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Are There Three Types of Sleep Apnea?

Posted On February 4, 2014
February 04, 2014

We all probably know someone who snores, which in turn, is the classic symptom of the most common type of sleep apnea, obstructive sleep apnea (OSA). With OSA, there is an anatomical reason for the breathing problem while a person sleeps. Not as easy to detect or as prevalent is a second form, or central sleep apnea (CSA), which occurs when the brain of effected individuals misinterpret the levels of oxygen and carbon dioxide being inhaled and exhaled, slowing down breathing rates to dangerously low levels. Both of these types will experience similar (other than snoring) symptoms of the disease such as fatigue, daytime sleepiness, lack of concentration, memory issues, mood swings and insomnia. So can a person only have OSA or CSA? Or are there three types of sleep apnea?

The answer is yes and no.

Three Types of Sleep Apnea or More

A person can actually have both OSA and CSA at the same time, which has been known as mixed sleep apnea and is fairly common. However, Mayo Clinic researchers identified a new form of sleep apnea, which they named complex sleep apnea (CompSA) or “treatment-emergent central sleep apnea.” What they discovered is the following. At first it might seem as though the individual has OSA with stoppage of breathing occurring 20 to 30 times an hour during the course of the night. And this is where the similarity ends. Even though it might seem like the obstruction has gone away, breathing pauses still occur despite the use of a continuous positive airway pressure (CPAP) machine or a bilevel device. As a result, aspects of CSA take over.

In the study of 223 Mayo Clinic Sleep Disorders Center patients, researchers verified the following:

  • Eighty-four percent of patients had OSA
  • Fifteen percent of patients had CompSA
  • Less than a half percent had CSA
  • Men had a higher incidence of CompSA
  • CompSA patients had similar histories of cardiovascular and sleep complaints closer to OSA patients

Besides the Mayo Clinic group, others have verified that with CompSA there is an increase in central apnea episodes when CPAP treatment is initiated with what had been a suspected diagnosis of OSA. As a result, the apnea hypopnea index (AHI), which is used to measure the severity of the disease, does not move toward the normal range even though the “obstruction” has been taken out of the picture. In a study published in Thorax, German researchers discovered that CompSA could be detected in about 18 percent of subjects who received CPAP therapy for their OSA.

How Is CompSA Treated

Due to the fact that CPAP or bilevel therapy can actually increase AHI without OSA being completely helped, neither is an option for patients with CompSA. Fortunately, VPAP Adapt SV is the first Food and Drug Administration (FDA)-approved device that can be used to treat CompSA (along with CSA and mixed sleep apnea). VPAP Adapt SV works to provide ventilator-like assistance on a breath-by-breath basis for those patients suffering from these types of sleep apnea. Basically, this device helps the individual breathe when their muscles fail to do so.

If you believe that you might have any type of sleep apnea, please contact one of our medical concierges today at 1-855-863-4537 or schedule a free consultation.

About Phoebe Ochman

Phoebe Ochman, Director of Communications for Sleep Apnea Treatment Centers of America, manages all content and communications for the company.
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