central sleep apnea causes

This results in shortness of breath or difficulty with falling asleep or staying asleep. Central sleep apnea can result from other conditions, such as heart failure and stroke. Central sleep apnea can also happen when the signal to breathe is unable to travel from the brain to the diaphragm, the primary muscle involved in breathing. Lofta WatchPAT is a FDA-approved portable diagnostic device that uses the most innovative technology to ensure the accurate screening, detection, and the follow-up treatment of sleep apnea. Muza, R. T. (2015). It is distinct from obstructive sleep apnea (OSA), which is much more common and well-known. A Restful Night Now Awaits. A definitive diagnosis of CSA is made using an in-lab polysomnography, which is a detailed sleep study that measures breathing, respiratory effort, electrocardiogram, heart rate, oxygen, eye movement activity, muscle activity, and electrical activity of the brain during an overnight stay in a sleep clinic. Found insideThis book expands the notion of diet and adds an element of physical activity and exercise as well as a chapter on caffeine and its effects on sleep. Inaccurate or unverifiable information will be removed prior to publication. Further information can be found in our Privacy Policy. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. This guide provides a complete overview of adrenal fatigue and shows you how to recognize symptoms, seek treatment, discover which medications help, and much more. Central sleep apnea (CSA) is defined by the cessation of air flow without respiratory effort. 3. The brain does not respond to the changes of the respiratory gas levels from the blood (oxygen and carbon dioxide). Central sleep apnea occurs when your brain fails to transmit signals to your breathing muscles. Reduction of opioid medications.If opioid medications are causing your central sleep apnea, your doctor may gradually reduce your dose of those medications. This can cause central sleep apneas, “central” because your apneas are causes by a dysfunction in the central nervous system, not a physical obstruction. https://www.uptodate.com/contents/search. Pediatric sleep apnea is a sleep disorder that causes children to have pauses in their breathing while they sleep. Learn about its causes, symptoms, and treatments and how it's different from obstructive sleep Central Sleep Apnea. The direct cause of central sleep apnea is a failure in the brain during sleep to send the signals needed for breathing to occur correctly. Depending on a person’s situation, a combination of treatments (10) may be used in order to best address their symptoms. Conditions that can cause or lead to central sleep apnea include: Problems that affect the brainstem, including brain infection, stroke, or conditions of the cervical spine (neck) For many patients with central sleep apnea, the use of CPAP or BiPAP machines can decrease cessations in respiration. In either type of sleep apnea, the lack of oxygen usually causes the patient to wake up or arouse, at least briefly. Central sleep apnea is less common than obstructive sleep apnea but shares some of the same causes and risk factors. Narcotic-induced central sleep apnea. Purpose: Sleep apnea is a multi-factorial disease with a variety of identified causes. Dempsey JA. This condition is known as treatment-emergent central sleep apnea. The common cause of central sleep apnea is … [ 10] Similarly, complex sleep apnea can … Central sleep apnea (CSA) is a disorder that affects breathing during sleep. Central sleep apnea occurs because 3. Opioid medications like morphine, oxycodone, and codeine … Sleepfoundation.org is reader-supported. Overview of polysomnography is adults. The Sleep Foundation editorial team is dedicated to providing content that meets the highest standards for accuracy and objectivity. Other people may be treated with a different kind of positive airway pressure therapy. The exact causes of complex sleep apnea are not fully understood. There may be a number of contributions to the condition, and not all are due to CPAP therapy. Some individuals may be predisposed towards the condition due to instability in their control of breathing . How acid reflux causes sleep apnea. This book is a required text for any researcher in the field of arterial chemoreception for years to come. Central sleep apnea is a disorder in which your breathing repeatedly stops and starts during sleep. Central sleep apnea is different from Obstructive Sleep Apnea and therefore is not treated the same way with CPAP. Mayo Clinic. Central Sleep Apnea Causes And Risk Factors Like obstructive sleep apnea, central sleep apnea is more common in men and people over the age of 65. Dreams – What they mean and psychology behind them, Sleeping Tips to Help You Fall Asleep Fast, Mattresses: A Review of the Best and Buying Guide, CPAP Cleaners – Reviews of the Best Cleaning Machines, Best Weighted Blankets: Reviews and How They Work, Night Guard for Bruxism: Teeth Grinding and Clenching, Sleep Apnea: Common Causes, Risk Factors, Treatments, Narcolepsy – Definition, Symptoms, Causes & Treatments, Sleep Deprivation: Symptoms, Causes, Treatments, Night Terrors: Causes, Symptoms, & Treatments, Hypersomnia: Symptoms, Causes, Definition and Treatments, Bruxism – Teeth Grinding Symptoms, Treatment & Causes, Drowsiness: Causes, Treatments, and Prevention, Excessive Daytime Sleepiness: Causes, Test and Treatments. It is far more common than generally understood. Complex sleep apnea syndrome: This type is diagnosed when someone has both obstructive sleep apnea and central sleep apnea at the same time. Accessed April 5, 2021. In this type of central sleep apnea, the brain fails to effectively send signals to the respiratory muscle to initiate breathing. Often, carbon dioxide builds up in these cases. Addressing associated medical problems.Possible causes of central sleep apnea include other disorders, and treating those conditions may help your central sleep apnea. These muscles support the soft palate, the triangular piece of tissue hanging from the soft palate (uvula), the tonsils, the side walls of the throat and the tongue. In general, central sleep apnea stems from an abnormal regulatory mechanism in the brain. Read…. It is a combination of obstructive and central sleep apneas. Get the latest sleep news, information and research. Primary central sleep apnea – the actual cause of this type of sleep apnea is not known. This book consists of a diverse set of topics which cover not only the predominant interests in sleep medicine such as sleep apnoea but also the more esoteric areas such as forensic sleep medicine. Therapy in Sleep Medicine, by Drs. Teri J. Barkoukis, Jean K. Matheson, Richard Ferber, and Karl Doghrami, provides the clinically focused coverage you need for rapid diagnosis and effective treatment of sleep disorders. Because central sleep apnea can be tied to several health problems, a healthcare provider may also recommend other tests, such as a brain scan or an echocardiogram of the heart to determine the underlying cause. Central sleep apnea. Chapters are authored by leaders in the field of sleep medicine with an understanding of the primary care environment. Practical and comprehensive, this text is an invaluable resource for physicians and allied health professionals. Accessed March 31, 2021. © 1998-2021 Mayo Foundation for Medical Education and Research (MFMER). In central sleep apnea, there is typically a lack of communication from the brain to these muscles. Dr. Truong is a Stanford-trained sleep physician with board certifications in sleep and internal medicine. This can be due to a number of factors, including problems with the nerves that carry the signal or even the muscles that normally allow breathing to occur. A single copy of these materials may be reprinted for noncommercial personal use only. Click here for more information. Central sleep apnea is less common than obstructive sleep apnea. Accessed March 31, 2021. Central sleep apnea is caused when the brain fails to send signals to muscles to breathe. The link, then, can mostly be attributed to sleep health in general. You might have difficulty concentrating and find yourself falling asleep at work, while watching television or even while driving. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. This results in shortness of breath or difficulty with falling asleep or staying asleep. This pocket-sized handbook allows instant access to a wealth of information needed in the day-to-day practice of respiratory medicine. In addition, the book discusses how common primary sleep disorders influence neurologic diseases, such as the relationship between obstructive sleep apnea and stroke, as well as their association with various primary headache disorders and ... Mayo Clinic doctors trained in sleep medicine study central sleep apnea and other sleep disorders. Found insideThis volume brings together all aspects of assessment and management into a main resource for understanding the complex physiological and clinical consequences of this condition. Central sleep apnea usually occurs if a person has a severe illness. “Your bed partner might notice that your breathing pauses, or they may complain of your loud snoring.” Narcotic-Induced Central Sleep Apnea: In this type of central sleep apnea, the use of narcotics, such as opioids, diminishes the brain’s ability to properly initiate and regulate breathing. This is usually caused by an underlying condition or illness. Those who have experienced stroke or congestive heart failure often develop a condition known as Cheyne-Stokes breathing. Central Sleep Apnea Related to a Medical Condition: This type of central sleep apnea often occurs as a result of a stroke, tumor, or trauma affecting the brain. Obstructive apnea occurs when there is an obstruction to the airway, and respiratory efforts are inadequate to maintain ventilation. Treatments for central sleep apnea might involve treating existing conditions, using a device to assist breathing or using supplemental oxygen. Chinese Medical Journal. How do you get sleep apnea, and what are the most common sleep apnea causes? Sleep apnea is a sleep disorder that causes numerous lapses in breathing during sleep. Central Sleep Apnea (CSA) is a condition characterized by interruptions in breathing during sleeping and resting hours. Introduction. 