What is Complex Sleep Apnea?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 12 October 2018
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Complex sleep apnea (CSA) is a breathing disorder characterized by periods of not being able to breathe during sleep. This form of sleep apnea mixes elements of central and obstructive sleep apnea, two different conditions that impair breathing during sleeping. Many patients do not realize they have sleep apnea unless someone around them observes them having difficulty during sleep, and treatment of complex sleep apnea can be somewhat complicated.

People with sleep apnea can experience symptoms like daytime sleepiness, fatigue, and depression. They usually do not recognize that they are having sleeping problems. A stay in a sleep clinic can be used to identify the apnea, learn what kind of apnea it is, and look for any other problems the patient may be experiencing during sleep. This information is used in the development of a treatment plan to address the patient's difficulty breathing and help the patient sleep more comfortably.

In obstructive sleep apnea, the most common form of sleep apnea, when someone sleeps and the muscles of the body relax, the throat closes, making it impossible for air to enter. Central sleep apnea involves a problem with the signals from the brain. The brain fails to control respiration, and the patient stops breathing briefly without struggling or waking up. In complex sleep apnea, people experience both forms of impediment to their breathing.


For obstructive apneas, the treatment often involves sleeping with a device to keep the airway open and help the patient breathe. This is less helpful for people with complex apnea, because while the airway will be kept open, the patient's brain can still malfunction, and the patient will still stop breathing during sleep. Trying a new sleeping position sometimes addresses this, keeping the respiratory centers of the brain functioning.

To treat complex sleep apnea, a doctor may recommend trying some different assistive devices for breathing and changing sleeping positions, in addition to staying in a sleep lab. Staying in a lab will allow doctors to observe the patient during sleep, and to make adjustments to the treatment plan if they are needed. Once a person is sleeping without interruption, the patient can be sent home and periodically reevaluated to see if the treatment is still effective.

People with complex sleep apnea and other forms of apnea sometimes have difficulty adhering to the treatment plan, because it can present hardships and be a nuisance. Breathing devices can be noisy, cumbersome, and uncomfortable. It can also be hard to adjust sleeping patterns. Patients may want to talk to their doctors about available alternatives to see if there is room for adjustment in the treatment plan.



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