Obstructive Sleep Apnoea (OSA) is the most prevalent sleep disorder in Australia, with over 780,000 people being diagnosed with the condition in Australia in 2019-20¹.

However, there is more than just one type of sleep apnoea that can impact your sleep.

We explore the different types of sleep apnoea, how they impact your sleep and what treatment you can get to ease your symptoms.

What are the two different types of sleep apnoea?

There are two different types of sleep apnoea, which are:

Obstructive sleep apnoea (OSA): This occurs when the throat muscles relax too much during sleep and is the most common form of sleep apnoea².

Central Sleep Apnoea (CSA): A rarer form of sleep apnoea and occurs when breathing stops during sleep and there is a pause before breathing starts again².

The difference between OSA and CSA is that CSA happens when your brain fails to send the right signals to your muscles to make you breathe during sleep³.

People diagnosed with CSA repeatedly stop trying to breathe as they sleep as the brain and the muscles that control breathing do not function properly³.

There is some overlap with OSA and CSA symptoms, including excessive daytime sleepiness, frequent nighttime awakenings and heavy impacts on your heart⁴.

What causes Obstructive Sleep Apnoea?

Obstructive sleep apnoea is where your muscles relax too much during sleep and obstructs your breathing.

There are different levels of severity around obstructive sleep apnoea, and there are also a range of causes.

Some causes include²:

• Being overweight or obese

• Certain illnesses, such as hypothyroidism which reduces your thyroid production

• Large tonsils and adenoids

• Nasal congestion or obstruction

• Alcohol, as this makes the throat muscles relax more during sleep

What causes Central Sleep Apnoea?

There are different types of Central Sleep Apnoea (CSA), and they are usually linked to underlying health conditions. Central Sleep Apnoea that exists on its own without a clear or identifiable cause is rare⁴.

The different types of CSA include⁵:

• Central Sleep Apnoea due to medication or substances: Sometimes, the use of certain types of medication or substances can impact the brain’s ability to regulate breathing, including opioids, morphine or codeine.

• Treatment-emergent Central Sleep Apnoea: This is where CSA is developed during CPAP treatment for obstructive sleep apnoea and often resolves itself without treatment.

• Central Sleep Apnoea due to high altitude periodic breathing: This occurs when a healthy person has ascended above 2.4kms in altitude, where the air has a lower concentration of oxygen. It can be caused by sleeping at a higher altitude.

• Central Sleep Apnoea due to a medical disorder with Cheyne-Stokes breathing: This is the most common form of CSA and is often found in people with heart conditions, including congestive heart failure and stroke. Breathing this way includes a pattern of small and large breaths. It includes cycles of under breathing and breathing stoppages⁶.

• Central Sleep Apnoea due to a medical disorder without Cheyne-Stokes breathing: This is a rare form of central sleep apnoea and is typically caused by damage to the brain stem through injury or disease.

What is Cheyne-Stokes breathing?

Cheyne-Stokes breathing is known as a rare abnormal breathing pattern that usually occurs while you’re asleep.

It has a specific pattern, which involves a period of fast, shallow breathing. This is then followed by slow, heavier breathing and some moments without any breathing at all, called apnoeas⁷.

It is associated with central sleep apnoea and is most commonly caused by heart failure and stroke.

Although it is considered as rare, up to 50% of people with heart failure breathe this way⁷.

What kind of treatment is available for Central Sleep Apnoea?

There’s a range of treatments available for central sleep apnoea. Treatments generally help normalise breathing patterns during sleep and aim to improve the quality and duration of your sleep⁴.

As CSA is often linked to another condition, treating that condition can help manage symptoms. For example, if central sleep apnoea is caused by opioid use, treatment would be to reduce the dosage or recommend a change in medicine.

You can also use CPAP machines while you’re sleeping to help aid breathing.

If you’re worried you may have central sleep apnoea, please visit your local GP for more information.

If you think you may have obstructive sleep apnoea, take our online sleep quiz.

References

¹Deloitte Access Economics and Sleep Health Foundation, Rise and try to shine: The social and economic cost of sleep disorders in Australia, accessed 27 March 2023

²Better Health Victoria, Sleep Apnoea, accessed 27 March 2023

³Hopkins Medicine, The Dangers of Uncontrolled Sleep Apnea, accessed 27 March 2023

⁴PubMed Central, Central Sleep Apnea, accessed 27 March 2023

⁵Sleep Foundation, Central Sleep Apnoea, accessed 27 March 2023

⁶Central Sydney Cardiology, Central Sleep Apnoea, accessed 27 March 2023

⁷Sleep Foundation US, Cheyne-Stokes Respirations, accessed 18 April 2023.