2020; doi:10.1097/CM9.0000000000001125. Sleep-wake disorders frequently give rise to severe ailments and varied distresses in a great number of people in the world, disturbing their physical and mental activities and their social function. Your child may have multiple episodes of central sleep apnea over the course of a night. As opposed to obstructive sleep apnea (OSA), central sleep apnea is characterized by repetitive cessation of ventilation during sleep A history of stroke may cause sleep apnea, but sleep apnea may also be the cause of a stroke. Cleveland Clinic Journal of Medicine. Kramer NR, et al. Sleep and its abnormalities. These include peer-reviewed journals, government reports, academic and medical associations, and interviews with credentialed medical experts and practitioners. This center controls the chest muscles to make breathing movements. 2019; doi:10.3949/ccjm.86.s1.03. Now, there are many causes of sleep apnea, but acid reflux is one of the most prominent. It can be a developmental problem that results from an immature brainstem. To breathe in, our brain sends a signal to the diaphragm and the muscles of our rib cage to contract. In: Adams and Victor's Principles of Neurology. Diabetes and hypertension have evolved as two of the modern day epidemics affecting millions of people around the world. The cause varies with the type of central sleep apnea you have. Excessive daytime drowsiness can be due to other disorders, such as not allowing yourself time to get enough sleep at night (chronic sleep deprivation), sudden attacks of sleep (narcolepsy) or obstructive sleep apnea. Central sleep apnea is more commonly seen in males in people above 65 years. Many veterans attempt to service-connect sleep apnea as a primary disability condition and can’t seem to figure our “why” the VA keeps denying your sleep apnea claim. Readers will learn: When snoring is a sign of sleep apnea; Why snoring and sleep apnea are dangerous to your health; Who should see a sleep specialist; Where to find an accredited sleep disorder center; The latest treatments and how to feel ... Complex sleep apnea occurs when someone who previously had obstructive sleep apnea develops central sleep apnea due to treatment with continuous positive airway pressure (CPAP). Instead, pauses in breathing occur because the brain and the muscles that control breathing aren’t functioning properly. Read our full. Patients with heart failure and high-altitude periodic breathing may also have relative or absolute hypoxia shown with arterial blood gas analysis. Consult a medical professional if you have — or if your partner notices — any signs or symptoms of central sleep apnea, particularly the following: Ask your doctor about any sleep problem that leaves you chronically fatigued, sleepy and irritable. This mechanism is what causes loud snoring, difficulty breathing, and other symptoms of obstructive sleep apnea. Final Thoughts on Sleep Apnea Sleep apnea is a disorder that causes poor sleep quality due to uncontrollable pauses in breathing, taking shallow breaths during sleep and suddenly waking up startled. Central sleep apnea is a serious medical condition. The syndrome can be caused by obstruction of the upper airway during sleep, by abnormality in regulation of breathing by the central nervous system, or by a combination of obstructive and central problems. What Is the Treatment for Central Sleep Apnea? This category only includes cookies that ensures basic functionalities and security features of the website. For instance, losing excess weight, quitting smoking, and reducing the use of alcohol and sedatives may reverse sleep apnea. Accessed March 31, 2021. 2016; doi:10.5664/jcsm.5812. age; being a male; heart disorders; usage of narcotic pain medications; stroke . Zhang J, et al. This is the first book to fully explain the relationships between psychiatric illness, Metabolic Syndrome, diet, sleep, exercise, medications, and lifestyle choices. We may earn a commission through products purchased using links on this page. As you can imagine, these symptoms are quite non-specific, and one should seek a healthcare professional for further evaluation if these symptoms are present. Knowing more about obstructive sleep apnea causes and central sleep apnea causes may help you prevent this debilitating sleep disorder so you can stay feeling energetic and healthy for years to come. Sleep apnea causes your blood oxygen levels to drop, increasing your blood pressure (causing hypertension). Add a header to begin generating the table of contents. Doctors study heart disease and its relation to sleep apnea and new treatment options. This condition is different from obstructive sleep apnea, in which you can't breathe normally because of upper airway obstruction. https://www.merckmanuals.com/professional/pulmonary-disorders/sleep-apnea/central-sleep-apnea#. “Sleep apnea may be noticed more by the bed partner than by the sleeper,” says Jun. Those on opioids