How Non-Obstructive Sleep Apnea Differs from Obstructive Sleep Apnea

Many people have sleep apnea yet they don’t know it. They put up with daytime fatigue, can’t concentrate, or even drift off while driving. They never feel rested, despite the number of hours they spend sleeping. They snore so loudly, yet don’t realize it’s a major sign of sleep apnea.

It’s a real risk, having sleep apnea, as the lack of sleep contributes to heart disease and diabetes – and to serious car accidents -- yet people often don’t hear much about this condition. 

If this sounds familiar, it’s time to learn more about sleep apnea – including the two basic types, non-obstructive and obstructive sleep apnea.

The good news: medical techniques are highly effective if practiced on a regular basis. 

There is still another important point to highlight. Two forms of sleep apnea exist -- and each has its own appropriate treatments that work best. 

Obstructive Sleep Apnea

Obstructive sleep apnea (often simply referred to by the acronym OSA) is the most common type and therefore, also extremely well understood. 

OSA is caused by a narrowing of the airways while asleep. It may also be triggered by other physical issues such as the tongue resting upon the soft palate. Either way, it becomes more difficult to breathe. 

Research indicates that OSA is more likely to occur in older individuals and males be slightly more at risk than females. Some common symptoms of OSA include:

  • Loud snoring that may disturb your partner.
  • Suddenly waking up in the middle of the night feeling breathless.
  • Frequent headaches for no obvious reason.
  • A dry nose, mouth or both.
  • Tiredness or the inability to concentrate throughout the day.

We should note that these symptoms can vary in terms of their severity. For example, someone who is suffering from a mild form of OSA might be unaware that a problem exists. Others could instead feel as if their entire life has been upturned and that it is nearly impossible to obtain a sound night of rest. 

Non-Obstructive Sleep Apnea

Non-obstructive sleep apnea is more commonly known as central sleep apnea (CSA). In this scenario, there is no physical blockage of the airways. CSA is instead thought to be rooted within the autonomic nervous system. 

The autonomic nervous system is responsible for many metabolic and physical functions that occur without conscious thought. Examples include blood pressure, heart rate, perspiration, digestion, and respiration. 

Central sleep apnea is therefore caused by "jumbled" communications between the brain and the muscles that coordinate breathing while asleep. 

Some causes of CSA are better understood than others. Here are some potential factors:

  • Those who are sleeping at relatively high altitudes.
  • Certain medications such as morphine and oxycodone can cause disruptions in the autonomic nervous system.
  • Cheyne-Stokes breathing (a condition that can sometimes coincide with other medical issues such as heart failure or stroke).
  • Devices used to treat OSA can sometimes cause CSA to develop (known as treatment-emergent central sleep apnea).

Also, a type of CSA known as idiopathic sleep apnea is not well understood.

Possible risk factors attributed to CSA may include potentially serious medical conditions, age, gender (to an extent), and even some methods commonly employed to treat OSA. 

How Will a Doctor Diagnose the Exact Type?

It is first important to mention that anyone who feels that they may be experiencing sleep apnea should consult with their primary care doctor or a sleep specialist. 

Specific tests are likely to be performed as part of a sleep study. A diagnosis is pivotal if you hope to be provided with the most targeted treatment options. 

What Steps Can be Taken to Reduce the Symptoms of CSA and OSA?

As highlighted earlier in this article, there are no known cures for either of these conditions. The main intention is therefore to mitigate the severity and duration of the symptoms themselves. The good news is that the use of a positive airway pressure (PAP) device is by far the most effective strategy.

A PAP will supply your body with air at a higher pressure. The intention here is to keep your airways open while at rest. Note that there are also several types available and these can be used to address specific needs. 

Some will offer additional accessories such as heated tubes and built-in humidifiers; both intended to provide additional levels of comfort. PAP therapy should be used each and every night in order to become familiar with their presence. 

Having said this, those who have been diagnosed with central sleep apnea may require further intervention. Many doctors will attempt to determine if an underlying problem within your autonomic nervous system exists. 

CSA may indicate the presence of another condition such as congestive heart failure. Additional tests may therefore be required. Some medications such as acetazolamide and sedative-hypnotic agents could likewise be warranted. However, these only tend to be prescribed when dealing with severe cases. 

Leading a Healthy Lifestyle

Similar to other chronic conditions, adopting healthier habits can have a profound impact upon your long-term prognosis. In addition to the standard approaches outlined above, here are some other worthwhile suggestions:

  • Abstain from drinking alcohol and smoking cigarettes.
  • Perform regular exercise to decrease your body mass index (BMI) and to increase your lung capacity – and to help you relax so you sleep better.
  • Embrace a healthy diet so you lose weight.
  • Try to go to sleep at the same time each night, as a restful bedtime routine can help promote good sleep.

While both OSA and CSA are somewhat different, both require professional medical advice to keep the associated symptoms in check. 

Sources:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561280/
  2. https://www.mayoclinic.org/diseases-conditions/central-sleep-apnea/symptoms-causes/syc-20352109
  3. https://www.ncbi.nlm.nih.gov/books/NBK539845/
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10204934/
  5. https://emedicine.medscape.com/article/304967-medication