Obstructive Sleep Apnea’s Ugly Stepsister: Central Sleep Apnea
Central sleep apnea means your brain tells you not to breathe, as opposed to obstructive sleep apnea, which is pausing in breathing due to your airway being blocked off anatomically. As the mother recounted all the signs, symptoms, unknowns, doctors’ visits, surgeries, recoveries, and day-to-day management of Chiari Malformation (her child’s official diagnosis), I couldn’t help scouring my brain for how I could help.
All judgment aside, please: occasionally (okay, okay…often) during my son’s hockey practice, some of us parents meander a block away to the restaurant which happens to have a lovely bar. We sit, we chat, we have a drink… maybe two, if you’re lucky. Usually, it’s just that. Casual, light-hearted fun to pass the hour outside of a cold, dingy hockey rink.
One time, however, it was different; it was a meaningful, heartfelt, and sometimes wrenching conversation that started when I casually mentioned to the mother of another player that I was a dental hygienist and “Oh, by the way, I also do this weird myofunctional therapy thing.” She asked some questions, and one thing led to another and to an admittance: Her daughter had sleep apnea. It wasn’t the sleep apnea we dental hygienists/myofunctional therapists are used to dealing with; it was central sleep apnea.
Essentially, central sleep apnea means your brain tells you not to breathe, as opposed to obstructive sleep apnea, which is pausing in breathing due to your airway being blocked off anatomically. As the mother recounted all the signs, symptoms, unknowns, doctors’ visits, surgeries, recoveries, and day-to-day management of Chiari Malformation (her child’s official diagnosis), I couldn’t help scouring my brain for how I could help.
Obstructive sleep apnea is often due to (or exaggerated by) a lack of muscle tone in the tongue and throat, meaning your tongue falls back into your throat and blocks your airway. Obstructive sleep apnea can be caused or exacerbated by many things, including but not limited to enlarged tonsils and/or adenoids, mouth breathing/open mouth posture, deviated septum, tongue-tie, underdeveloped jaws, allergies, etc. Myofunctional therapy, when paired with surgically correcting anatomy if necessary, can help improve all these causes with exercises to increase tonality and restore proper function.
On the other hand, central sleep apnea has only a neurological root. For those with Chiari Malformation, brain tissue may be compressed, causing issues in transmitting cues to breathe from the brain to the diaphragm. We help sleep apnea all the time! It felt frustrating to know sleep apnea so well and realize this was a totally different beast.
Learn more about myofunctional therapy in treating obstructive sleep apnea here. For more information about Chiari Malformation and how it relates to sleep apnea in children, consult this article in the Journal of Clinical Sleep Management.