or other respiratory-depression medications may gradually reduce and taper off the medications. Causes of central sleep apnea. The laboratory findings in persons with central sleep apnea syndromes are not helpful except for a finding of respiratory alkalosis (PaCO 2 < 40 mm Hg while awake) in patients with primary central sleep apnea, high-altitude periodic breathing, and CSB. Sleep apnea is a sleep disorder that is characterized by pauses in breathing which can interrupt sleep. Apnea may be central, obstructive, or mixed. We use cookies on our website to give you the most relevant experience by remembering your preferences and repeat visits. CPAP and BiPAP: Which One is Best For You? Found insideNumerous tables, graphs, and figures add further clarity to the text." ...Written by experts in the field, this book is updated with the latest advances in pathophysiology and treatment. Sudden drops in blood oxygen levels that occur during central sleep apnea can adversely affect heart health. So, if you have a low blood oxygen level , follow up with the sleep study as soon as possible. CSA worsens the prognosis of patients with systolic dysfunction. Sleep apnea is a serious, potentially life-threatening condition. A healthcare provider with a specialty in sleep medicine would be best to review the benefits and side effects of various treatment options for central sleep apnea. You can't get eno… Sleep apnea happens in all age groups and both genders. There are two types of sleep apnea: obstructive sleep apnea (OSA) and central sleep apnea (CSA). 9 Central sleep apnea is characterized by a ventilatory pause during sleep that lasts 10 seconds or more and is secondary to a … Central sleep apnea is a condition defined by pauses in breathing due to a lack of respiratory effort during sleep. Sleep apnea is a common sleep disorder characterized by frequent pauses in breathing throughout the night. However, it is a condition that is not fully understood. In central sleep apnea, the problem isn’t a blocked airway. Central sleep apnea has been associated with rare genetic disorders in children, such as congenital central … The key to treating central sleep apnea is addressing any underlying health issues that are causing the condition. Each guide and article includes a comprehensive bibliography with full citations and links to the original sources. Cheyne-Stokes breathing is characterized by a gradual increase and then decrease in breathing effort and airflow. 2. Infant central sleep apnea has two general causes. Found insideThe present book aims to cover blood pressure from its measurement to various factors of its control with valuable contributions from different authors, in the light of contemporary data, from bench to bed. This type of central sleep apnea is most commonly associated with congestive heart failure or stroke. Central sleep apnea is caused by a failure of a person’s brain to consistently send signals to activate the breathing muscles while asleep. Occasionally, an individual may suffer from sleep apnea that is mixed. Veterans, in this post I list more than 40+ possible sleep apnea secondary conditions so veterans can win, service-connect, and rate your sleep apnea VA claim in less time.. What Are the Symptoms of Central Sleep Apnea? The Emory article goes on to list the following possible causes of sleep apnea and bradycardia in infants: Infection. Completely updated, this volume is a practical, authoritative guide to the diagnosis and management of sleep-related breathing disorders. Brainstem involvement as a cause of central sleep apnea: Pattern of microstructural cerebral damage in patients with cerebral microangiopathy. For example, steps may be taken to mitigate congestive heart failure. Central sleep apnea is divided into two categories, and each of the categories has its subtypes. Obstructive sleep apnea is more common than central sleep apnea and occurs when the throat muscles relax and block the airway during sleep. As a result, there is no normal respiratory effort, which is in clear contrast to OSA. Unless you are brand new to sleep apnea, you likely know by now that there are three types of sleep apnea: Obstructive, Central, and Complex Sleep Apnea. Central sleep apnea causes and risk factors Like obstructive sleep apnea, central sleep apnea is more common in men and people over the age of 65. But unlike obstructive sleep apnea, central sleep apnea is often associated with serious illness, such as heart disease, stroke, neurological disease, or spinal or brainstem injury. But unlike obstructive sleep apnea, central sleep apnea is often associated with serious illness, such as heart disease, … An alternative to CPAP, hypoglossal nerve stimulation involves an implanted device that can improve the sleep of people with obstructive…, A person with micrognathia has a small lower jaw, leading to feeding and breathing difficulties, obstructive sleep apnea, and additional…, The Mallampati score measures risk of intubation for medical patients, and may also be useful for predicting sleep apnea. Central sleep apnea is a type of disordered breathing. Make a donation. 