Examining the Three Types of Sleep Apnea

Do you wake up feeling exhausted despite a full night’s sleep?

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You might be one of the millions battling sleep apnea, a silent intruder that steals your rest and jeopardizes your health.

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This common yet serious disorder disrupts your sleep with repeated pauses in breathing, leaving you feeling drained and at risk for heart problems. The American Heart Association (AHA) has sounded the alarm, urging us to understand the serious implications of sleep apnea.

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This blog will explore the three main types of sleep apnea: Obstructive Sleep Apnea (OSA), Central Sleep Apnea (CSA), and Complex Sleep Apnea Syndrome. We’ll look into their symptoms, risk factors, complications, and treatment options.

What is Sleep Apnea?

Sleep apnea is a disorder that causes breathing to stop and start repeatedly during sleep.

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This disruption can lead to poor sleep quality and a range of health issues, including increased risk of cardiovascular diseases such as high blood pressure, heart attack, and stroke. Understanding the specific types of sleep apnea is crucial for effective diagnosis and treatment.

1. Obstructive Sleep Apnea (OSA)

Definition

Obstructive Sleep Apnea (OSA) is the most common form of sleep apnea. This type of apnea occurs when the muscles in the back of the throat relax excessively during sleep, blocking the airway. This blockage can lead to pauses in breathing that can last from a few seconds to minutes, often resulting in fragmented sleep and reduced oxygen levels in the blood.

Symptoms

Common symptoms of OSA include

• Loud snoring
• Gasping or choking during sleep
• Excessive daytime sleepiness
• Morning headaches
• Dry mouth or sore throat upon waking
• Difficulty concentrating
• Irritability and mood swings

Risk Factors

Several factors can increase the likelihood of developing OSA, including

• Obesity

Excess weight can lead to the narrowing of the airway.

• Large tonsils or adenoids

These can obstruct the airway, particularly in children.

• Small lower jaw

This anatomical feature can lead to airway blockage.

• Nasal congestion

Chronic nasal congestion can hinder airflow.

• Smoking and alcohol consumption

Both can relax the throat muscles and worsen OSA.

• Family history

Genetics also play a role in the likelihood of developing sleep apnea.

Complications

If left untreated, OSA can lead to serious health complications, such as

• High blood pressure

The repeated drops in oxygen levels can strain the cardiovascular system.

• Heart disease

OSA is linked to an increased risk of heart attacks and arrhythmias.

• Stroke

The risk of stroke is notably higher in persons with untreated OSA.

• Type 2 diabetes

Insulin resistance is more common in those with OSA.

• Metabolic syndrome

OSA is associated with a cluster of conditions that increase heart disease risk.

2. Central Sleep Apnea (CSA)

Definition

Central Sleep Apnea (CSA) is less common than OSA and occurs when the brain fails to send signals to the muscles that control breathing. This results in irregular breathing patterns during sleep. This means that unlike OSA, CSA is not caused by a physical blockage in the airway.

Symptoms

Symptoms of CSA include

• Cheyne-Stokes respiration

This is characterized by alternating periods of rapid, shallow breathing followed by periods of no breathing.

• Excessive daytime sleepiness
• Insomnia
• Mental confusion

Risk Factors

CSA is often associated with certain medical conditions and factors, such as

• Heart failure

Individuals with heart failure are at a higher risk for CSA.

• Stroke

A history of stroke can increase the likelihood of developing CSA.

• Certain medications

Opioids and sedatives can depress the respiratory system and contribute to CSA.

• Brain tumors

Tumors affecting the brain can disrupt normal breathing patterns during sleep.

Complications

The complications of CSA can include

• Pulmonary hypertension

Increased blood pressure in the lungs can occur due to repeated breathing interruptions.

• Right-sided heart failure

This can develop as a result of increased strain on the heart from CSA.

3. Treatment-emergent Central Sleep Apnea

Definition

Treatment-emergent central sleep apnea is the development of central sleep apnea events after treatment of OSA with Inspire therapy, sleep apnea surgery, oral appliances, or most commonly, PAP therapy. Previously referred to as complex sleep apnea, it is characterized by the presence of obstructive events that persist even after treatment. Treatment-emergent central sleep apnea is often resolved by ongoing positive airway pressure therapy.

Symptoms

Symptoms of treatment-emergent central sleep apnea include a combination of those seen in both OSA and CSA, such as

• Excessive daytime sleepiness
• Morning headaches
• Repetitive awakenings
• Insomnia
• Fatigue
• Poor concentration
• Moodiness

Risk Factors

The risk factors for treatment-emergent central sleep apnea include

• Sex (male)
• Older age
• Heart failure or coronary artery disease
• Severe obstructive sleep apnea
• Detection of a mixture of obstructive, mixed, and central apneas during initial

polysomnography

• Higher arousal index on baseline polysomnography
• Use of higher levels of CPAP (i.e. over-titration)
• High altitude
• Oral breathing
• Opioid use
• Supine sleep position

Sleep Apnea Diagnosis

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Diagnosing sleep apnea typically involves a sleep study, also called a polysomnography. This test monitors various physiological parameters during sleep, including

• Brain waves
• Heart rate
• Breathing patterns
• Blood oxygen levels

In some cases, a home sleep study may be an option for diagnosing sleep apnea, particularly for those with a high likelihood of OSA.

Treatment Options for Sleep Apnea

The treatment for sleep apnea varies based on its type and severity. Common treatment options include

• Lifestyle Changes

Weight loss, avoiding alcohol and sedatives before bed, and quitting smoking can significantly improve sleep apnea symptoms.

• Oral Appliances

Custom-made mouthguards can help keep the airway open by repositioning the jaw and tongue.

• Continuous Positive Airway Pressure (CPAP)

This is the most common treatment for OSA. A CPAP machine delivers a steady stream of air to keep the airways open during sleep.

• Bilevel Positive Airway Pressure (BiPAP)

BiPAP is a sleep apnea treatment that delivers varying levels of air pressure, helping to both open the airway and assist breathing. It's often used for people with complex sleep apnea or those who cannot tolerate CPAP therapy.

• Implantable Treatment Options

Inspire Therapy is recommended for moderate to severe OSA while Remedē Therapy is recommended for moderate to severe CSA. Remedē is an implantable device that functions automatically to restore a normal breathing pattern without the need for masks or medications. Meanwhile, Inspire is an implantable treatment device used for stimulating airway muscles to keep them open.

Importance of Early Treatment

Early detection and treatment of sleep apnea are crucial for preventing serious health complications.

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Untreated sleep apnea can lead to a cascade of problems, including cardiovascular diseases, high blood pressure, type 2 diabetes, and metabolic syndrome. By addressing sleep apnea promptly, individuals can significantly reduce their risk of developing these conditions.

Your Next Step to Better Sleep

Recognizing the different types of sleep apnea is crucial for understanding this often-overlooked health issue.

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If you suspect you or a loved one may have sleep apnea, don't ignore the signs. Seeking professional help is essential for a proper diagnosis and effective treatment plan. Consult the experts at nightly.health for questions about diagnosing and treating sleep apnea. Your initial sleep assessment is on us!

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Remember, by prioritizing quality sleep, you're investing in a healthier, happier, and longer life. A restful sleep is the foundation of a vibrant day—and life!

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