Obstructive And Complex Sleep Apnea Comparison

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Obstructive And Complex Sleep Apnea Comparison

Obstructive Sleep Apnea – What Is It?

Obstructive sleep apnea is a common sleep disorder in which your breathing stops and restarts many times while you sleep. This can prevent your body from getting enough oxygen. The most common type of sleep apnea, obstructive sleep apnea, is caused by the airway periodically closing during the night, which causes gasping for breath. Frequent episodes or “apneas” eventually lead to chronic sleep deprivation. Along with sleep loss, the condition, if left untreated, can lead to other mental and physical health issues.

Most people don’t realize they have sleep apnea and remain undiagnosed for many years, if not a lifetime. Many people rationalize sleep apnea by living with just always being tired.

Complex Sleep Apnea – What Is It?

Complex sleep apnea is a combination of both central and obstructive sleep apnea symptoms. It’s considered complex when the patient does not receive resolved or lesser symptoms after any type of treatment. Additionally, patients with complex sleep apnea could still have many apneas throughout the night even while using a CPAP machine.

Doctors will diagnose a person with complex sleep apnea when CPAP therapy is not resolving their sleep apnea. Patients may experience having a more open airway, but not enough to where apneas are lessensed, resulting in complex sleep apnea. The underlying cause may be a neurologicial issue that cannot be resolved with CPAP treatment.

Obstructive and Complex Sleep Apnea – How to Recognize Which One You Have?

Obstructive sleep symptoms include:

  • Gasping for air in the middle of sleep
  • Morning headaches
  • Loud snoring
  • Dry mouth in the morning
  • Drowsiness even after a night’s sleep
  • Poor concentration, memory and irritability

Complex sleep apnea symptoms are very similar to obstructive sleep apnea. The only difference is that with CPAP treatment, the symptoms do not improve. Usually, complex sleep apnea is only discovered after initial treatment with CPAP for OSA fails to produce results.

Because some of the causes of complex sleep apnea are associated with signals in the brain, it is difficult in a sleep study to pinpoint the exact type of sleep apnea a patient might be experiencing until after CPAP treatment is tried.

Hypopneas – Obstructive And Complex 

Obstructive Hypopnea

Obstructive hypopneas happen in obstructive sleep apnea when a person’s airway has blockages throughout their night’s sleep. Blockages can occur when a person’s throat muscles and tissues become more prominent and narrow the airway. It’s caused by obesity or hypothyroidism.

However, a person’s bone structure could also contribute to obstructive hypopnes. Their jaw shape or size of their tonsils could cause their airway to be a little more constricted. If a child experiences hypopneas, it’s likely due to their tonsil and adenoids sizes.

Mixed Hypopnea

Mixed hypopneas occur among people who have both central sleep apnea and obstructive sleep apnea, so in appearance they are the same. But the hypopneas in central sleep apnea occur because the brain briefly stops sending the body signals to breathe. The patient may also experience typical hypopneas due to a blocked airway as well, making diagnosis difficult.

Mixed hypopneas can be much more serious as they can affect the health of the brain stem, so that immediate diagnosis and treatment is important.

Obstructive and Complex Sleep Apnea – Treatment Options 


CPAP stands for continuous positive airway pressure. Sleep apnea patients have a tendency for their airways to close, leading to disruptive and unhealthy sleep patterns. This treatment for sleep apnea uses mild air pressure to keep your airways open while you sleep. CPAP is one of the most common treatments for obstructive sleep apnea but may also have benefits for patients with complex sleep apnea.

CPAP machines deliver a prescribed air pressure setting through a hose to a mask while the patient sleeps. This continuous flow of air helps keep the airway open, allowing the patient to get the full night’s sleep that they need.

Adjusting to breathing pressurized air through a mask can be difficult at first, but many CPAP machines offer ramp features that start with a lower pressure setting while the patient is falling asleep, and then ramp up to the prescribed higher setting once they are fully asleep, so they do not feel the discomfort.


BiPAP or bilevel positive airway pressure helps reduce symptoms in both obstructive and complex sleep apnea. Unlike a CPAP machine which delivers a constant standard pressure, a BiPAP machine has two pressure settings. One pressure is for inhalation (IPAP) and a lower pressure for exhalation (EPAP). When you breathe in, the pressure will increase to the prescribed amount, and lower during exhalation. Many people cannot tolerate CPAP therapy and have been prescribed this specific therapy by their doctor.

Many patients may choose BiPAP therapy because CPAP therapy delivers a continuous pressure, which makes it difficult for them to breathe. By alternating pressure during inhalation and exhalation, patients with either obstructive sleep apnea or complex sleep apnea may find this type of therapy more comfortable.


Adaptive Servo Ventilation (ASV) is a non-invasive ventilatory treatment option to help treat those who have obstructive, central, or complex sleep apnea. This treatment is newer than other forms of sleep apnea treatment and monitors a person’s breathing to correct their breathing pattern.

Although ASV is a treatment for sleep apnea, it has many differences to other treatments like CPAP therapy. ASV is asjusted and customized for each patient, and doesn’t provide one fixed pressure like some CPAP machines do. It adapts to each person’s breathing pattern and continuously adjusts itself to cater to the person.

Key Takeaways

Determining the type of sleep apnea, you have is the first step in proper treatment. Speak to your doctor about any symptoms and consider a sleep apnea test to confirm a diagnosis. Once a type of sleep apnea is identified, your doctor will recommend the type of treatment that best fits you. No matter what type of sleep apnea you have, it is important to get diagnosed and treated to improve sleep health and ensure physical and mental health overall.

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