What is Complex Sleep Apnea?

Having sleep apnea is a challenge like no other. First, the cause of this sleep disorder is not easy to identify. Sometimes, the primary issue is not the disorder itself, but an underlying health condition causing it. Therefore, you must partake in many tests to get a proper diagnosis.

The situation is even trickier when your diagnosis shows you have complex sleep apnea, a sleep disorder derived from central sleep apnea treatment. But what is complex sleep apnea, exactly?

Learn more about this sleep disorder in this article, where you also will find information about its causes, how to treat it, and more.

What is Complex Sleep Apnea?

Complex sleep apnea is a sleep disorder. Normally, it occurs when a person with obstructive sleep apnea undergoes continuous positive airway pressure treatment. Specialists also call this condition “treatment emergent central sleep apnea” because of its unique developing method.

In many ways, complex sleep apnea is a combination of many factors. Let’s break them down for a clearer understanding of the problem.

What is Obstructive Sleep Apnea?

Obstructive sleep apnea occurs when you experience a narrowed or blocked airway while sleeping. This problem can lower the level of oxygen in your blood, interrupt your breathing, and prompt you to awaken abruptly.

Once you or a close one notices these symptoms, a doctor or specialist will ask you to take several tests. A polysomnogram is the most common sleep study to evaluate this sleep disorder. This study proves that you may have obstructive sleep apnea depending on several factors.

Following evaluation and obstructive sleep apnea diagnosis, the doctor will recommend several treatment options.

Obstructive Sleep Apnea Treatment & Complex Sleep Apnea Development

Usually, continuous positive airway pressure therapy is the most effective method to treat obstructive sleep apnea. It consists of receiving oxygen through a mask and into the nose and mouth.

A constant flow of additional oxygen does not allow your upper airway to collapse or obstruct your breathing. Consequently, this procedure also prevents you from snoring.

However, some cases react negatively to CPAP. Since the treatment produces changes in your breathing, you may hold your breath inadvertently. The accumulation of these factors results in central sleep apnea.

That’s how complex sleep apnea occurs during CPAP therapy. Essentially, the treatment resolves incidents of obstructive breathing, whereas central apnea may develop from it.

What is a Polysomnography?

A polysomnography is a sleep study that evaluates body functions during sleep. Specialists in charge of the test attach multiple sensors to the body, like the chest and head. After setting the sensors and initiating the test, these are some of the functions under evaluation:

·        Diverse sleeping phases and their development during the night.

·        The effort needed by the patient to breathe air.

·        How much air enters and leaves the body while breathing.

·        The amount of oxygen and its levels in the bloodstream.

·        Different heart functions, like the heart rate and its rhythm.

Furthermore, the specialist will also evaluate if you stop breathing while sleeping. They keep track of these breathing pauses, how long they lasted, and how many occurred. After collecting this data, they use it to assess the sleep apnea condition and indicate its severity.

The Importance of a Sleep Study

Sleep apnea can have diverse effects, and the condition’s impact could vary between nights. Specialists require a comprehensive study to evaluate these changes and determine how to act accordingly.

In some cases, slight increases in your obstructive sleep apnea hypopnea index are tolerable. It will depend on your initial condition, and if you respond positively to the therapy. Overall, devices to treat sleep apnea syndromes are effective, but the measurements are often estimates and not exact.

Therefore, a thorough study of your sleep apnea condition is necessary. This study provides a detailed analysis of your sleeping habits to determine what’s wrong.

Complex Sleep Apnea Causes

While CPAP treatment is the most common cause of complex sleep apnea, other factors also can result in this sleep disorder. Specialists consider more variables to determine the most effective approach to treat the emerging condition properly.

If you have problems controlling your breathing, your predisposition for complex sleep apnea is higher. Additionally, the condition is more likely to develop if you have issues falling and staying asleep. Other cases have proven that a low carbon dioxide level is another potential cause.

Can Other Treatments for Obstructive Sleep Apnea Cause Complex Sleep Apnea?

Other treatments associated with sleep apnea can lead to complex sleep apnea development. For example, undergoing surgeries or implementing oral appliances to treat sleep apnea have been linked to complex sleep apnea in many cases.

The use of PAP machines for home therapy also requires special care. Improper adjustment of the configuration could cause PAP pressures higher or lower than necessary. As a result, you could experience a loss of breathing control and develop the condition.

Complex Sleep Apnea Complications

The complications related to complex sleep apnea are similar to how obstructive sleep apnea affects your daily life.

Higher accident risks. This condition affects your ability to rest well during the night, leading to excessive daytime sleepiness. Incapacity to stay awake during the day can put you at different risks, like motor vehicle accidents.

Lack of concentration. Feeling unrested and sleepy during the day also affects your capacity to concentrate. This issue will hinder your efficiency at work or while studying. In children, complex sleep apnea impacts their learning skills.

Heart problems. Uncommon sleeping patterns and sudden awakenings cause your blood pressure to drop. As a result, the risks of suffering a heart attack, hypertension, and irregular heart rhythms are higher.

Relationships damaged. If you share a bed with a partner or a family member sleeps close, sleep apnea will also affect their lifestyle. This condition includes symptoms like abrupt awakenings, choking, gasping, and snoring.

These are only a few of the complications resulting from sleep apnea and its variations.

