Understanding the Different Types of Sleep Apnea

Sleep apnea is a common but potentially serious sleep disorder in which breathing repeatedly stops and starts during sleep. These interruptions in breathing can last from a few seconds to over a minute, often occurring multiple times per hour. Because they fragment the normal sleep cycle, sleep apnea can lead to poor-quality sleep, daytime fatigue, and an increased risk of cardiovascular and metabolic problems.


There are three main types of sleep apnea: Obstructive Sleep Apnea (OSA), Central Sleep Apnea (CSA), and Complex Sleep Apnea Syndrome (CompSAS). Although they share some overlapping symptoms, each type has distinct underlying causes, mechanisms, and risk factors.

1. Obstructive Sleep Apnea (OSA)

OSA is the most common type of sleep apnea. It occurs when the muscles in the throat relax excessively during sleep, causing the soft tissues of the airway, such as the soft palate, tongue, and tonsils - to collapse and block airflow. This obstruction triggers brief awakenings as the brain signals the body to reopen the airway.

Common symptoms of OSA include:

  • Loud, chronic snoring.
  • Episodes where breathing stops during sleep (often reported by a partner).
  • Gasping or choking sensations during the night.
  • Excessive daytime sleepiness.
  • Morning headaches and dry mouth.

Risk factors for OSA:

  • Excess body weight: Fat deposits around the upper airway can narrow it.
  • Anatomical features: Enlarged tonsils, thick neck circumference, or a small jaw.
  • Age and gender: More common in men and in people over 40.
  • Lifestyle factors: Alcohol use, smoking, and sleeping on the back.

2. Central Sleep Apnea (CSA)

CSA is less common and results from the brain failing to send consistent signals to the respiratory muscles. In other words, the airway remains open, but the body temporarily “forgets” to breathe. CSA is often linked to underlying medical conditions or certain medications.

Common symptoms of CSA include:

  • Irregular breathing patterns during sleep.
  • Shortness of breath upon waking.
  • Difficulty staying asleep (insomnia).
  • Fatigue and poor concentration during the day.

Risk factors for CSA:

  • Heart disorders: Such as congestive heart failure or atrial fibrillation.
  • Neurological conditions: Including stroke or brainstem injury.
  • Certain medications: Opioid pain relievers can suppress breathing signals.
  • High-altitude sleeping: Reduced oxygen levels can trigger CSA.

3. Complex Sleep Apnea Syndrome (CompSAS)

Also known as treatment-emergent central sleep apnea, CompSAS is a combination of both OSA and CSA. It typically appears when someone with OSA begins CPAP (Continuous Positive Airway Pressure) therapy to keep the airway open but then develops central apneas during treatment.

The exact cause is still being researched, but it is believed to involve changes in breathing regulation triggered by the therapy.

Symptoms of CompSAS can resemble a mix of OSA and CSA symptoms, including snoring, gasping, and disrupted sleep, along with pauses in breathing not related to airway blockage.

Why It Matters to Identify the Type of Sleep Apnea

Determining which type of sleep apnea you have is essential because treatment strategies differ.

  • OSA is often managed with CPAP or oral appliances, lifestyle changes, and sometimes surgery.
  • CSA may require addressing the underlying medical condition, adaptive servo-ventilation (ASV), or supplemental oxygen.
  • CompSAS treatment might involve adjusting CPAP settings or switching to a different therapy mode.

If you suspect sleep apnea whether due to loud snoring, chronic fatigue, or observed breathing pauses, it is important to undergo a sleep study for an accurate diagnosis. Early detection can greatly reduce long-term health risks, including high blood pressure, heart disease, and stroke.


Location: Adelaide SA, Australia

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