Sleep apnea is a sleep disorder that is caused by the inability to breathe properly during sleep. It is usually marked by waking up abruptly gasping for air, loud and/or chronic snoring, and periods of decreased or absent breathing during sleep.1 Other sleep apnea symptoms include trouble sleeping at night, difficulty concentrating, mood changes, insomnia, and excessive daytime sleepiness.
Sleep apnea is a condition that can, if untreated, cause serious health problems, including high blood pressure, strokes, heart attacks, cardiomyopathy, and diabetes. There are three main types of sleep apnea: central sleep apnea, obstructive sleep apnea, and mixed or complex sleep apnea, which is a combination of the first two. Differentiating and diagnosing the type and form of sleep apnea you have is imperative to finding the best management and care.
Obstructive sleep apnea (OSA) is the most common form of sleep apnea.2 This type of sleep apnea is caused by muscles in the back of the throat relaxing, which can block or narrow the airways. This prohibits you from getting adequate oxygen during sleep, creating an increase of carbon dioxide in the bloodstream. Because the airway is narrowed or blocked, and there is not enough oxygen in the system, the brain wakes you up suddenly in order to force you to breathe. When this happens, you might snort or gasp awake. This phenomenon can happen repeatedly throughout the night, even hundreds of times, preventing deep REM cycles and restorative sleep. Despite their disruptive nature, these bouts of wakefulness are often so brief that you might not be aware that they are happening.
Some sleep apnea risk factors for OSA include obesity, restricted or narrowed airways, having a large neck, and alcohol or nicotine use. CPAP machines are often used to treat obstructive sleep apnea.
Central sleep apnea (CSA) occurs when the brain does not send signals to the body to breathe regularly during sleep, causing breaks in breathing.3 This can also manifest as very shallow breathing. The causes of CSA are less clear than OSA, but can often be linked to a condition in the heart or brain. Sometimes the cause of CSA is idiopathic, in which case it is classified as primary central sleep apnea.4
Another type of CSA is called Cheyne-Stroke Breathing Pattern, which involves an alternating pattern of hyperventilation and apneas (periods of reduced or non-existent breathing) that is usually brought on by congestive heart failure or a stroke.5 The use of certain drugs or substances, specifically opioids, can also cause central sleep apnea.
This third type of sleep apnea has only recently been widely recognized as a separate diagnosis.6 Mixed or complex sleep apnea, as its name suggests, is a combination of the other two major types of sleep apnea. Those with complex sleep apnea demonstrate symptoms of obstructive sleep apnea and central sleep apnea happening in the same sleep episode.
It is important to acknowledge complex sleep apnea as a separate and distinct type of sleep apnea when diagnosing it and coming up with a treatment plan.7 Patients with complex sleep apnea are most commonly diagnosed first with obstructive sleep apnea (OSA). Sometimes while being treated for obstructive sleep apnea the presence of central sleep apnea becomes apparent—this occurrence is called treatment-emergent central sleep apnea. The best approach for treating this form of sleep apnea is still being explored.8
No, sleep apnea does not cause your heart to stop. However, the inability to breathe properly can slow and bring down your heart rate.9
The types of sleep apnea are central sleep apnea, obstructive sleep apnea, and a combination of both of those, called mixed or complex sleep apnea.
You may have sleep apnea if you exhibit some or all of these sleep apnea symptoms: very loud snoring, an inability to feel well-rested, excessive daytime sleepiness, shallow breathing, difficulty falling asleep, and mood changes.
Generally, no. Sleep apnea is a chronic lifelong condition. People can develop sleep apnea at any age. However, in some cases, particularly in children, it can be resolved if caught and treated early on. The older you get, the higher your risk for developing sleep apnea. The effects of sleep apnea are also thought to intensify over time.
© 2021 American Sleep Association.