How to Diagnose and Treat Different Types of Sleep Apnea

Sleep apnea is a potentially serious sleep disorder where breathing repeatedly stops and starts during sleep. Left untreated, it can lead to high blood pressure, heart disease, stroke, and other complications. Because obstructive sleep apnea (OSA), central sleep apnea (CSA), and complex sleep apnea syndrome (CompSAS) have different underlying causes, choosing the right treatment starts with an accurate diagnosis. This guide explains how to diagnose and treat types of sleep apnea effectively, the available testing methods, and the most common treatment options.

Diagnosis of Sleep Apnea

Accurate diagnosis is essential because each type of sleep apnea may require a different treatment plan. The evaluation usually begins with a consultation, a review of symptoms, and a physical examination. From there, your doctor may recommend one of the following sleep studies.

Polysomnography (Overnight Sleep Study)

Polysomnography is considered the gold standard for diagnosing sleep apnea. Conducted in a sleep laboratory, it records:

• Brain activity (EEG) to determine sleep stages.

• Airflow through your nose and mouth.

• Breathing effort via chest and abdominal movement.
  Blood oxygen levels (pulse oximetry).

• Heart rate and rhythm.

• Leg movements.

Advantages:

• Detects OSA, CSA, and CompSAS with high accuracy.

• Identifies other sleep disorders, such as restless legs syndrome or narcolepsy.

Disadvantages:

• More expensive than home testing.

• Requires spending a night at a sleep clinic.

Home Sleep Apnea Test (HSAT)

HSAT is a simpler, more affordable test performed at home. It typically measures:

• Airflow.

• Breathing effort.

• Blood oxygen saturation.

Advantages:

• Comfortable, familiar environment.

• Lower cost and faster results.

Limitations:

• Primarily detects OSA; less effective for diagnosing CSA or other complex disorders.

• May require follow-up polysomnography if results are inconclusive.

Treatment Options for Sleep Apnea

Treatment depends on the type and severity of sleep apnea, as well as the patient’s overall health. In many cases, lifestyle changes are recommended alongside medical interventions.

Continuous Positive Airway Pressure (CPAP)

CPAP therapy delivers a steady stream of air through a mask, keeping the airway open during sleep. It is the first-line treatment for moderate to severe OSA and can also help some CSA patients.

Pros: Highly effective when used consistently.
Cons: Some people experience discomfort, nasal congestion, or mask leakage.

Bi-level Positive Airway Pressure (BiPAP)

BiPAP delivers two different pressures—higher when inhaling and lower when exhaling—making it more comfortable for patients who have trouble exhaling against constant pressure. It is sometimes prescribed for CSA or patients who cannot tolerate CPAP.

Adaptive Servo-Ventilation (ASV)

ASV is a specialized form of PAP therapy that adjusts airflow dynamically to stabilize breathing, often used for CSA or CompSAS.

Oral Appliances

Custom-made devices reposition the lower jaw and tongue to prevent airway collapse. These are mainly used for mild to moderate OSA or for patients who cannot tolerate CPAP.

Surgery

Surgical options aim to remove or reduce tissue blocking the airway or reposition anatomical structures. Common procedures include:

• Uvulopalatopharyngoplasty (UPPP): Removes soft tissue from the throat.

• Maxillomandibular advancement: Moves the jaw forward.

• Hypoglossal nerve stimulation: An implanted device stimulates tongue muscles to prevent collapse.
  
  

Medications

While not a primary treatment for OSA, certain drugs may help manage CSA by stimulating breathing or addressing underlying heart or neurological conditions.

Lifestyle Modifications

These are often the first step and may also support other treatments:

• Weight loss to reduce fat around the airway.

• Avoiding alcohol and sedatives that relax throat muscles.

• Sleeping on your side to prevent airway collapse.

• Regular exercise to improve cardiovascular health.

   When to Seek Medical Advice

You should consult a healthcare provider if you experience:

• Loud, chronic snoring.

• Pauses in breathing during sleep (observed by a partner).

• Frequent nighttime awakenings.

• Excessive daytime sleepiness.

• Morning headaches, irritability, or difficulty concentrating.

Why early action matters:
Untreated sleep apnea can lead to serious health problems, including high blood pressure, arrhythmia, heart failure, stroke, and type 2 diabetes. Early diagnosis and treatment improve both quality of life and long-term health outcomes.

Expert Recommendations

• Consistency is key: For CPAP and other PAP therapies to work, they must be used every night.

• Follow-up care: Regular check-ins with your sleep specialist help adjust settings, troubleshoot issues, and track progress.

• Tailored treatment: Not every solution works for everyone—treatment should be customized based on type, severity, and patient preferences.

If you suspect you have sleep apnea, seek professional evaluation promptly. Choosing the right diagnostic test and treatment plan can restore restful sleep, improve energy levels, and protect your heart and brain health.