Key Signs & Management of Central Sleep Apnea

Differences Between Central and Obstructive Sleep Apnea

Sleep apnea is a disorder characterized by pauses in breathing or periods of shallow breathing during sleep. It’s not a one-size-fits-all condition; there are several types, including Central Sleep Apnea (CSA) and Obstructive Sleep Apnea (OSA). Understanding the differences between these two can be crucial for effective management and treatment. This article delves into the distinctions between CSA and OSA, shedding light on their causes, symptoms, risk factors, diagnosis, and treatment options.

Defining Central and Obstructive Sleep Apnea

Before diving into their differences, it’s important to define what CSA and OSA are. CSA occurs when the brain does not send the signals needed to breathe, due to instability in the respiratory control center. OSA, on the other hand, happens when the throat muscles intermittently relax and block the airway during sleep.

Causes and Risk Factors

The root causes of CSA and OSA differ significantly, as do the risk factors associated with each condition.

Central Sleep Apnea:

  • Causes: CSA is often linked to other medical conditions, such as heart failure, stroke, or kidney failure, which affect the brain’s ability to control breathing.
  • Risk Factors: Conditions that can increase the risk include being older, male, and having heart disorders.

Obstructive Sleep Apnea:

  • Causes: OSA is primarily caused by a physical blockage of the airway when the soft tissues in the throat collapse and close during sleep.
  • Risk Factors: Factors that heighten the risk of OSA include obesity, smoking, nasal congestion, a narrow airway, or having a family history of sleep apnea.

Symptoms: Unique and Overlapping

While CSA and OSA share some common symptoms, there are key differences that help distinguish between the two.

Common Symptoms:

  • Snoring (more typical in OSA)
  • Daytime sleepiness or fatigue
  • Restless sleep
  • Sudden awakenings with a sensation of gasping or choking (more typical in OSA)
  • Morning headaches
  • Night sweats
  • Mood changes

Unique to Central Sleep Apnea:

  • More frequent episodes of wakefulness during the night
  • Less common occurrence of snoring

Diagnosis: Tailoring the Approach

The diagnosis of CSA and OSA involves different approaches due to the distinct nature of each condition.

  • Obstructive Sleep Apnea: Diagnosis usually involves a sleep study called polysomnography, which records bodily functions during sleep. Signs of physical obstruction to airflow despite efforts to breathe are key indicators of OSA.
  • Central Sleep Apnea: While polysomnography is also used to diagnose CSA, doctors specifically look for periods of no respiratory effort in the presence of apneas or hypopneas to confirm CSA.

Treatment Options: Diverse and Specific

Treatment strategies for CSA and OSA vary, addressing the unique causes and mechanisms of each type.

Central Sleep Apnea Treatments:

  • Addressing underlying conditions
  • Adaptive servo-ventilation (ASV)
  • Continuous positive airway pressure (CPAP)
  • Bilevel positive airway pressure (BiPAP)

Obstructive Sleep Apnea Treatments:

  • CPAP therapy
  • Oral appliances designed to keep the throat open
  • Lifestyle changes (e.g., weight loss, sleeping on the side)
  • Surgery (for severe cases)


Though they share a name and some symptoms, Central and Obstructive Sleep Apnea are fundamentally different disorders, each with its own set of causes, risk factors, and treatments. Understanding these differences is essential for anyone seeking to manage sleep apnea or support someone who is. Accurate diagnosis and tailored treatment can significantly improve quality of life, highlighting the importance of professional evaluation and intervention in cases of suspected sleep apnea.