Apnea literally means “without breath.”

There are 3 types of sleep apnea: obstructive, central and mixed. Of the three types, obstructive sleep apnea (OSA for short) is the most common. This is where there is an intermittent airflow blockage during sleep. OSA can be seen in all age groups, but the frequency increases with age and obesity. This is where the upper airway gets partially or completely blocked while sleeping. It can be caused by weight on the chest or in the neck, weakened diaphragm muscle which causes you to work harder to breath while sleeping. 

Symptoms of OSA is loud snoring, gasping for air while sleeping, and stopping to breath while sleeping. There are behaviors that can help with these symptoms such as side sleeping, elevate the head of your bed and losing weight. Testing needs to be ordered by a medical provider to see the severity of the sleep apnea. During a sleep study, a respiratory disturbance index (RDI) is evaluated. This is an average number of episodes of apnea, hypopnea and arousals from sleep due to a respiratory event per hour of sleep. 

Treatment for OSA is CPAP (continuous positive airway pressure). This is a machine that will give a constant pressure via a nasal mask or face mask to help push the obstruction out of the way. This pressure is set during a sleep study that would include looking at your respiratory effort, brain waves, vital signs and oxygen needs. Another treatment for OSA is losing weight. As you reduce your weight by 10% you can reduce your RDI by up to 26%. Other benefits of losing weight is lowered blood pressure, improved snoring and sleep structure, and improved pulmonary function. As one loses weight this can change the pressure that is needed in the CPAP machine. There is also a need to have your mask (face mask or nasal mask) to be refitted because of the weight loss. If there is a leak in the mask and the seal is insufficient, the pressure from the machine is not enough to keep the obstruction out of the way. Your durable medical company can help you with the mask fitting. If you are having to tighten your mask to make a seal you need either a new mask or to be refitted.

The only way one should stop using the CPAP or treatment for OSA is from a provider. No one should just stop using a machine without being retested. As the weight comes off, the medical provider needs to kept in the loop. Another sleep study, either in lab or at home study, needs to be completed to see if there is a decrease in the RDI, arousals and oxygen needs. No one should just stop using the treatment because they feel better. 

Central sleep apnea (CSA) is the cessation of the respiratory drive resulting in the lack of respiratory movements. During sleep your breathing is disrupted because there is a lack of communication from your brain to your diaphragm and lungs. The major difference between OSA and CSA, during CSA your brain doesn’t tell your muscles to breathe. Treatment for CSA is normally BiPap. This is a machine that has 2 level of pressure. A higher pressure that gives a breath and augments your own spontaneous respiration. The lower pressure is a pressure that keeps the airways open. 

If one has CSA, stopping treatment should not happen without being retested. This retest should be an in lab study.