How to Treat Complex Sleep Apnea Syndromes?

Resolving the underlying cause is the appropriate method to take care of a complex sleep apnea syndrome.

Adjusting the CPAP Machine

For instance, the pressure of the airway treatment could be too high or too low. In this case, a quick adjustment of the machine is more than enough to control the situation.

Fixing a Mask Leak

Other treatments like oral appliances are potential causes for this condition. Sometimes, the mask has a leak that alters the efficiency of the CPAP therapy. Adjusting the face mask or fixing the leak with a more adequate mask fitting could potentially resolve the situation.

Another Therapy Alternative

If you’re not responding to continuous positive airway pressure positively, following another therapy may work. Therefore, options like bilevel positive airway pressure (BPAP) and adaptive servo ventilation are also worth considering.

Normally, these therapy options available for sleep apnea treatment require you to partake in a titration study. Specialists use this study to evaluate your current condition and determine the most effective settings for the devices.

The Condition May Improve Over Time

However, the simplest solutions are often the most effective. Complex sleep apnea develops in 5%-15% of patients undergoing treatment. In 98% of these cases, it was only a matter of time before the condition resolved itself.

Thus, you may not even need to do anything to notice improvements after suffering from this disorder. You can just continue your therapy as scheduled and wait. Over time, the condition will likely wear off as you continue working on your sleep apnea.

Difference Between Obstructive Sleep Apnea and Central Sleep Apnea Syndromes

Obstructive sleep apnea (OSA) and central sleep apnea (CSA) are two different conditions. The most significant difference between these two problems is how each one originates.

The cause of obstructive sleep apnea is a blockage within the upper airway. This obstruction occurs when the muscles at the back of your throat relax, normally during sleeping. When this problem happens, you cannot breathe properly. Each breathing pause can last around 10 seconds or more.

Alternatively, central sleep apnea occurs when your brain and breathing muscles do not communicate properly. This issue keeps your muscles from functioning normally, preventing your body to pull air into your lungs. The results are breathing pauses during sleep.

Some of the symptoms between the two conditions are also similar.

In any case, consulting with a specialist is the correct approach if you or a close one notices symptoms related to sleep apnea. Identifying which type you have is the first step to assessing the situation and coming up with proper treatment.

What are Other Methods to Treat Obstructive Sleep Apnea?

Treating obstructive sleep apnea with CPAP therapy can cause complex sleep apnea. So, are there other methods to resolve this problem? These are a few common alternatives to CPAP.

Surgery. There may not be any other solution than to resolve upper airway blocks surgically. This solution is often the last resource, and a specialist must determine there’s no other alternative.

Positional Therapy. This type of therapy recommends sleeping on your side instead of over your back. Sometimes, gravity is another factor that can affect your throat muscles and create an airway blockage. By sleeping on your side, you prevent this problem entirely.

Nasal Sprays. Sinus and nasal congestion problems can affect your ability to breathe properly and increase OSA risks. Using a simple nasal spray can be enough to prevent a sleep disordered breathing.

Losing Weight. People with excess weight are more likely to have OSA, mostly because of extra tissue blocking the upper airway. In this case, losing even a small fraction of weight can provide a significant improvement.

Avoid Alcoholic Beverages. While avoiding alcohol is not therapy, it usually provides good results. When you drink alcohol before going to bed, your muscles relax too much. Therefore, your likelihood of experiencing issues with airflow is higher.

Things to Keep in Mind Following a Complex Sleep Apnea Diagnostic

A complex sleep apnea diagnostic may sound terrifying. Nonetheless, only a handful of people experience this condition and the vast majority improve without complications. Thus, there’s nothing to worry about if you take the correct steps.

Learn About Sleep Apnea

Developing complex sleep apnea is mostly a risk if you undergo treatment for obstructive sleep apnea. If you suffer from this sleep disorder, research and be ready for what to expect. Knowing that developing complex sleep apnea is a risk will allow you to complete the process with peace of mind.

Be Ready to Try Different Therapies

Complex sleep apnea is more likely to occur while doing CPAP treatment, but other therapies using oral appliances are also potential causes.

Before undergoing any of these therapies, consult with your doctor on what alternatives to take if the procedure is ineffective. This way, transitioning from CPAP to another therapy will be easier.

Be Patient

As mentioned before, complex sleep apnea often requires time to resolve. Sometimes, there’s no need to interfere or act differently to this condition. The disorder could be temporary and all you must do is be patient and nothing more.

Noticing the Symptoms

Noticing sleep apnea complications is not easy.

Usually, you don’t necessarily notice that you wake up suddenly due to a breathing interruption. These situations are subtle enough that you may not realize they’re happening. Your body often changes position and goes back to sleeping almost immediately.

However, these small moments take a toll on the body. Many people feel sleepy during the day believing they slept well while the truth is the opposite. Since breathing pauses due to sleep apnea can occur regularly during the night, sometimes you don’t rest at all.

Final Words

Complex sleep apnea is not a problem for most patients undergoing continuous positive airflow pressure (CPAP). However, knowing this condition is a minor risk is still necessary to get the full picture.

Fortunately, this condition does not require active treatment in most cases. Most people diagnosed with complex sleep apnea improved over time without interference. If you notice OSA symptoms and require attention, don’t hesitate to consult with your doctor or specialist.