Different types of sleep apnea：Obstructive sleep apnea and Central sleep apnea

Sleep apnea

The main types of sleep apnea are:

Obstructive sleep apnea (OSA), which is the more common form that occurs when throat muscles relax and block the flow of air into the lungs ¹. Patients may present with classic symptoms, including snoring, unrefreshing sleep, choking arousals, poor sleep quality, reduced neurocognitive functioning or even motor vehicle accidents sustained due to ‘micro-sleeps’ whilst driving ².

Central sleep apnea (CSA), which occurs when the brain doesn't send proper signals to the muscles that control breathing ¹. The pathophysiology is complex and can involve hyperventilation or hypoventilation states. In most cases encountered in clinical practice, it is associated with left ventricular failure or neurological pathology, including opioid use; in the former, it may manifest as Cheyne–Stokes respiration (CSR). Management should therefore include a multidisciplinary strategy to address the underlying cause, including optimization of heart failure and minimization of opioids or sedative medications, as applicable ².

Mixed or complex sleep apnea, also known as treatment-emergent central sleep apnea, which occurs when someone has both obstructive sleep apnea and central sleep apnea.

Diagnosis of OSA

In-laboratory polysomnography (PSG) remains the gold standard for diagnosis of sleep apnea (both obstructive and central).