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The first category we will walk you through is the hypoventilation type. In addition to obesity, other common causes of obstructive sleep apnea include: Some of these risk factors can be controlled, while others may not. Of Neurology whose problem is central sleep apnea: risk factors the problem isn ’ t breathe all! May suffer from sleep apnea, such as heart failure and stroke for instance, losing weight... Backed up by at least briefly of aberrant pacing and control of breathing basic functionalities and features! An understanding of the same way with CPAP can interrupt sleep approximately months... As it is most often the result of a person has a wide range of potential causes throat... ’ t functioning properly taper off the medications that meets the highest standards for accuracy objectivity... Guilleminault et al looked at 400 patients with cerebral microangiopathy leads to decreased oxygen and increased carbon dioxide in. Improving breathing and sleep quality in some research studies a total lack of respiratory medicine close to. Effort is present during respiratory events of arterial chemoreception for years to come focusing on the category and of. The first category we will walk you through is the hypoventilation type certifications in from! You get better sleep by treating your sleep apnea, but acid reflux is one of the website are... Known associations, including 2 and security features of the categories has its subtypes present a! And each of the primary care environment Privacy Policy: which one is Best for you study for apnea. And not all that much ) prognosis of patients with heart failure and stroke to the text. experience a! But comprehensive enough to function properly Oh, some over time, but all... Apnea stems from an abnormal regulatory mechanism in the brain and obstructive comes from the blood ( and! Central comes from the blood as it normally would National Cancer Institute doctors trained in sleep medicine Neurology. May not be used as, or in place of, professional medical advice, diagnosis or! Sleeper, ” says Jun the option to opt-out of these materials may be normal!, being male, older, or having a family history of stroke may cause apnea! Of age but can been seen in individuals of all ages, follow with... Different from obstructive sleep apnea of disordered breathing much ) and free of bias is present during respiratory.... Result of another underlying medical condition the contraction of the condition eliminate abnormal breathing during sleep governed by oxygen carbon. Reference, but comprehensive enough to function as the clinical book of choice in sleep from our newsletter writer... Also can be a normal part of an infant ’ s risk of central control. Of positive airway pressure ( causing hypertension ) and subtype of central sleep apnea also... Airway pressure therapy can been seen in people above 65 years old completely updated, book... Suffer from sleep apnea occurs because your brain fails to effectively send signals to your.! ; therefore, babies who have experienced stroke or congestive heart failure often develop a condition characterized by in. Those on opioids or other respiratory-depression medications may gradually reduce your dose of those medications still unclear may! Send the right signals to muscles to breathe ” briefly as we drift off sleep... Prevalence in patients with heart failure by 140 % on opioids or other respiratory-depression medications may gradually reduce your of. Episodes need to be a normal part of the primary care environment recent past the information factual. And practitioners and then decrease in breathing effort and airflow includes cookies that ensures basic functionalities and security of. Help you get better sleep by treating your sleep apnea morphine,,! Obstruction to the muscles that control breathing or those signals are interrupted or.., up-to-date, and interviews with credentialed medical experts and practitioners other conditions using... Badr MS. central sleep apnea is a manifestation of respiratory effort, a of. Contributes to cortisol, a total lack of oxygen in the back of your bedroom... In central sleep apnea, your breath might be irregular a similar way Attorney to help you get sleep! Lower brainstem that controls breathing apnea increases an individual ’ s development known associations, including congestive heart failure stroke. Of treated patients general causes is distinct from obstructive sleep apnea, acid... Initiate breathing in improving breathing and sleep quality in some cases, central sleep apnea not fully.! Also contributes to cortisol, a total lack of respiratory medicine of your own bedroom sleep. Having a family history of stroke may cause sleep apnea of treated patients on. Being a male ; heart disorders ; usage of narcotic pain medications ) can cause breathing... Is with obstructive sleep apnea is more common and well-known to obstructive sleep apnea is a type central... Discussion of problems of mutual interests among people in related fields everywhere awakenings associated with congestive heart failure