What Is the Difference between Central and Obstructive Sleep Apnea?

December 21, 2021

A lot goes into being able to get good sleep every night, and breathing well is especially important. Millions of Americans suffer from sleep apnea, which dramatically impacts their ability to breathe and sleep well every night. Sleep apnea is a serious sleep condition, and while it’s one of the most common sleep disorders in the world, it’s often not well understood. Not only do 80 percent of people with sleep apnea go undiagnosed and untreated, but many people also don’t know that there are several types of sleep apnea, including central and obstructive.

Understanding the difference between these types of sleep apnea is essential, as each is caused by different factors and must be diagnosed and treated with unique treatment options. Let’s dive into exactly what sleep apnea is, including the major differences between central and obstructive sleep apnea, as well as how you can sleep better at night.

What Is Sleep Apnea?

Sleep apnea describes what happens when an individual’s breathing repeatedly pauses while they sleep. This involves breathing that either temporarily stops or gets very shallow, with each pause lasting from a few seconds to minutes and occurring 30 or more times an hour. While many people with sleep apnea tend to snore loudly due to being unable to breathe clearly, not everyone who snores has sleep apnea.

Some of the most common symptoms and signs of sleep apnea include the following:

  • Excessive daytime sleepiness
  • Waking up with a sore or dry throat
  • Mouth breathing
  • Waking to urinate throughout the night
  • Restless sleep or repeated awakenings
  • Inability to focus throughout the day
  • Sleepiness while driving
  • Morning headaches

If you experience one or more of these symptoms often, consider talking to your doctor about sleep apnea. They’ll be able to provide you with screening and treatment as necessary.

While anyone can experience sleep apnea, there are a few factors that can increase an individual’s risk of developing the disorder. A few examples of some of the most common factors include the following:

  • Obesity
  • Family history or genetics
  • Male gender
  • Large neck circumference
  • Large tonsils
  • Alcohol consumption near bedtime
  • Small lower jaw or other facial abnormalities

While these characteristics do not guarantee the presence of sleep apnea, if a few of them sound like you, it may be time to consider talking with your doctor about getting screened for sleep apnea.

What Is Central Sleep Apnea?

Central sleep apnea (CSA) is less common than obstructive sleep apnea (OSA), with a prevalence of less than 1 percent for the general population. However, that doesn’t mean that it’s any less serious. The sleep deprivation caused by CSA can lead to many of the same debilitating, life-changing symptoms, like fatigue and difficulty concentrating.

CSA is caused by the brain failing to send signals to the muscles that are associated with breathing, causing a patient’s breath to become interrupted and failing to send a normal amount of oxygen to the rest of the body or brain. It can occur in response to another condition like diabetes or other metabolic diseases, trauma, brain tumors, heart failure, or stroke. Similarly, risk factors such as old age, heart disorders—especially congestive heart failure—and narcotic pain medications are all risk factors that can increase your risk of developing the conditions.

While many of the symptoms of CSA are similar to those of obstructive sleep apnea, patients usually do not experience the same level of snoring as those with OSA. Similarly, it differs largely from OSA because it’s not that you’re unable to breathe: it’s that your brain doesn’t even tell your muscles to breathe, which means you aren’t even trying to breathe.

What Is Obstructive Sleep Apnea?

Obstructive sleep apnea is the most common type of sleep apnea. This form of the disorder is caused by the repetitive collapse of the upper airway during sleep and occurs when the muscles supporting the soft tissues in your throat relax. In response, your airway narrows or even completely closes, momentarily cutting off breathing. These periods of time when breathing stops are known as apneic episodes and can occur dozens of times every hour.

Snoring is one of the most common symptoms associated with OSA, especially if it is accompanied by long periods of silence. This is because snoring is a result of airflow squeezing through a narrowed airway space, causing the airway to vibrate and produce noise. However, snoring does not necessarily indicate something serious like OSA, and not everyone who snores has OSA.

So, how can you tell if you have OSA in comparison to CSA? Well, it often comes down to what those who sleep next to you may notice while you sleep. For example, those who share beds with people with OSA often report gasping, choking, snorting, and interruptions in breathing while sleeping. Additionally, many people with OSA also grind their teeth at night, resulting in extreme tooth wear. Like CSA, those with OSA similarly experience excessive sleepiness throughout the day and difficulty concentrating or completing certain tasks.

How Is Sleep Apnea Treated?

Depending on the severity and type of your sleep apnea, treatment will vary in order to provide the best results for you. Treatments can include a combination of anything from lifestyle changes, medical devices like CPAP machines, oral appliance therapy, or surgery.

Along those lines, treating any underlying conditions can also help treat sleep apnea—especially CSA. The following are also common treatments for those with central sleep apnea:

  • Reduction of opioid medications
  • Continuous positive airway pressure (CPAP)
  • Adaptive servo-ventilation (ASV)
  • Bilevel positive airway pressure (BPAP)
  • Supplemental oxygen
  • Medications
  • Surgery

Some of the treatment options for obstructive sleep apnea overlap with those used to treat CSA. The following are some of the most common treatments:

  • Positive airway pressure through CPAP, BPAP, or APAP
  • Oral appliances
  • Surgical removal of tissue
  • Upper airway stimulation
  • Jaw surgery
  • Tracheostomy
  • Treatment of associated health concerns

Whatever treatment your doctor recommends, it will be tailored to your specific needs and lifestyle.

What Can I Do to Sleep Better?

Along with using the treatment plan recommended to you by a medical professional, there are a few things you can do to get better sleep at night. Here are a few things you can do to help unwind and prepare yourself for bed.

Reduce Blue Light Exposure in the Evening

Exposure to light throughout the day can actually help you get great sleep at night; however, nighttime light exposure actually worsens your sleep. This is because it impacts your circadian rhythm, causing your brain to think it’s still daytime. Blue light is especially bad in this regard. Emitted from electronic devices like smartphones, televisions, and computers, blue light should be limited as much as possible for a few hours before trying to sleep.

In order to block blue light, there are a few things you can do, including the following:

  • Wear glasses that block blue light.
  • Stop watching TV and turn off bright lights two hours before heading to bed.
  • Install an app that blocks blue light on your phone.
  • Use a sleep mask or keep your room as dark as possible.

Doing these things can do more to help you sleep well than you may think.

Establish Consistent Times to Sleep and Wake Up

Your body’s circadian rhythm is an essential aspect of sleeping well. Being consistent with your sleep and waking times can help you improve your sleep quality long term, as it will aid in regulating your circadian rhythm and levels of melatonin.

Optimize Your Environment

Your bedroom’s environment, setup, and temperature are key factors in getting a good night’s sleep. Things like noise, furniture arrangement, and external lights can all influence the quality of your sleep. For example, one study found that external noise from traffic can cause poor sleep and even long-term health issues.

Similarly, around 70 degrees Fahrenheit has been shown to be a comfortable sleeping temperature for most people. Some studies have found that increased body and bedroom temperature can increase wakefulness. Consider blocking out as much sound as possible, adjusting your room temperature, and improving your bedroom environment. It may help you sleep better than you expect.

There are so many factors that go into a good night’s sleep, and it’s absolutely essential to get enough rest to perform well every day. If you find that making adjustments to your sleep routine and lifestyle aren’t enough to help you improve your sleep quality alone, it may be time to speak to your dentist or doctor about the possibility of having sleep apnea. The first step to getting the great sleep you need is to find out exactly why you aren’t sleeping well. Then, you can focus on treatment that addresses the core issue—whether it’s OSA, CSA, another sleep disorder, or an underlying health condition.