Chiari malformation is a brain condition that can cause a wide range of symptoms and comorbid conditions, such as sleep apnea. In fact, studies show that 50% of Chiarians have sleep apnea-hypopnea syndrome and some cases result in sudden death. Because of this, it is crucial for everyone who is diagnosed with Chiari malformation to get tested for sleep apnea. Here's what you need to know if you or your child has been diagnosed with Chiari.
Chiari malformation & your body's autonomic system
Chiari malformation is a condition in which the cerebellar tonsils extend beyond where they should and into the spinal cord opening, which can block the flow of cerebral spinal fluid and/or put pressure on the medulla oblongata of the brain stem. The medulla oblongata contains crucial nerves that control your body's autonomic system. Pressure on these nerves can affect your breathing and airway control, muscle control, temperature regulation, blood pressure, heart rate, and digestion.
Sleep apnea hypopnea & hyercapnia
Due to your body's inability to regulate breathing and control your airway, you have a likely chance of developing sleep apnea-hypopnea. This is caused by the collapsing of the upper airway. What's important to understand with this condition is that it can lead to hypercapnia, which is the excessive build up on carbon dioxide in the bloodstream due to the inability to achieve adequate respiration to release the carbon dioxide from your lungs.
Too much carbon dioxide in your bloodstream can lead to death. Symptoms of mild hypercapnia mimic some of the symptoms of Chiari, including headaches, lethargy, and confusion. Therefore, it's important to not only have sleep studies done to determine if you have sleep apnea, but it's also important to have diagnostic tests done to regularly monitor and detect hypercapnia.
Chiari malformation, sleep apnea & opioid analgesics
Another crucial thing to understand about Chiari and sleep apnea is the role that opioid analgesics can play in sudden death. Pain medication is often necessary for people with Chiari to control the headaches and body aches that are caused by the brain condition. However, researchers believe opioids may cause sudden unexpected neurogenic (problem in the nervous system) cardiac death by contributing to further breathing difficulties during sleep and leading to hypercapnia.
While your neurosurgeon and neurologist can recommend treatment for your Chiari malformation, which can include posterior fossa decompression, you will also need to see a sleep specialist and a pulmonologist to evaluate you for sleep apnea and hypercapnia. For more information, check out sites like http://www.alleghenybrainandspinesurgeons.com.
