Sleep apnea is more than just loud snoring or disrupted rest; it is a serious medical condition that can significantly affect your health and quality of life. However, not all sleep apnea is the same.
Identifying which type of sleep apnea you have is crucial, as each type stems from different causes and requires different treatment approaches.
What Are the Different Types of Sleep Apnea?
While sleep apnea is a general term for a sleep disorder that obstructs airflow in your windpipe, it encompasses different types, each with unique diagnoses and treatments. The three main types of sleep apnea are:
- Obstructive Sleep Apnea
- Central Sleep Apnea
- Complex Sleep Apnea
What Is Obstructive Sleep Apnea (OSA)?
It is the most common type among the three. The obstruction usually occurs when the muscles that support the tongue, soft palate, and throat relax too much during sleep. As a result, these structures collapse inward, narrowing or sealing off the airway. This can happen multiple times throughout the night, sometimes hundreds of times, disrupting the natural sleep cycle and reducing oxygen levels in the blood.
What Are the Symptoms of OSA?
Monitoring the signs of OSA during the night is challenging for the individual experiencing it, as breathing disruptions occur during sleep, making them largely unaware. Often, a partner, family member, or roommate is the first to notice the symptoms, though some signs may also manifest during the day. Common symptoms include:
- Loud and persistent snoring
- Abrupt awakening
- Irritability or mood swings
- Morning headache
- Excessive tiredness
- Depression
- Poor memory and concentration
What Are the Risk Factors for OSA?
OSA does not affect everyone equally. While it can occur in people of all ages and body types, certain risk factors significantly increase the likelihood of developing this condition, such as:
- Age
- Smoking
- Excess weight or obesity
- Neck circumference
- A narrowed airway
- Being male
- Family history
- Use of alcohol, sedatives, or tranquillisers
What Are the Treatment Options for OSA?
Treatments may vary depending on the specific case a person has. Some people may only need to change their sleeping position, while others may require surgery for better airflow. Depending on your individual factors, your ENT specialist may recommend:
- Oral appliances
- Surgery (in severe cases)
- Continuous Positive Airway Pressure (CPAP) therapy
- Lifestyle changes (weight loss, avoiding alcohol)
What Is Central Sleep Apnea (CSA)?
Comparatively, CSA is less common than OSA. Rather than being caused by a blocked airway, it originates from the brain's failure to send the proper signals that trigger breathing. In simple terms, the brain momentarily "forgets" to tell the respiratory muscles to do their job. As a result, the person experiences pauses in breathing, not because they cannot breathe, but because the body has stopped trying to.
What Are the Symptoms of Central Sleep Apnea?
While some symptoms of CSA can be quite similar to OSA, others are more subtle and challenging to detect. CSA often presents without the loud snoring or gasping for air typical of OSA. Additionally, individuals with CSA may experience breathing pauses even while awake.
- Insomnia
- Mood swings
- Excessive tiredness
- Difficulty concentrating
- Episodes of stopped breathing
- Shortness of breath that awakens you
What Are the Risk Factors for Central Sleep Apnea?
Although CSA is much less common than OSA, several medical conditions and factors increase the likelihood of developing CSA, many of which involve the nervous system or respiratory control centres in the brain.
- Stroke
- Heart disorders
- Sleeping at high altitude
- Use of certain medications
What Are the Treatments for Central Sleep Apnea?
CSA often requires addressing the root medical issue triggering the condition. Treatments of the condition are usually designed to address the underlying cause rather than the apnea alone. These options include:
- Supplemental oxygen
- CPAP or BiPAP machines
- Medications to stimulate breathing
What Is Complex Sleep Apnea (CompSAS)?
Complex sleep apnea is a hybrid condition that combines features of both obstructive and central sleep apnea. At first glance, it may appear to be a straightforward case of obstructive OSA. But over time, especially during treatment, the underlying picture becomes more complicated.
What Are the Symptoms of CompSAS?
The symptoms of complex sleep apnea are a combination of both OSA and CSA. This overlap often makes it difficult to diagnose without a thorough sleep study, especially since the symptoms can shift over time.
- Headaches
- Dry mouth
- Insomnia
- Daytime fatigue
- Brief waking from sleep
- Episodes of stopped breathing
What Are the Risk Factors for CompSAS?
While the condition is not yet fully understood, certain factors increase the likelihood of developing it. These include:
- Existing OSA
- Use of CPAP therapy
What Are the Treatment Options for CompSAS?
Treatment must address the physical collapse of the airway (seen in OSA) as well as the disrupted brain signals that impair breathing (typical of CSA). This dual nature often makes treatment more intricate than for either OSA or CSA alone. Common options include:
- Supplemental oxygen
- Watchful waiting
- Lifestyle changes
- Adaptive Servo-Ventilation (ASV)
- Bilevel Positive Airway Pressure (BPAP)
What to Do If You Suspect You Have Sleep Apnea
Understanding how to prevent long-term complications from sleep apnea can significantly improve your daily life, starting with recognising the symptoms.
Equally important is pinpointing the exact type of sleep apnea you are experiencing. While some patients respond well to lifestyle changes or medical devices, others might require medication or surgery. A proper diagnosis is crucial, as it guides the most effective and targeted treatment approach.
If you suspect you may be suffering from sleep apnea and are looking for expert guidance, we welcome you to consult with us at Barrie Tan ENT Head and Neck Surgery in Singapore. Our clinic offers specialised care for sleep-related breathing disorders and other ENT conditions. Contact us to schedule an appointment.
