Did anyone have central sleep apnea as a result of styloid-C1 carotid sheeth compression? I’m going to have bilateral styloidecomy relatively soon, but my sleep is killing me and was hoping to hear from someone whose sleep apnea was resolved after styloidecomy. Perhaps Vegas nerve irritation or IIH? I don’t seem able to access CCI doctors, and I’m very unwell and hoping to improve after styloidecomy removal.
@KyleNeedsHelp I didn’t have sleep apnea but I had terrible insomnia with frequent awakenings. I had a carotid sheath fasciotomy as part of my right sided decompression back in October 2024. My sleep has improved tremendously since then. Hope that’s useful info.
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Hi @KyleNeedsHelp, I also experience central apneas as suggested by a sleep test I did a while back, though they are not too serious. Nevertheless, I similarly wondered whether they may be caused by my bilateral eagle’s, for which I haven’t yet had surgery. Doing a bit of digging I was able to find these two papers: (Sleep Apnea and Asymptomatic Carotid Stenosis: A Complex Interaction - ScienceDirect, https://academic.oup.com/sleep/article-abstract/33/3/327/2454496?redirectedFrom=PDF). Now in all I’ll say below, please bear in mind that I have no medical training. But based on what I understand, the authors describe how the central apnea observed in the examined cohorts seems to be correlated with (and they suggest is induced by) extracranial carotid artery stenosis. Just to be clear, the stenosis discussed in these papers is caused by atherosclerosis (plaque build-up inside the arteries), not by extrinsic compression as in the case of Eagle’s syndrome. Nevertheless, the causal mechanism the authors propose has to do with dysfunction of the chemoreceptors that exist within the carotid bodies, as a consequence of the stenosis. As far as I understand, these are receptors that can “sense” the concentration of carbon dioxide in the blood and its pH, and play a crucial role in regulating unconscious breathing. Information from these receptors is relayed to the brain through the carotid sinus nerve (Carotid sinus nerve - Wikipedia), which is a branch of the glossopharyngeal nerve.
What follows is purely conjecture on my part, so please take it with a pinch of salt. But I wonder whether impairment of the nerves that relay information from the carotid bodies to the brain may similarly cause central apnea. Not necessarily through direct compression of the carotid sinus nerve by the styloids (I’m not even sure this is possible anatomically, the carotid sinus seems to be much lower that the styloids), but maybe through compression further upstream, e.g. of the glossopharyngeal nerve, which is commonly compressed in Eagle’s. I had a quick look, but couldn’t find any meaningful papers on this. If anybody does, I’d love to see them.
I’m also very curious to see whether surgery helps, so please keep us updated if you plan to have it soon!
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Great information @crumblecookie! You’ve drawn what I think is definitely a possible conclusion regarding relationship between carotid & glossopharyngeal nerve compression/irritation & central sleep apnea. Thank you for the link to the paper, too.
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My husband had moderate sleep apnea before the surgery. He had a sleep test a couple of months after the styloidectomy/C1 shave/digastric removal. He still has apnea but it was overall down a few points.
But now it’s been 6 months, and I’d be so curious for him to do another study. Anecdotally, I’d say it is much lower now because of the resected digastric muscle, maybe pulling on the SCM or other nearby ligature. I haven’t heard him sleep yell in 6-8 weeks. He still shows some signs of apnea but overall it appears to be reducing more and more over time.
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We have had some members whose styloids are long enough to irritate the carotid sinus, so that’s a really good point & a good study, thank you! I don’t know if the vagus nerve has anything to do with it as well, it does have autonomic nervous system functions…
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More good news from your end re: JC’s continuing recovery from troublesome symptoms. I hope some of the others that came back are receding again, @Val7426. 
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