Central Sleep Apnea vs Obstructive Sleep Apnea

Have you ever fallen asleep only to be awakened some time later gasping for air or choking? Or maybe a family member has observed you doing this? Do you sleep plenty of hours at night and still feel tired or fatigued throughout the day? Do you have problems with carrying too much weight or do you have illnesses that affect your ability to breathe?

If any of these scenarios describes you or a family member, then you should consider that this might involve a condition known as sleep apnea. Sleep apnea is a disorder where the ability to breathe during sleep is inhibited for some reason. Two types of sleep apnea have been categorized: Central Sleep Apnea and Obstructive Sleep Apnea. Both have basically the same symptoms, and are often treated in the same way, but the reasons for the inability to breathe are different.

Symptoms of Sleep Apnea

Before discussing the differences between the two types of sleep apnea, it may be helpful to look at the commonalities. Both types of sleep apnea are detrimental to the health in a variety of ways, potentially leading to other diseases that could even cause premature death. Sleep apnea is often first noticed by family members because one of the main symptoms is loud snoring, which is much more easily observed by someone else living in the household.

Symptoms and signs of sleep apnea may include:

  • Loud snoring
  • Daytime drowsiness or fatigue (including during activity such as driving)
  • Sometimes waking with a choking or gasping sensation
  • Difficulty with concentration or memory
  • Mood changes such as irritability and depression
  • Insomnia (difficulty falling asleep or staying asleep)

Certain people are more at risk of developing sleep apnea than others, and some of the risk factors for obstructive sleep apnea and/or central sleep apnea include:

  • Obesity or being overweight
  • Being male (men are twice as likely to develop sleep apnea)
  • Large neck circumference (17” or more in men, 16” or more in women)
  • Family history of sleep apnea
  • Use of certain drugs such as opiates (oxycodone, for example)
  • Sleeping on your back
  • Smoking
  • Being middle aged or older
  • A narrowed airway, enlarged adenoids, or swollen tonsils
  • Use of alcohol, tranquilizers or sedatives
  • Nasal congestion, allergies, or deviated septum
  • Hypothyroidism (causes swelling of the tongue)
  • Congestive heart disorders
  • Stroke
  • High Altitude
  • Heart or kidney failure

Obstructive Sleep Apnea Syndrome

The more common of the two types of Sleep Apnea, Obstructive Sleep Apnea (OSA) is a condition in which the body stops breathing at various times during sleep due to a physical blockage of the airway. This type of sleep apnea affects up to 10% people in the United States and can lead to many different other types of serious health problems.

Central Sleep Apnea Syndrome

This syndrome is less common than Obstructive Sleep Apnea and is a neurological condition. Although your brain is typically responsible for regulating your breathing, with Central Sleep Apnea (CSA), the brain is actually the culprit for “forgetting” to communicate to the body to tell it to breathe during sleep. For people with CSA, the body doesn’t even make any effort to try to inhale, which is different than OSA (when people’s bodies try to inhale but cannot).

One factor that is often found among people with Central Sleep Apnea is Cheyne-Stokes breathing, where shallow breathing is triggered due to increasing levels of Carbon Dioxide (CO2) and then the breathing becomes deeper and deeper. This cycle progresses throughout the night as breathing stops and starts again in this form of sleep apnea.

Treatment for people with Central Sleep Apnea may be more complicated and challenging than for those with Obstructive Sleep Apnea. Most people find that their doctor recommended the use of a CPAP (Continuous Positive Airway Pressure) machine that keeps the airways open and promotes respiration in a healthy manner. These machines have a function that can literally “breathe” for people when they are not inclined to breathe on their own.

Mixed Sleep Apnea

Sometimes people who have one type of sleep apnea end up developing the other as well, and this is then referred to as Mixed or Combined sleep apnea. Typically this happens when a person starts out with obstructive sleep apnea and is treated with a CPAP (Continuous Positive Airway Pressure) machine which, in turn, causes the person to develop central sleep apnea as well.

Treatment for Sleep Apnea

Some people with certain causes for sleep apnea may be candidates for surgical procedures that could clear up their obstructive sleep apnea problems. Other people with obstructive sleep apnea may find that losing weight and sleeping on their sides or stomachs help to minimize the incidences of breathing problems.

The most common, and typically thought by doctors to be most effective treatment for sleep apnea, is the use of a CPAP or Bi-PAP machine. This may be especially needed for those who have Central Sleep Apnea, as the machine tells the body to breathe even when the brain won’t.

People who use a sleep apnea machine often find that sleeping with the tubes can be uncomfortable, but there are certain pillows that are designed specifically to work with CPAP machines. In addition, many people find that an adjustable mattress is effective in promoting comfort and healthier breathing for people with sleep apnea.


Central Sleep Apnea and Obstructive Sleep Apnea are both forms of this sleeping condition which, if left untreated, can have dangerous consequences. But the good news is that sleep apnea is a disorder that can be treated in a non-invasive manner, with hope for return to a very normal lifestyle without the debilitating symptoms. If you are concerned that you or a family member might have sleep apnea, it’s best to contact a medical professional or sleep specialist for a checkup or sleep study that can provide a diagnosis. Your loud snoring may be much more than annoying to your family—it could be harmful to your own health as well!

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