The Differences Between Obstructive Sleep Apnea and Central Sleep Apnea
Sleep apnea is a serious sleep disorder characterized by interrupted breathing during sleep. These breathing disruptions, or apneas, can happen 20-30 times per hour and continue on and off throughout the night. They are often accompanied by gasping or choking as the body struggles to regain breath. The National Sleep Foundation reports that up to 20% of the population is affected by sleep apnea, yet an astounding 85% of those suffering from this sleep health condition are unaware they have it.
The two most common types of sleep apnea are Obstructive Sleep Apnea (OSA) and Central Sleep Apnea (CSA). While both types share common signs and symptoms, as well as risk factors for other serious health comorbidities, it is physiology that distinguishes these two disorders.
What is Obstructive Sleep Apnea?
Obstructive Sleep Apnea is the most common form of the disorder. As the name indicates, it is caused by an obstruction or blockage. The muscles in the throat and tongue relax during sleep and can block the breathing airway. This is especially true in those who carry excess weight and/or have a large neck circumference. In fact, obesity is the most frequent risk factor for the disease.
OSA is most common in men between the ages of 50 and 70, and its prevalence increases with age, according to the Mayo Clinic. Snoring is the sign most associated with obstructive sleep apnea. While not everyone who snores has the condition, most people with OSA do snore. Other common symptoms of OSA are daytime sleepiness and brain fog, waking up with a dry mouth, restless sleep, and morning headache.
Symptoms of OSA are challenging, but the real danger lies in not getting diagnosed due to the serious comorbidities associated with the condition. When breathing intermittently stops, blood oxygen levels fall. Our bodies respond by releasing the hormone epinephrine. This “fight or flight” response elevates the heart rate and can lead to high blood pressure. Overall heart function decreases because it becomes less efficient at pumping blood, and the heart itself is affected by the pressure changes in the chest. According to the American College of Cardiology, patients with OSA are four times more likely to have abnormal heart rhythms, including atrial fibrillation. They are also two times more likely to have a heart attack.
What is Central Sleep Apnea?
Central Sleep Apnea (CSA) is less common than Obstructive Sleep Apnea. Unlike OSA, Central Sleep Apnea is not caused by a physical obstruction but rather by a lack of communication between the brain and the muscles that control your breathing. Symptoms of CSA are nearly identical to those of OSA; however snoring is most associated with the latter. Unlike Obstructive Sleep Apnea, there are several different types of Central Sleep Apnea.
One type, known as Cheyne-Stokes, can result from other conditions such as heart failure or stroke and is characterized by an increase and decrease in breathing patterns. Drug-induced Apnea can be the result of taking certain medications, particularly opioids, which can change your breathing regularity. High-altitude Periodic Breathing is a type of Central Sleep Apnea that reflects a Cheyne-Stokes breathing pattern in high-altitude locations. CSA, like OSA, is also more common in men, particularly those over age 60, due to the higher likelihood of other coexisting medical conditions.
Treatment
The most common treatment for Obstructive Sleep Apnea is Continuous Positive Airway Pressure therapy, more commonly known as CPAP. CPAP devices work by pressurizing, filtering, and delivering air through a hose and mask that you wear on your face while sleeping. CPAP keeps airways open and improves breathing quality, leading to improved sleep and better overall health.
With Central Sleep Apnea, the first course of treatment is to resolve the underlying health issue. For cases that are more persistent or severe, patients may be prescribed CPAP therapy to promote steadier breathing.
The most important step in treating sleep apnea is to get diagnosed by a sleep specialist so the appropriate therapy can be prescribed. Long-term lifestyle changes that promote healthy weight are also essential since obesity is a common risk factor for both types of sleep apnea and many of the co-morbid conditions associated with this sleep health condition. Taking these steps will help mitigate serious health complications and promote good sleep and overall health.