Sleep apnea is when someone repeatedly stops breathing while they are sleeping.1 Breathing stops temporarily and then recommences, causing sudden drops in blood oxygen levels. Sleep apnea symptoms include a dry mouth upon waking, insomnia, daytime grogginess, and irritability.2
There are three types of sleep apnea. Central sleep apnea is when the sleep apnea cause is due to the actual central nervous signals for breathing. Breathing may also be halted by the relaxation of throat muscles, known as obstructive sleep apnea. When both occur, the condition is known as complex sleep apnea syndrome. There are different risk factors, complications, and treatments for central vs obstructive sleep apnea, so it is important to identify which type is afflicting a patient.
Central sleep apnea is when our central nervous system’s breathing signals are disrupted. Although we can exert conscious control over our breathing, our bodies are able to breathe without us having to remember to do so. The central nervous system regulates our breathing rate, sending signals to our breathing muscles.3 If this process becomes disrupted enough to cause sleep apnea, it is known as central sleep apnea.
The type of disruption can fall into two broad categories. One disruption is when there is an impaired central breathing drive. This is where the parts of the central nervous system that generate the signals to breathe are disrupted. The causes may be due to the growth of a tumor, or can be congenital.
Central sleep apnea can also occur if the central nervous system successfully generates a signal, but the signal is unable to cause breath. This can be due to a number of factors, including problems with the nerves that carry the signal or even the muscles that normally allow breathing to occur.4
Obstructive sleep apnea is when there is physical obstruction by the tissues of your throat. If some of the muscles in your throat relax, it can cause the tissues normally kept out of the path of breathing to constrict your airway. In mild instances of airway obstruction, this may manifest as snoring.5 When the airway is entirely blocked, even momentarily, it is obstructive sleep apnea.
Obstructive sleep apnea is more common than central sleep apnea. There are a number of obstructive sleep apnea risk factors that increase the chances your airway may become obstructed during sleep. Drug use, including smoking cigarettes, drinking alcohol, and consuming sedatives or tranquilizers all increase the chances of obstructive sleep apnea.
Obstructive sleep apnea is two to three times as common in men than women. The risk of obstructive sleep apnea increases with age, as well as with body mass index. A congenitally narrowed throat makes it more likely that your breathing will be obstructed while sleeping.
Whether it is central vs obstructive sleep apnea, there are complications that arise from periods of low oxygen due to breathing disruption while sleeping. The sudden drops in blood oxygen levels can tax the cardiovascular system, leading to spikes in blood pressure and overall hypertension or high blood pressure.6
Sleep apnea sufferers report daytime fatigue and grogginess, as well as difficulty staying focused. Sleep apnea can even increase your risk of developing Type II diabetes.
All types of sleep apnea can be treated with sleep apnea equipment such as a continuous positive airway pressure machine, or a CPAP machine.7
OSA stands for obstructive sleep apnea, and CSA stands for central sleep apnea. OSA is when a part of the throat obstructs breathing. CSA is when your central nervous system or brain fails to send the correct signals to breath. Both involve cessation and resumption of breathing while sleeping.
The risk factors for central sleep apnea are advanced age, congestive heart failure, a history of stroke, and opioid use or abuse. Men are more likely to exhibit central sleep apnea than women. Stress is not considered to be a contributing factor for central sleep apnea.8
Narcotic induced central sleep apnea can be treated by reducing the dosage of the medication causing the interruptions in breathing9. Treatments for other causes of central sleep apnea utilize modern pharmaceuticals or medical devices.
If someone has both central sleep apnea and obstructive sleep apnea, it is termed complex sleep apnea syndrome.
© 2021 American Sleep Association.