Difference Between Obstructive And Central Sleep Apnea: How Are They Treated?

Frequent pauses between breathing while you sleep are the hallmark of sleep apnea, a common but dangerous sleep disease. Among the various types of sleep apnea, obstructive sleep apnea (OSA) and central sleep apnea (CSA) are the most prevalent.

Understanding the differences between these two conditions is crucial for effective diagnosis and treatment. This blog will explore the distinctions between obstructive and central sleep apnea, their symptoms, causes, and treatment options.

What is Obstructive Sleep Apnea (OSA)?

Obstructive sleep apnea occurs when the muscles in the throat relax excessively during sleep, leading to a temporary blockage of the airway. This obstruction can result in disrupted sleep and decreased oxygen supply to the body.

Symptoms of OSA

• Loud snoring
• Gasping or choking during sleep
• Excessive daytime sleepiness
• Morning headaches
• Difficulty concentrating
• Irritability and mood changes

Causes of OSA

• Obesity: Excess weight can increase the amount of tissue in the throat, leading to airway obstruction.
  
• Anatomical factors: Structural abnormalities in the airway, such as enlarged tonsils or a deviated septum, can contribute to obstructive sleep apnea.
  
• Age: The risk of developing OSA increases with age as muscle tone in the throat decreases.
  
• Family history: A genetic predisposition to OSA may be present in some individuals.

What Is Central Sleep Apnea (CSA)?

Contrary to obstructive sleep apnea, central sleep apnea is less prevalent. It occurs when the brain fails to send proper signals to the muscles that control breathing, leading to pauses in breathing during sleep. Unlike OSA, CSA does not result from an airway blockage.

Symptoms of CSA

• Episodes of stopped breathing during sleep
• Excessive daytime sleepiness
• Difficulty staying asleep
• Waking up feeling unrefreshed
• Mood swings and irritability

Causes of CSA

• Heart conditions: People with heart failure are at a higher risk for CSA.
  
• Stroke: A stroke can disrupt the brain’s normal functioning, including its ability to control breathing.
  
• High altitude: Sleeping at high altitudes can affect breathing patterns and lead to CSA.
  
• Certain medications: Opioids and other sedative medications can depress the central nervous system, affecting breathing control.

Treatment Options for Obstructive Sleep Apnea

Treatments for OSA focus on alleviating airway obstruction and improving breathing during sleep.

1. Lifestyle Changes

• Weight loss: Reducing excess weight can significantly decrease the severity of OSA symptoms.
  
• Positional therapy: Sleeping on one’s side instead of the back can help keep the airway open.
  
• Avoiding alcohol and sedatives: These substances can relax throat muscles, increasing the risk of airway obstruction.

2. Continuous Positive Airway Pressure (CPAP)

• The most popular and successful therapy for OSA is CPAP. It involves wearing a mask connected to a machine that delivers a continuous stream of air, keeping the airway open during sleep.

3. Oral Appliances

• Custom-fitted dental devices can help reposition the jaw and tongue to keep the airway open. These are often recommended for patients with mild to moderate OSA.

4. Surgery

• Surgical options may be considered if other treatments fail. Common procedures include:
  • Uvulopalatopharyngoplasty (UPPP): Removal of excess tissue in the throat.
    
  • Genioglossus advancement: Repositioning the tongue muscle attachment.
    
  • Tracheostomy: Creating an opening in the neck to bypass a blocked airway (usually reserved for severe cases).

Treatment Options for Central Sleep Apnea

Treating CSA requires addressing the underlying causes of the condition.

1. Adaptive Servo-Ventilation (ASV)

• ASV is a specialized device that adjusts air pressure based on detected breathing patterns, making it effective for CSA patients.

2. Positive Airway Pressure (PAP) Therapy

• Similar to CPAP, PAP therapy provides air pressure to help keep the airway open. This may be adjusted to suit CSA patients.

3. Treatment of Underlying Conditions

• Addressing underlying health issues, such as heart failure or neurological disorders, can significantly improve CSA symptoms. This may involve medications, lifestyle changes, or cardiac interventions.

4. Oxygen Therapy

• Supplemental oxygen may be used to maintain adequate oxygen levels during sleep, particularly for patients with respiratory conditions.

When To Seek Help?

If you or a loved ones notice symptoms of sleep apnea, it is crucial to seek professional evaluation and treatment. Left untreated, sleep apnea can lead to serious health issues, including cardiovascular problems, diabetes, and impaired cognitive function.

Signs To Look for:

• Persistent snoring or gasping during sleep
• Extreme daytime fatigue
• Difficulty concentrating or memory issues
• Morning headaches

Understanding the differences between obstructive and central sleep apnea is vital for effective diagnosis and treatment. While OSA is often related to physical obstructions in the airway, CSA results from neurological issues that affect breathing control.

Both conditions can significantly impact overall health and quality of life, but effective treatments are available. If you suspect you may have sleep apnea, consult a healthcare professional to explore your options and take the first step toward better sleep and improved health.