Hyperventilation Connection to Central Sleep Apnoea

There is not usually a snoring component to the problem of Central Sleep Apnoea (CSA), but there maybe be an aspect of what Konstantin Buteyko called ‘hidden hyperventilation’ since CSA responds to the inhalation of supplemental carbon dioxide.

Maintaining a constant pressure of carbon dioxide is the primary way of regulating breathing, and it seems that for a variety of reasons that are not fully known, there is a malfunction in the part in the brain that does this with people who have central sleep apnoea, because the pressure is not regulated properly. This is like a variation on Cheyne-Stokes breathing that is found in people who have head injuries, severe illness, or in healthy people who are sleeping at altitude.

Carbon dioxide concentration only needs to increase a fraction to stimulate the breathing, and similarly it only needs to drop a fraction to make the breathing not be stimulated, and a fraction more to make it stop. This may be what is happening with CSA because the person passively stops breathing, rather than still attempting to breathe like the people with Obstructive Sleep Apnoea (OSA), who’s airway is sucked close.

Older people tend to have more central sleep apnoea, and on the whole, older people have a greater tolerance to having less oxygen and more carbon dioxide in the blood during sleep than is generally considered ideal for good health. The apnoeas are most likely to happen during REM sleep when breathing is elevated, compared to that of slow wave sleep.

Blood flow to the brain drops considerably with hyperventilation, and so it is possible that a habit of low-grade hyperventilation could lengthen the time that the brain takes to register a change in carbon dioxide pressure in someone with central sleep apnoea as a result of the breathing pattern of REM sleep. The nerves that stimulate breathing may also be negatively affected by a reduction in their blood supply and consequent oxygen delivery.

To test if hyperventilation is the link that you have been looking for to control your CSA, see if you have other symptoms of chronic hyperventilation by taking the test.