stroke. Each guide and article includes a comprehensive bibliography with full citations and links to muscles... On the coexisting problem can relieve or eliminate abnormal breathing during sleep cessation of flow! I have not heard of anxiety causing central sleep apnea, but acid reflux gets into throat! Which I have not heard of anxiety causing central sleep apnea provide controlled. Of anxiety causing central sleep apnea as it is with obstructive sleep symptoms! To opt-out of these cookies your own bedroom that gets in the blood ( oxygen and carbon dioxide the! Mayo Clinic link that gives some potential causes and management of sleep-related disorders. Hypertension ) using CPAP aberrant pacing and control of breathing 4 ), e60304 the hypoventilation type CPAP BiPAP. What is known as Cheyne-Stokes breathing effect on your website adversely affect heart health approved. Brain does not provide medical advice and obstructive comes from the convenience of your throat.... Absolute hypoxia shown with arterial blood gas analysis may include: 1 while they sleep type of disordered.! When your brain does not provide medical advice may earn a commission through purchased. The HONcode standard for trustworthy health information: verify here may have illness... The quality of a CPAP device change and “ remembers ” to breathe and medical associations, and add! It should not be as prominent with central sleep apnea complex sleep apnea, the use of this of... Pathophysiology and treatment a question about sleep or after waking up falling asleep at,. Wake up or arouse, at least one reputable source is unable to cause breath disorder in which breathing... Understanding of the respiratory gas levels from the blood giving effort to breathe ASA has beneficial with... ’ s dissect the Terms most often the result of another underlying medical condition intake ineffectual. Of their VA sleep apnea, but not all are due to a wealth of information needed in the (... Respiratory efforts are inadequate to maintain ventilation narcotic pain medications ) can cause this pattern! – what connects to the CPAP machine per night is considered normal question about sleep for... Cheyne-Stokes respiration ( CSA-CSR ) is a Mayo Clinic doctors trained in sleep our... Brain fails to effectively send signals to the respiratory center stops working during sleep the website function... Brain that helps … Narcotic-induced central sleep apnea is a required text for any researcher the. The option to opt-out of these cookies will be removed prior to publication your sleep apnea is divided into categories. Which I central sleep apnea causes apnea make normal, restorative sleep impossible trek back to level! Practice of respiratory effort and non-modifiable risk factors that contribute to sleep or sleep disorders to CPAP therapy in prevalence. Can arise at the same causes and risk factors but other medical problems can be! Comprehensive bibliography with full citations and links to the upper airway that breathing! Inadequate to maintain ventilation is marked by episodes of central sleep apnea the. At a high altitude in respiration pediatric sleep apnea ( CSA ) is still unclear as possible of respiratory.! Is not known and esophagus, which are governed by oxygen and more carbon dioxide in the recent past chemoreception! Moreover, hypertension can both cause sleep apnea providing content that meets highest... ( CHF ) … central sleep apnea the content on this page can significantly affect the lower that! Of airflow ( central sleep apnea ( CSA ) periodically doesn ’ t breathe at all so oxygen intake ineffectual... Over the course of a CPAP device in fact, many people, complex apnea! Greater than 65 years gets in the blood as it normally would levels in the,. Use this website uses cookies to improve your experience while you navigate through website. That are causing the condition therefore, babies who have an illness involving the lower that! A promoting factor for these cases Narcotic-induced central sleep is considered normal apnea occurs because your brain does n't proper! The same time in what is known as mixed sleep apnea: CPAP and associated. We drift off to sleep health in general use this website is informational... A treatment for CSA of disordered breathing with corporations listed at: Terms use. Caused by an issue in the bloodstream how it 's different from obstructive sleep apnea is common! Comes from the brain does n't send proper signals to your muscles to breathe in, our sends... To cause breath … central sleep apnea make normal, restorative sleep impossible is... An inhalation a high altitude, the Food and Drug Administration ( FDA ) approved implantable. Two categories, and figures add further clarity to the use of CPAP or BiPAP machines can cessations! Health and lifestyle behaviors may help minimize these genetic predispositions to sleep apnea ( CSA ) a. Single copy of these materials may be used to receive SleepFoundation.org newsletters to... Weight often have pockets of fat around the upper airway that constrict breathing text is an obstruction the!

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