Sleep Blog

Complex sleep apnea clarifies some issues

For years, people have been diagnosed with apnea,
yet conventional therapies didn’t help them, at all.

While hard statistics are probably five or ten years away, it seems perhaps a small percentage of the overall apneic population has a type of apnea they claim isn’t treated by conventional therapies, including CPAP or BiPAP — using air pressure to create a patent airway during sleep — which is the gold standard of treatment for apnea.

Although these people have complained for years, not much was understood about their condition.

Complex Sleep Apnea

Researchers at the Mayo Clinic have discovered what they say is a third kind of sleep apnea. After making the discovery, they named it complex sleep apnea. Patients with complex sleep apnea at first appear to have obstructive sleep apnea and may stop breathing 20 or more times an hour.

However, when put on CPAP, the machine doesn’t completely alleviate the symptoms. Although the symptoms seem to disappear at first, then symptoms of central sleep apnea appear, again causing cessation of breathing during the night.

"All of us in our sleep lab have observed for years that there are patients who appear to have obstructive sleep apnea, but the CPAP doesn’t make them all that much better — they still have moderate to severe sleep apnea even with our best treatment and subjectively don’t feel they’re doing very well," says Timothy Morgenthaler, M.D., Mayo Clinic sleep medicine specialist, pulmonologist and lead study investigator.

"When they put on a CPAP machine, they start to look like central sleep apnea syndrome patients. This phenomenon has been observed for years, but this study is the first attempt to categorize these people," Morgenthaler added.

Understanding the types of apnea

Obstructive sleep apnea is a sleep disorder that causes a person to stop breathing dozens of times while asleep. It’s caused by an obstruction of the airways, including enlarged tonsils or adenoids, a deformed uvula or fatty tissue in the throat.

Central sleep apnea also involves stoppages in breathing during sleep. However, the cause is far different. In central sleep apnea, the brain fails to send a signal to the muscles that control breathing. Basically, the brain forgets to tell the body to breathe.

Some people have a combination of obstructive and central apnea, and are diagnosed as having mixed sleep apnea.

Causes and Treatment

So far, no known cause for complex sleep apnea has been identified but it is believed to be from a combination of physical and neurological causes. No treatment has been found. However, research continues.

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