Health condition
Central sleep apnoea
Central sleep apnoea - breathing pauses because the brain stops sending the signal, not because the throat blocks - is rarer than obstructive apnoea and points to underlying causes: heart failure, opioid medication and altitude head the list.
Why trust this guide
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Editorial team
Written by our editorial team from the UK sources listed on each page.
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Sourced from guidance
Checked against current NHS and UK specialist society guidance at the time of review.
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Current for 2026
Reviewed on 2026-09-27 with the next review scheduled for 2027-09-27.
Key facts
The essentials at a glance.
The symptoms to recognise, when to seek help, which specialist to see, and what treatment usually involves.
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The distinction: no snoring-and-struggle pattern - breathing simply stops quietly, with no effort, then resumes; often noticed as disturbed sleep, insomnia or witnessed silent pauses
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Key associations: heart failure (Cheyne-Stokes breathing), long-term opioid use, stroke, and high altitude
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Diagnosis requires a sleep study that measures breathing effort - distinguishing absent effort (central) from blocked effort (obstructive)
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Specialist: a consultant in sleep medicine with cardiology input; treating the underlying cause comes first, with adaptive servo-ventilation or other support for selected cases
Understanding the condition
What it is and what happens next.
What causes it, how it is diagnosed, and the treatment routes available in the UK.
What it is and how it feels
Obstructive apnoea is a plumbing problem; central apnoea is a control problem: the brainstem's respiratory centre periodically withholds the command to breathe, producing silent pauses without the snoring, choking and struggling of the obstructive form - which is why bed partners describe eerie stillness rather than noise, and why sufferers present with fragmented sleep, insomnia or fatigue more often than classic sleepiness. The pattern matters because central apnoea is usually a messenger: waxing-waning Cheyne-Stokes respiration signals heart failure and correlates with its severity, opioid medications suppress respiratory drive dose-dependently, and strokes, kidney failure and altitude each produce their own versions.
Diagnosis and treatment routes
Diagnosis needs a study measuring respiratory effort alongside airflow - effort absent during pauses defines central events - and a proportion of patients show mixed central and obstructive disease, which shapes treatment. Management starts upstream: optimising heart failure therapy can markedly reduce Cheyne-Stokes breathing, tapering opioids where feasible addresses drug-induced apnoea, and treating the primary condition always precedes gadgetry. Where significant central apnoea persists, options include CPAP (effective in a subset), adaptive servo-ventilation - with important cardiology-led selection rules in heart failure - oxygen therapy, and emerging phrenic nerve stimulation, all decisions for a specialist sleep service working alongside cardiology. In many parts of the UK, routine NHS referrals for this kind of problem currently take 20-45+ weeks, whereas an initial appointment with a private consultant is typically available within around two weeks.
Seeing a specialist
Who to see, and how quickly you can be seen.
The specialist for this condition is usually a consultant in sleep and respiratory medicine. Your GP can refer you on the NHS, or you can arrange a private consultation directly.
A quiet reminder
This guide is for information, not medical advice.
Your GP knows your history and can tell you which parts apply to you. If in doubt, see them - and seek urgent care for any of the emergency symptoms described above.
Frequently asked
Common questions about Central sleep apnoea.
Quick, plain-English answers to what people ask us most.
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What is central sleep apnoea?
Central sleep apnoea is a condition where breathing repeatedly pauses during sleep because the brain temporarily stops sending the signals needed to trigger breathing, rather than because the airway is physically blocked. It is often related to underlying heart failure or certain neurological conditions. It is less common than obstructive sleep apnoea but is an important condition to recognise and treat.
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What causes central sleep apnoea?
It is commonly associated with heart failure, stroke, certain brain conditions affecting breathing control, high altitude, and medications such as opioids that suppress respiratory drive. In some cases, no clear cause is found. Identifying underlying heart failure in particular is important, as treating it often improves the sleep apnoea.
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What are the symptoms?
Symptoms include noticed pauses in breathing during sleep (often reported by a partner), waking suddenly feeling breathless, poor sleep quality, excessive daytime tiredness, and morning headaches. Symptoms of any underlying condition, such as breathlessness from heart failure, may also be present. It can significantly affect quality of life if untreated.
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Is central sleep apnoea serious?
Yes, particularly because it is often linked to heart failure and can worsen cardiovascular outcomes if left untreated, in addition to affecting sleep quality and daytime function. It is generally taken seriously by sleep and cardiology specialists working together. Effective treatment can improve both sleep and, in some cases, underlying heart function.
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How is it diagnosed and treated?
Diagnosis is made with an overnight sleep study that identifies the specific pattern of breathing pauses without airway obstruction. Treatment includes managing underlying conditions like heart failure, and specific breathing devices such as adaptive servo-ventilation designed for central apnoea, alongside review of any contributing medications. A combined sleep medicine and cardiology approach is often most effective.
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Can central sleep apnoea be cured?
If linked to a reversible cause, such as a medication that can be adjusted, symptoms may resolve once that cause is addressed. Where it is linked to ongoing heart failure or a chronic neurological condition, it is usually managed long-term rather than cured outright, though effective treatment can substantially improve symptoms and quality of life. Ongoing specialist follow-up helps track response to treatment.
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When should I see a specialist?
See a doctor if you or a partner notice breathing pauses during sleep, particularly alongside symptoms of heart failure or unexplained tiredness. NHS sleep clinic waits can extend to several weeks; a private consultation is typically available within about 2 weeks for prompt investigation.