Millions of people in the United States are affected by sleep apnea, a type of sleep disorder that affects your breathing at night. There are two primary types of sleep apnea: central sleep apnea (CSA) and obstructive sleep apnea (OSA). While both can significantly affect your health and well-being, there are some key differences between the two.
Both CSA and OSA can affect your sleep quality and overall health. One is no more serious than the other. However, CSA can be caused by serious conditions like heart failure and brain injury. CSA may also be more difficult to treat than OSA, as it has many different causes that may require different solutions.
CSA is less common than OSA. CSA occurs when the part of your brain that controls breathing does not work properly. During sleep, you will experience pauses in your breathing because your body does not know it should take a breath. Unlike with OSA, your airway is not blocked. Instead, your brain is not sending the right signals, so you experience breathing pauses as well as shallow and irregular breathing.
Snoring is reported less frequently with CSA. However, you may wake up feeling short of breath or have chest discomfort. CSA is caused by an underlying health issue such as heart disease, certain types of stroke, or the use of sedating medications. Neurological conditions like Parkinson’s disease, Alzheimer’s disease, and amyotrophic lateral sclerosis (ALS) are also linked to CSA.
If your healthcare provider suspects that you have a form of sleep apnea, they may order a sleep study, also known as a polysomnography. This test allows them to evaluate your sleep, determine if you have sleep apnea, and, if so, which type you have. During the test, the physician is looking at what happens within your body when you have pauses in breathing. Your body responds differently depending on the type of sleep apnea you have, and your oxygen saturation levels will be different.
OSA is the most common form of sleep apnea, affecting about 83.7 million adults in the U.S. in 2024. This sleep disorder occurs when your throat muscles relax during sleep. Once relaxed, the muscles can partially or completely block your airway, causing you to snore or wake up gasping or choking. This creates fragmented or disrupted sleep, leading to excessive daytime sleepiness.
Obstructive sleep apnea may increase your risk for other health conditions, especially if left untreated. For instance, OSA has been linked to high blood pressure, heart attack, and stroke. OSA also affects your cognitive abilities, resulting in poor concentration and depression. Some evidence suggests OSA puts you at greater risk for a car accident, likely due to increased daytime sleepiness and lowered alertness.
Like CSA, OSA is diagnosed with a sleep study. If they diagnose you with OSA, they will discuss your treatment options and lifestyle changes you can make.
Both CSA and OSA are types of sleep apnea that can negatively impact your health, disrupt your sleep, and cause daytime sleepiness. However, they have different causes, prevalence, and prognoses. Here’s a look at how the two compare:
Characteristic
Central Sleep Apnea
Obstructive Sleep Apnea
Cause
Your brain fails to signal breathing
Your airway is blocked while sleeping
Why It Happens
Your brain’s control center is not working properly
Your throat muscles relax while you’re sleeping
Key Symptoms
Shortness of breath, headaches, daytime sleepiness, restless sleep, memory impairment
Snoring, gasping for air, choking, daytime sleepiness, pauses in breathing
Accompanying Conditions
Heart failure, brain injury, certain types of stroke, sedating medications
Overweight or obese, large neck circumference, high blood pressure
Prevalence
Less than 1% in the general population; about 1% in older adults
25-30% of men and 9-17% of women
Treatment
Interventions like CPAP, medications, supplemental oxygen, nerve stimulation
Interventions like CPAP machines, oral appliances, lifestyle changes, or surgery
Prognosis
Poor prognosis in people who have the condition and heart failure
Favorable prognosis with adherence to CPAP usage
Although OSA and CSA are two different types of sleep apnea, they are both often treated with a PAP machine, typically a CPAP. This is a medical device that produces positive airway pressure.
Evidence supporting specific treatments for CSA is lacking, particularly because CSA can have many different causes. For example, it’s unclear if CPAP is beneficial for CSA, as the airway is not blocked in this type.
Other treatments for CSA might involve:
- Supplemental oxygen
- Carbon dioxide
- Phrenic nerve stimulation
- Medications
Treatments for OSA include:
- CPAP: The most promising treatment is the use of a CPAP machine. A 2020 study found that people with OSA who used a CPAP machine consistently experienced an improvement in daytime sleepiness, fatigue, snoring, and nocturia (waking up frequently at night to pee).
- Zepbound (tirzepatide): The U.S. Food and Drug Administration (FDA) has also approved the use of the drug Zepbound (tirzepatide) for treating moderate to severe OSA in people with obesity.
- Lifestyle changes: These include changing sleep positions, managing weight, and limiting alcohol. Oral appliances or surgery might also be recommended, especially if you have trouble using the CPAP consistently.
If you consistently wake up tired in the morning, feel short of breath, have trouble concentrating, or have a partner who has expressed concern over your snoring or breathing habits at night, you should see a healthcare provider for evaluation. They can review your symptoms and order a sleep study if they feel one is warranted.
The key is not to ignore the symptoms of sleep apnea, such as:
- Loud snoring
- Pauses in breathing
- Fatigue and tiredness
- Daytime sleepiness
- Shortness of breath
- Chest discomfort
- Choking or gagging
- Morning headaches
- Dry mouth
- Fragmented sleep
- Poor concentration
- Mood changes
- Impaired driving
Untreated sleep apnea can lead to other health conditions like high blood pressure, diabetes, heart attack, stroke, and more. However, getting treatment can improve your overall health and quality of life.
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