What is the Difference Between Obstructive and Central Sleep Apnoea?

obstructive vs central sleep apnoea — (source: resmed)

A common sleep disorder that affects thousands of individuals is sleep apnoea. In this condition, individuals have trouble breathing during their sleep for repetitive times. However, there are two types of it, including obstructive and central sleep apnoea.

If you have difficulty breathing while sleeping and want to know which one you are suffering from, check this detailed comparison of obstructive vs central sleep apnoea.

What Is Obstructive Sleep Apnoea?

When the muscles in the back of your throat relax too much, it causes obstructive sleep apnoea, which prevents normal breathing. This is because these muscles support the tongue, tonsils, uvula, the triangular portion of tissue hanging from the soft palate, and the back of your mouth's roof (soft palate).

As you breathe in, the muscles relax, and your airway narrows down or closes. This makes breathing difficult for ten seconds or longer. Additionally, your blood's oxygen saturation may decrease, and carbon dioxide levels may rise.

What Is Central Sleep Apnoea?

Central sleep apnoea develops when your brain fails to communicate properly with the breathing muscles. In this condition, your breathing starts and repeatedly stops while you sleep.

Heart failure and stroke are the two common disorders leading to central sleep apnoea.

What Is the Difference Between Central and Obstructive Sleep Apnoea?

This disorder is distinct from obstructive sleep apnoea, in which the upper airway is blocked, and you cannot breathe normally. Obstructive sleep apnoea is more frequent than central sleep apnoea. To know more about the difference between central and obstructive sleep apnoea, check the following table:

Parameters	CSA	OSA
Meaning and Concept	Central Sleep Apnoea occurs when your brain fails to send correct signals to the muscles that control your breathing.	Obstructive sleep apnoea occurs when muscles in the back of your throat do not allow normal breathing as they relax too much.
Symptoms	The symptoms of CSA include morning headaches, snoring, difficulty concentrating, and more.	The symptoms of OSA include excessive sleepiness during the daytime, mood changes such as irritability and depression and many more.
Causes	Central sleep apnoea can be caused due to sleeping at high altitudes, heart failure, stroke and other reasons.	Excess body weight, old age, being male, genetics, and many other reasons can cause obstructive sleep apnoea.
Risk Factors	The risk factors are higher for males than females.	The risk factors are not based on gender but on numerous other reasons.
Treatment Method	The treatment methods include medications.	The treatment methods include more exercise than medication.

What Are the Symptoms of Obstructive and Central Sleep Apnoea?

There are a few similar symptoms between central sleep apnoea and obstructive sleep apnoea. On the other hand, there are a few dissimilar symptoms between the two as well. Let us discuss both in brief.

Symptoms of Obstructive Sleep Apnoea

The signs and symptoms of obstructive sleep apnoea include:

Loud snoring.
Excessive daytime sleepiness.
Morning headache.
High blood pressure.
Changes in mood, such as irritability and depression.
Awakening with a sore throat or dry mouth.
Regular episodes of stopped breathing during sleep.
Decreased libido.

Symptoms of Central Sleep Apnoea

The signs and symptoms of central sleep apnoea are:

Snoring.
Mood changes.
Observed incidents of abnormal breathing patterns or not breathing at all during sleep.
Insomnia.
Excessive daytime sleepiness.
Morning headaches.

What Are the Causes of Obstructive and Central Sleep Apnoea?

Causes can be another comparison to mention under OSA Vs CSA. Various reasons can result in central and obstructive sleep apnoea, and both vary.

Causes of Obstructive Sleep Apnoea

The causes of obstructive sleep apnoea include:

Obesity Hypoventilation Syndrome: This is a disorder in obese people which causes difficulty in breathing.
Chronic Lung Diseases: Chronic lung diseases, including asthma, pulmonary fibrosis, chronic obstructive pulmonary disease or stroke, can develop OSA.
Fluid Building Up in Neck: It can be due to kidney or heart failure obstructing the upper airway.
Pregnancy: Pregnancy is one of the top causes of developing obstructive sleep apnoea.
Stroke or Other Neuromuscular Conditions: This causes interference in brain signals sent to one's airway and chest muscles, thus leading to obstructive sleep apnoea.
Endocrine Conditions: Hypothyroidism, polycystic ovary syndrome, acromegaly and other conditions which can affect one’s breathing while being asleep can lead to the condition.

Causes of Central Sleep Apnoea

There are several reasons that cause central sleep apnoea.

Cheyne-Stokes Breathing: The two conditions most frequently linked to this type of central sleep apnoea are congestive heart failure and stroke. The breathing effort and airflow gradually rise and then fall during Cheyne-Stokes breathing. Central sleep apnoea is the absolute absence of airflow during the smallest breathing exertion.
High-altitude Periodic Breathing: If you are at an extremely high altitude, a Cheyne-Stokes breathing pattern could appear. The alternating rapid breathing (hyperventilation) and under breathing, are caused by the altered oxygen levels at this altitude.
Drug-Induced Apnoea: Your breathing may become erratic, rise and decrease in a regular pattern, or temporarily stop if you take certain OTT medications. These include opioids like morphine (MS Contin, Kadian, and others), oxycodone (Roxicodone, Oxycontin, and others), or codeine.
Treatment-Emergent Central Sleep Apnoea: While receiving treatment for obstructive sleep apnoea with continuous positive airway pressure (CPAP), some patients may develop central sleep apnoea. This disorder, which combines obstructive and central sleep apnoeas, is known as treatment-emergent central sleep apnoea.

What Are the Risk Factors of Obstructive and Central Sleep Apnoea?

Now that you know the symptoms and causes of both the sleeping disorders, you should know about the risk factors too.

Risk Factors for Obstructive Sleep Apnoea

The risk factors for obstructive sleep apnoea are:

Excess weight.
A narrowed airway.
Old age.
Family history.
Nasal congestion.
Smoking.
Use of alcohol, tranquilizer and sedatives.
Neck circumference.
Being male.

Risk Factors of Central Sleep Apnoea

The risk factors of central sleep apnoea are:

Heart disorders.
Old age.
Stroke.
Narcotic pain medications.

This is all for obstructive vs central sleep apnoea that people should know about. If you are experiencing something similar, then without wasting any time, you should consult a doctor.

FAQs About Obstructive and Sleep Apnoea

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Which medical conditions coexist with obstructive sleep apnoea?

The prevalence of OSA increases with coexisting medical conditions such as stroke, pregnancy, hypothyroidism, congestive heart failure and Polycystic Ovary Syndrome (PCOS).

Does central sleep apnoea ever go away?

There is no cure for this chronic medical condition; however, with lifestyle changes and other treatments, one can reduce one's sleep apnoea symptoms.