3 Types of Sleep Apnea
by Dr. Scott Bolding
Obstructive sleep apnea affects almost 30 million Americans. Every day people across the country wake up feeling tired no matter how much they sleep at night.
A lot of people know about sleep apnea. But did you know that there are different types of sleep apnea? Even though obstructive sleep apnea is the most common type of sleep apnea, some people actually have either central or complex sleep apnea.
While these different types share symptoms they are very different. And they require different treatments from different specialists. So, getting the right treatment depends on knowing what type of sleep apnea you have.
In this post, we’ll discuss the different types of sleep apnea. Understanding how they’re different will help you as you talk to your doctor. You’ll be able to get the right treatment from the right specialist. And that’s the key to getting the sleep you need.
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Obstructive Sleep Apnea
The Most Common Type of Sleep Apnea
Obstructive sleep apnea is a type of sleep apnea where you stop breathing while you sleep. What makes it different from the other types of sleep apnea is that there is an obstruction that makes it hard for you to breathe.
When you sleep the muscles in your throat relax. This is a normal part of sleep. However, your throat is supposed to stay open enough to let air pass through. When you have obstructive sleep apnea these muscles relax too much. This makes it hard for air to get through. The airway collapses and you can’t breathe.
Your body sends signals to your brain that air isn’t getting through. So, your brain makes you wake up momentarily to reopen the airway. Most of the time you won’t notice that you’ve woken up because you go back to sleep right away.
Obstructive sleep apnea is the most common type of sleep apnea. It’s even more common in older adults and men.
What Are the Symptoms of OSA?
You probably won’t know that you have sleep apnea right away. In fact, sleep apnea often goes undiagnosed because most patients aren’t aware that they’re waking up at night.
However, you may begin to notice the following side effects of obstructive sleep apnea:
- Feeling tired no matter how much sleep you get
- Headaches in the morning
- Dry mouth in the morning
Snoring is another common symptom of obstructive sleep apnea. Your partner may comment on how much you snore at night. Of course, snoring doesn’t always mean you have sleep apnea. But if you notice other symptoms you should talk to your doctor about obstructive sleep apnea.
What Are the Causes of OSA?
Obstructive sleep apnea is caused by something that keeps air from getting through your airway. This can happen for a number of reasons including:
- Narrowed airway
Men and older adults are also at higher risk of developing obstructive sleep apnea.
Who Treats This Type of Sleep Apnea?
Treating sleep apnea involves a collaborative approach. At PRECiDENT, we believe that bringing in different specialists is the best way to get you the care you need. You can start with your primary care physician. But they may refer you to another specialist. The specialists who can treat OSA include an ENT (ear, nose, and throat) and an oral maxillofacial surgeon.
Ultimately the treatment depends on the root cause and severity of your sleep apnea.
For those who have mild OSA a CPAP or oral appliance should do the job. We may also recommend losing weight and changing how you sleep as well, depending on your case.
More severe obstructive sleep apnea can be treated with surgery.
Central Sleep Apnea
A Less Common Type of Sleep Apnea
Central sleep apnea also stops you from breathing while you sleep. However, this type of sleep apnea is not caused by an obstruction in the airway. It’s actually a neurological issue. With central sleep apnea, your brain isn’t sending the right signals to the muscles that help you breathe. So, while you sleep these muscles stop working and you stop breathing.
Central sleep apnea is not as common as obstructive sleep apnea.
What Are the Symptoms of CSA?
There are several symptoms that overlap between the different types of sleep apnea. You will feel tired during the day. You have a hard time concentrating at work or school. You may wake up every morning with a headache.
But unlike obstructive sleep apnea, central sleep apnea doesn’t usually have snoring as a common symptom. <
Some symptoms unique to central sleep apnea include:
- Waking up with shortness of breath
What Are the Causes of This Type of Sleep Apnea?
Central sleep apnea has a number of causes. Unlike obstructive sleep apnea, central sleep apnea is linked to issues in the brainstem.
The cause depends on the type of central sleep apnea. And in some cases, there is no clear cause.
Causes of central sleep apnea include:
- High altitude
- Medical conditions like kidney disease or stroke
Another common condition associated with central sleep apnea is Cheyne-Stokes breathing. This condition happens when your breathing increases and decreases throughout the night. When your breathing effort is at its lowest you may stop breathing altogether.
Sometimes there is no clear cause of CSA and this is known as idiopathic central sleep apnea.
Who Treats Central Sleep Apnea?
Unlike obstructive sleep apnea, central sleep apnea can’t be treated by an ENT or an oral maxillofacial surgeon. Since CSA is caused by issues with the brainstem you need to see a neurologist.
Treatment will also depend on the type of central sleep apnea you have. You may need to reduce certain medications or change the way you sleep. Sometimes a CPAP can help with CSA but other times it can make things worse.
Complex Sleep Apnea
Complex sleep apnea is a very rare type of sleep apnea. It happens when you’ve previously had obstructive sleep apnea and then develop central sleep apnea. Central sleep apnea develops after CPAP treatment.
You’ll know you have complex sleep apnea if you try treating OSA with a CPAP machine, but still, feel tired. The CPAP machine will open the airway but your brain isn’t communicating with the muscles that control breathing. A split sleep study can help determine if you’re at risk of developing complex sleep apnea.
Complex sleep apnea often goes away over time. However, you can treat it by adjusting the pressure on your CPAP machine. Your doctor will be able to give you the best suggestion for what to do.
How to Know Which Type of Sleep Apnea You Have?
The best way to know which type of sleep apnea you have is to get a thorough diagnosis. This involves evaluating your symptoms, a physical examination, and sometimes a sleep study.
You should start keeping a list of your symptoms before you talk to your doctor. Note how you feel each morning, how much your partner says you snore, and anything else you might think is important. Your doctor will also want to know about your medical history.
Examining your airway involves both physically looking at the airway and getting X-rays. This allows us to see if there is an obstruction in your airway.
Finally, we will recommend a sleep study. A sleep study allows us to collect information about your sleep. We can see how often you wake up to breathe during the night. Sometimes you may do a split sleep study. In this case, you will be woken up halfway through the night and hooked up to a CPAP machine. The CPAP lets us see if your breathing problems are caused by an obstruction in the airway. Then, we can decide if you have OSA or another type of sleep apnea.