Understanding the Different Types of Sleep Apnea: Central, Obstructive, and Complex

Posted on by Gateway Center for Sleep Apnea & TMJ Therapy

Sleep apnea is a serious sleep disorder that affects millions of people, often without them realizing it. This condition disrupts normal breathing during sleep, leading to poor rest, daytime fatigue, and a host of potential health complications. While many people associate sleep apnea with snoring, the condition is far more complex and can take different forms. The three main types of sleep apnea are Obstructive Sleep Apnea (OSA), Central Sleep Apnea (CSA), and Complex Sleep Apnea Syndrome (CompSA). Understanding the differences between these conditions is essential for accurate diagnosis and effective treatment.

Obstructive Sleep Apnea (OSA)

OSA is the most common type of sleep apnea. It occurs when the muscles in the throat relax excessively during sleep, causing a partial or complete blockage of the airway. When airflow is restricted, oxygen levels drop, prompting the brain to wake the body briefly to restore normal breathing. These interruptions can happen multiple times per hour, often without the person being aware.

Common Causes of OSA

  • Excess weight or obesity, which increases the likelihood of airway collapse
  • Large tonsils or adenoids, which can obstruct airflow
  • Chronic nasal congestion or sinus issues
  • Weak or overly relaxed throat muscles, often influenced by aging or alcohol use

Symptoms of OSA

  • Loud snoring, often accompanied by choking or gasping sounds
  • Waking up frequently throughout the night
  • Excessive daytime sleepiness and difficulty concentrating
  • Morning headaches or dry mouth

Health Risks Associated with OSA

OSA can have significant long-term effects on overall health. If left untreated, it increases the risk of:

  • Heart disease and high blood pressure due to repeated oxygen deprivation
  • Type 2 diabetes, as poor sleep can interfere with insulin regulation
  • Stroke, as interruptions in breathing can impact blood circulation to the brain

Central Sleep Apnea (CSA)

CSA is different from OSA because it is not caused by a physical obstruction in the airway. Instead, it occurs when the brain fails to send the correct signals to the muscles responsible for breathing. As a result, the body temporarily stops making an effort to breathe.

Common Causes of CSA

  • Neurological conditions that affect brain function
  • Use of opioid medications, which can suppress respiratory signals
  • High-altitude exposure, which can affect breathing control
  • Congestive heart failure, which can impact the brain’s ability to regulate breathing

Symptoms of CSA

  • Irregular breathing patterns during sleep
  • Sudden shortness of breath upon waking
  • Difficulty falling or staying asleep
  • Frequent awakenings throughout the night

Health Risks Associated with CSA

CSA is often linked to underlying medical conditions that require attention. It can contribute to:

  • Heart failure and arrhythmias, due to disrupted oxygen levels
  • Cognitive decline, as poor oxygenation can affect brain function over time
  • Severe fatigue, impacting daily activities and increasing the risk of accidents

Complex Sleep Apnea Syndrome (CompSA)

CompSA, also known as treatment-emergent central sleep apnea, is a combination of OSA and CSA. It is often identified when a patient undergoing treatment for OSA, such as CPAP therapy, begins to exhibit symptoms of CSA.

How CompSA Develops:

When a patient with OSA starts using a CPAP (Continuous Positive Airway Pressure) machine, the sudden increase in airflow can cause the brain to overcompensate, temporarily suppressing natural breathing efforts. This can result in a shift from obstructive to central apnea episodes.

Symptoms of CompSA

  • Symptoms of both OSA (snoring, daytime fatigue) and CSA (irregular breathing patterns)
  • Increased breathing instability despite CPAP use
  • Difficulty adjusting to CPAP treatment

Diagnosis and Treatment Options

Because sleep apnea can vary in type and severity, an accurate diagnosis is essential for effective treatment. A sleep study, also known as polysomnography, is the gold standard for diagnosing sleep apnea. Some patients may also benefit from at-home sleep tests that monitor breathing patterns.

Treatment for Obstructive Sleep Apnea

  • CPAP Therapy: A machine that delivers continuous air pressure to keep the airway open during sleep.
  • Oral Appliances: Custom-fitted dental devices that reposition the jaw to prevent airway collapse.
  • Lifestyle Modifications: Weight loss, positional therapy (sleeping on the side), and avoiding alcohol before bedtime.
  • Surgical Options: In some cases, surgery may be recommended to remove airway obstructions.

Treatment for Central Sleep Apnea:

  • Adaptive Servo-Ventilation (ASV): A specialized device that adjusts airflow based on breathing patterns.
  • Supplemental Oxygen: Helps maintain stable oxygen levels during sleep.
  • Addressing Underlying Conditions: Treating conditions like heart failure may improve CSA symptoms.

Treatment for Complex Sleep Apnea Syndrome:

  • A combination of therapies tailored to the patient’s response to treatment.
  • Adjustments to CPAP settings or alternative treatments like ASV may be recommended.

Take Control of Your Sleep Health Today

Understanding the differences between Obstructive Sleep Apnea, Central Sleep Apnea, and Complex Sleep Apnea Syndrome is crucial for getting the right diagnosis and treatment. Sleep apnea can have serious consequences for your health, but with proper care, you can achieve restful, uninterrupted sleep.

If you experience symptoms of sleep apnea, such as excessive daytime sleepiness, loud snoring, or difficulty breathing during sleep, it’s important to seek professional help. At Gateway Center for Sleep Apnea & TMJ Therapy, our team is dedicated to helping you find a solution that fits your needs. Schedule a consultation today to take the first step toward better sleep and improved health.