The Differences Between Obstructive, Central and Complex Sleep Apnea

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Sleep apnea is a medical condition where you temporarily stop breathing throughout the night. When this occurs, your breathing pauses, leaving you with a sudden drop in your blood oxygen levels before starting up again. You might have sleep apnea if you wake up with chronic dry mouth, headaches, trouble sleeping, daytime fatigue and moodiness. This condition comes in three forms: Obstructive (OSA), Central (CSA), and Complex.

Obstructive Sleep Apnea

OSA leaves your upper airway partially or completely blocked while you try to get a good night’s sleep. When this happens, the muscles in your chest and diaphragm have to work overtime to try to get the blocked airway to open and pull air into your lungs.

Things to prevent this include staying away from alcohol anywhere from four to six hours before turning in. Losing weight and even sleeping on your side help tremendously. Just a 10 percent drop in weight can lower your respiratory disturbance index (RDI)! Weight loss also reduces blood pressure, improving snoring and your pulmonary function. The easiest version to treat is mild sleep apnea, while moderate-to-severe typically involves using a CPAP machine to treat your sleep apnea. The kind we tend to see most is OSA, where your airway is blocked when the tongue and throat relax too much.

Central Sleep Apnea

CSA occurs when the brain forgets to breathe because of the central nervous signals for breathing. If both of these happen, we call it complex sleep apnea syndrome. So someone using a CPAP device to control their OSA may find themselves developing central sleep apnea with its accompanying breathing patterns referred to as complex sleep apnea. It often happens when you are suffering from a medical condition like heart failure and stroke. It can also arise when sleeping at a high altitude. You will want to schedule an exam if you experience these symptoms:

  • Shortness of breath that wakes you up
  • Have pauses in your breathing while sleeping
  • Trouble staying asleep
  • Serious daytime drowsiness where you fall asleep during normal tasks like driving

Treating central sleep apnea:

  • Fixing medical issues like heart failure might improve central sleep apnea
  • Lowering opioid medications
  • Wearing a continuous positive airway pressure (CPAP) mask
  • Adaptive servo-ventilation (ASV) adjusting the delivery of pressurized air
  • Bilevel positive airway pressure (BPAP) delivers pressure when you breathe in and out
  • Supplemental oxygen
  • Medications like acetazolamide to stimulate breathing
  • Surgery

Complex Sleep Apnea Causes

Complex sleep apnea is a combination of the two sleep apneas above (OSA and CSA). It involves having the obstruction of OSA and then developing breathing patterns called “treatment-emergent central apnea” while being treated with a CPAP device.

  • Your CPAP machine could be providing too much or too little air pressure
  • Your CPAP mask could be leaking
  • You gain excess weight
  • Narcotic drugs and opioids can suppress the activity in your central nervous system, like heroin, codeine, oxycodone, hydrocodone, morphine, etc.

Possible Treatment Options

  • Lose weight to lower your apneic events and possibly eliminate your sleep apnea
  • Use a positive airway pressure (PAP) machine to keep your airway open with a CPAP (continuous positive airway pressure), BiPAP (bilevel positive airway pressure), and VPAP (variable positive airway pressure) machine.
  • Use a CPAP along with oxygen.
  • Get a sleep study done to ensure the CPAP is working for your symptoms.
  • Use an Adaptive Servo Ventilation (ASV) tailored to your unique needs as your breathing stabilizes.
  • Take acetazolamide, a prescription drug for opioid therapy, to reduce the depressant effects.
  • As your complex sleep resolves, you may be fine just using an oral apnea appliance to keep your airways open.

Getting Help

When it comes to your overall health, a good night’s sleep is essential! To achieve this, you need to understand the type of sleep apnea you have. Whether mild, moderate, or severe, the right treatments can help you win your battle against poor sleep. We are here to help you with your sleep apnea symptoms. Call to learn more!