This form of sleep apnea is also known as complex sleep apnea. This is because it is a combination of obstructive sleep apnea and central sleep apnea. According to a 2014 publication by Khan & Franco, complex sleep apnea occurs when there has been persistent central sleep apnea for more than 5 hours, despite the airway being cleared by positive airway pressure. In complex sleep apnea, there appears to be no clear cause such as systolic heart failure or narcotics. Since complex sleep apnea is a combination of obstructive sleep apnea and central sleep apnea, this article will discuss different facts of each.
Obstructive Sleep Apnea
This is the most common type of sleep apnea, which affects men more than it does women. Only a handful of patients get to be diagnosed while the rest remain undiagnosed and suffer in silence.
Obstructive sleep apnea, as the name suggests, is caused by complete or partial obstruction of the airway during sleep. A person's throat muscles relax during sleep, which causes either fatty tissues or the tongue to fall into the airway, blocking the air flow. Because of the obstruction, oxygen to the brain is reduced, thus signaling the brain to wake up the body to signal it that it needs oxygen. This is when the patient makes a loud choking, gasping or snorting sound during sleep after which the person is forced to take a deep breath in order to push air past the obstruction.
After the deep breath is taken, the breath signals the body to go back to sleep, after which the whole process is repeated. Depending on the severity of the sleep apnea, this process may occur several or a hundred times a night. Obstructive sleep apnea is categorized into mild, moderate and severe.
Central Sleep Apnea
Central sleep apnea on the other hand, occurs once the brain fails to signal the breath controlling muscle. While obstructive sleep apnea is mechanical, central sleep apnea is a communication issue. This form is not as common as obstructive sleep apnea. Conditions that affect the brain cause this type of sleep apnea. Such conditions include Parkinson's disease, brain infection or brain stroke, heart failure and narcotic painkillers.
Symptoms of this condition include chronic fatigue, shortness of breath, mood changes, morning headaches, difficulty concentrating, and irregular breathing during sleep, restless sleep and excessive daytime drowsiness.
Mixed Sleep Apnea
Patients who are treated for obstructive sleep apnea tend to develop symptoms of central sleep apnea after using Continuous Positive Airway Pressure (CPAP). Complex sleep apnea is diagnosed after a patient continues to have breathing difficulty despite being successfully treated by CPAP therapy.
The available form of treatment for complex sleep apnea is CPAP machines, but only if it is set at the lowest pressure setting. This will help in keeping the airways free from any blockage, but at the same time, it will also help in preventing CSA symptoms from developing. Where CPAP has failed, BIPAP therapy can also be used.
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