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Non-Obstructive Alveolar Hypoventilation, Idiopathic

What is it?

This problem occurs when you have low nighttime oxygen levels that are not caused by a medical condition or by any other problem such as obesity. It is an uncommon condition, and little is known about its causes. Sometimes this problem also occurs during the daytime.

The main feature of this condition is reduced breathing volume. This means that there is less air coming into and going from your lungs.

This problem often disturbs your sleep. It can cause insomnia or excessive daytime sleepiness. It can also cause you to have a headache when you wake up in the morning.

Low oxygen levels at night can contribute to heart problems. These problems include heart failure and high blood pressure.

Low oxygen levels are more common during the REM stage of sleep.

Other names for this disorder include the following:

  • Central alveolar hypoventilation
  • Idiopathic central alveolar hypoventilation
  • Non-apnic alveolar hypoventilation
  • Primary alveolar hypoventilation

Who gets it?

Very little is known about who has this disorder. It does appear to be more common in men than in women. It can also be more common in people who use certain medications. These medications contribute to shallower breathing patterns. Examples include the following:

  • Sleeping pills
  • Anti-anxiety medications
  • Pain killers
  • Alcohol

How do I know if I have it?

  1. Does an overnight sleep study show episodes of shallow breathing?

  2. Do these episodes cause a significant decrease in your oxygen levels?

  3. Does this pattern cause awakenings from sleep or irregular heart rhythms?

  4. Is there no evidence of a lung disease, skeletal malformation or neuromuscular disorder that would explain the problem?

  5. Have any other types of disorders that can cause this problem been ruled out?

If the answer to these questions is “yes,” then you might have sleep related non-obstructive alveolar hypoventilation, idiopathic.

Do I need to see a sleep specialist?

Yes. This problem can greatly disturb your sleep. It can cause you to wake up many times at night. It can also case disruptive body movements. This problem is most often diagnosed at night. An overnight sleep study at a sleep center can detect it.

What will the doctor need to know?

The doctor will want to know about your entire medical history. You should also describe any sleep related problems that you have. Report if you have shortness of breath at night or during the day. Tell your doctor if you have swelling in your feet, legs or arms. Your doctor will also want to know if you ever notice that your fingers, toes or lips turn a bluish color.

Will I need to take any tests?

Yes. There are two ways to find out whether or not you have this problem. The first method is for you to go to a sleep center for an overnight sleep study. This will assess your breathing patterns, oxygen levels and sleep quality.

A second method involves overnight oximetery. This is when you wear a clip on your finger during the night. The clip is attached to a small box. This process measures your average oxygen levels as you sleep. Your doctor can then determine if the problem is present.

How is it treated?

The first step is to determine if another medical problem is the cause of this sleep related breathing disorder. Treatment can then target the underlying problem.

While your doctor evaluates your condition, he or she may place you on oxygen at night. This will help improve your oxygen levels. To use the oxygen, you normally wear a small plastic tube in your nose. This is called a cannula. Often you only need to use this at night when you sleep.

Sometimes a small BPAP machine is used instead of or in addition to oxygen. BPAP stands for bi-level positive airway pressure. A BPAP machine is about the size of a shoebox. It provides a pressurized flow of air to the airway and lungs. This helps you inhale more deeply. It also improves your body’s exchange of oxygen and carbon dioxide.

To use the BPAP, you have to wear a small mask over your nose when you sleep at night. Some people wear a mask that covers the nose and mouth.

The BPAP system is much like CPAP. The difference is that BPAP provides a higher level of air pressure when you breathe in and a lower level when you breathe out. CPAP provides one constant level of air pressure.

By Donald R. Townsend, PhD
Updated April 25, 2006

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If I have low oxygen levels during the night, does this mean I have hypoventilation?

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