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What Is Complex Sleep Apnea?

May 30, 2023


Sleep apnea is a common sleep disorder that affects millions of people worldwide. While most individuals with sleep apnea are diagnosed with obstructive sleep apnea (OSA) or central sleep apnea (CSA), there is another type called complex sleep apnea. This type of sleep apnea adds new layers of difficulty to managing sleep apnea.

Understanding Complex Sleep Apnea 

Complex sleep apnea, also known as treatment-emergent central sleep apnea, is a subtype of sleep apnea that occurs when a person with obstructive sleep apnea develops central sleep apnea symptoms after undergoing treatment. CSA differs from OSA as it disrupts the brain’s signaling to the muscles responsible for breathing. This combination of obstructive and central apneas poses unique challenges in diagnosis and management.

Causes and Risk Factors 

While the exact causes of complex sleep apnea are not fully understood, several factors may contribute to its development. One factor may be pre-existing conditions of risks. It may occur more commonly in those with sleep disorders like insomnia. This type of sleep apnea also appears more frequently in those with low carbon dioxide levels. Treatment-related factors may also contribute to the development of CSA. Persistent positive airway pressure (CPAP) therapy, a standard treatment for OSA, can sometimes trigger or unmask central sleep apnea in some individuals. 


The symptoms of complex sleep apnea can be similar to those of other types of apneas, including excessive daytime sleepiness and morning headaches. Individuals with this type of sleep apnea have varied symptoms, and some experience no symptoms at all.

Treatment Options

For many, complex sleep apnea resolves on its own and requires no treatment. However, there are around 2% of people who the condition persists in. Most providers will recommend switching to another type of therapy for the original sleep apnea, which may include:

  1. Adaptive Servo-Ventilation (ASV): ASV therapy is a specialized form of positive airway pressure therapy that adjusts the air pressure based on the individual’s breathing patterns. It can effectively treat both obstructive and central apneas.
  2. Bi-level Positive Airway Pressure (BiPAP): BiPAP machines provide different air pressure levels during inhalation and exhalation, making breathing easier for individuals. BiPAP may be recommended if CPAP or ASV therapy is not sufficient.

Making lifestyle modifications can also help improve the symptoms of complex sleep apnea. These changes include maintaining a healthy weight, avoiding alcohol and sedatives before bedtime, sleeping on your side, and practicing good sleep hygiene.

Are you struggling to get the sleep you need? If you’ve tried our 5-day plan but still have issues, it might be time to consider a sleep study. Visit: www.advancedhomecareonline.com/sleep-studies to get started.

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