnoea, medical condition-induced central sleep apnoea (eg: kidney disease and stroke) and idiopathic/ primary central sleep apnoea are the various types.
Abnormal breathing patterns during sleep, episodes of breathlessness during sleep, snoring, disturbed sleep, insomnia, excessive sleep during day-time, headache especially in mornings, mood changes and difficulty in concentrating are the common symptoms of central sleep apnoea.
Causes of central sleep apnoea
The reason behind various types of sleep apnoea is different. Central sleep apnoea is mainly caused by disturbances in signal transmission from brain to breathing muscles.
Age (above 60 years), male sex, heart disease, stroke, high altitude, brain tumour, structural lesions of brainstem, use of opioids and CRAP are the common risk factors.
Treatment of central sleep apnoea
Central sleep apnoea can be managed by treating the underlying disease, reducing the use of opioids, oxygen supplementation or medicines (acetazolamide) to stimulate breathing. Techniques like CPAP, Adaptive Servo-ventilation (ASV), Bilevel positive airway pressure (BPAP) are often useful. Transvenous phrenic nerve stimulation is the latest surgical intervention to correct central sleep apnoea.
Complications of central sleep apnoea
Chronic central sleep apnoea may cause fatigue and cardiovascular diseases.
Ayurvedic Concept of central sleep apnoea
Any type of disturbance in breathing comes in Swaasa but central sleep apnoea has connections with other conditions also. It can be understood, connected with Vaata kopa in siras, especially of Praana vayu. Sometimes there will be Aavarana by kapha, as it is the seat of Kapha. In some cases, it affects the power of sensory organs like eyes, nose etc.
Ayurvedic Nidana of central sleep apnoea
Rookshata – excessive dryness in the body
Vyayama – excess physical exercise
Langhana – fasting and other measures that reduce body weight
Atyahara – excessive food intake
Abhighaata – physical injuries
Adhwa – travelling
Vegodeerana & dharana – Forceful expulsion or restricting of natural urges like urine
Ayurvedic treatment for central sleep apnoea
Therapies to reduce Kapha & obstructions to the channels in the head –
Nasya – nasal drops with herbal powders or oils
Dhoomapana – Fumigation/ smoking with herbs
Kabala – Gargling with herbal decoctions or medicated oils in warm water
Gandoosha – holding medicated decoctions inside the mouth for a while and spitting it out
Sirodhara -pouring of medicated liquids over the forehead
Swedana – sweating therapies
Herbal Preparations for central sleep apnoea
Guluchyadi kashayam
Vidaryadi Kashayam
Anutailam
Arimedadi tailam
Ksheerabala tailam
Yashtimadhu churna
Agasthya Rasayan
Diet & Regimen
Avoid food items that cause an increase in Kapha.
Avoid sticky oily & heavy food at night.
Avoid dairy products as much as possible
Take fresh warm and nutritious food rich in vegetables fruits pulses etc.
Avoid sedentary lifestyle & day sleeping habit
Maintain a healthy daily routine with sleep schedule
Yoga & Pranayama
Central sleep apnoea gets reduced remarkably with the practice of Yoga and pranayama under expert supervision
Ushtrasana (camel pose)
Savasana(corpse pose
Ardhamatsyendrasana(semi-spinal twisted pose)
Bhujangasana(serpant or cobra pose)
Simha garjana (making roaring exhalation in Lion pose)
Ujjayi pranayama
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