Sleep apnea is a potentially serious sleep disorder in which breathing repeatedly stops and starts during sleep. The most common signs include loud snoring, gasping for air and excessive daytime sleepiness. There are three main types of sleep apnea: obstructive sleep apnea (OSA), central sleep apnea (CSA), and complex (mixed) sleep apnea syndrome. Each type has distinct characteristics, and understanding these is crucial for effective diagnosis and treatment.

Types of Sleep Apnea

• 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 the airway to narrow or close entirely. This blockage restricts airflow, leading to brief pauses in breathing. When the brain detects that you are not breathing, it briefly wakes you up to restore normal breathing. These disruptions, though brief, can occur repeatedly throughout the night, resulting in poor sleep quality. Common risk factors for OSA include obesity, large neck circumference, a narrowed airway and a family history of the disorder. OSA is also more common in older adults and men, though it can affect women and children as well.
• Central Sleep Apnea (CSA): Unlike OSA, central sleep apnea occurs not because of airway obstruction but due to a failure in the brain’s signals that control breathing. In CSA, the brain intermittently stops sending proper signals to the muscles responsible for breathing. As a result, breathing temporarily stops and starts again. This type of sleep apnea is less common and is often associated with medical conditions such as heart failure, stroke or the use of certain medications like opioids. Because CSA is related to the brain’s function rather than physical obstruction, its symptoms can be more subtle. People with CSA may experience frequent awakenings, difficulty staying asleep and waking up with shortness of breath.
• Complex (Mixed) Sleep Apnea Syndrome: This condition, also known as treatment-emergent central sleep apnea, is a combination of both obstructive and central sleep apnea. It often starts as OSA but develops into CSA after treatment begins, usually with the use of continuous positive airway pressure (CPAP) therapy. While the exact cause of this condition is still being studied, it highlights the complexity of sleep apnea and the need for thorough diagnosis and treatment planning.

Diagnosing Sleep Apnea

Diagnosing sleep apnea typically involves a combination of medical history, physical examination and specialized sleep studies. If you suspect that you have sleep apnea, your doctor will guide you through a series of steps to confirm the diagnosis and determine the severity of the condition.

• Medical History and Symptom Review: Your healthcare provider will start by reviewing your medical history and asking about your sleep habits, snoring, breathing patterns and daytime sleepiness. Often, the presence of a bed partner or family member who has noticed irregularities in your sleep can provide valuable insight into your condition.
• Physical Examination: A physical examination is often done to look for specific risk factors such as enlarged tonsils, a deviated septum, or a thick neck which could contribute to airway obstruction.
• Polysomnography (Sleep Study): The most definitive method for diagnosing sleep apnea is a polysomnography, also known as a sleep study. This overnight test records various bodily functions during sleep, such as brain waves, oxygen levels, heart rate and breathing patterns. It can be conducted in a sleep clinic or at home, depending on your doctor’s recommendations. The results of this study help determine the type and severity of sleep apnea.
• Home Sleep Apnea Test (HSAT): In some cases, your provider may recommend a home sleep apnea test. This is a simplified version of a polysomnography that monitors airflow, oxygen levels and breathing effort. It is a more convenient option but may not be suitable for detecting all types of sleep apnea, particularly CSA.

Seeking Treatment

Sleep apnea, whether obstructive, central or complex, is a condition that should never be ignored. If left untreated, it can lead to serious health issues such as heart disease, hypertension and stroke. Early diagnosis is essential, and a combination of symptom review, physical examination and sleep studies can help identify the type of sleep apnea you have and inform an effective treatment plan. If you have concerns about your sleep health, please give us a call to schedule a consultation.