What is the difference between an obstructive and a central sleep apnea syndrome?

The two major groups of sleep apnea differ in obstructive sleep apnea and central sleep apnea.

Obstructive sleep apnea syndrome

In obstructive sleep apnea syndrome – also called OSAS – the airways collapse. The natural constriction of our airways is directly above our larynx lid. In obstructive sleep apnea, the trachea closes here. As a result, no gas exchange can take place in the lungs, ie there is an undersupply of oxygen and the carbon dioxide as degradation product can not be removed from the cells. The lack of oxygen puts the body on alert. The proportion of stress hormones is increasing. We are catapulted from deep sleep into light sleep or wakefulness. The technical term for this is Arousel. It releases large amounts of adrenaline and similar hormones. We wake up. The respiratory muscles relax. We can breathe again.

For the body, the lack of oxygen is a life-threatening condition. The body tries to remedy the lack of oxygen through an emergency program. Here, the blood vessels are widened, increases the pumping power of the heart, peripheral parts of the body cut off from the supply. In the process, unproven cells die off, which leads, for example, to increased forgetfulness in an untreated sleep apnea syndrome. Vessels that are under high pressure may develop microfissures that form plaques. This leads to blood clots that can close entire blood vessels. Similar to a garden hose, which is under pressure for a long time in the sun under constant expansion gets small cracks. He is leaking. In our blood vessels plaques form in these small cracks. Also the metabolism is changed by the lack of oxygen and the body stress. New studies show that the so-called metabolic syndrome is favored. Some sleep apnea patients need to water up to 10 times per night. Here I always like to bring an old proverb for a better explanation:

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Sleep apnea: causes and classification

The increased pressure leads to increased diuresis. An increase in noradrenaline in the adrenal cortex leads to nocturia. This increased nocturnal urination is very annoying for the patients. The more they look forward to a therapy initiation on the fast return to normal, ie once or twice a night.


The recurrent waste of oxygen concentration and the repetitive wake-up reactions lead to a disturbed sleep architecture. The proportion of deep sleep and dream sleep is reduced and no restful sleep is possible. The consequences are partly a dramatic limitation of performance and concentration. Even after 10 hours of sleep, people sometimes have a compulsive sleep urge and endanger not only themselves but also society in the traffic and as a machine operator. Especially professional truck drivers, bus drivers, pilots, dangerous goods transporters, crane operators and similar occupational groups are a danger not only for themselves. Often, the affected persons do not know about their illness for a long time and withdraw more and more from the social life due to their daytime tiredness.

 Factors leading to obstructive sleep apnea syndrome:

Various factors play a role here.

First, there is the family disposition to a narrowing of the orophargus. You certainly know families in which the father, the grandfather and the uncle suffer from sleep apnea.

Furthermore, obesity promotes a narrowing of the pharynx due to the pressure of the fatty tissue on the neck. Often people with a BMI over 30 are affected.

Sleep apnea: causes and classification

Through the hormone change in the menopause changes the tissue tension – also in the throat area -. For this reason, the group of women over 50 is more affected than younger women. This has been proven by international studies.

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Endangering men and women

The data show that obstructive sleep apnea syndrome is present at a 4: 1 ratio in both men and women in the general population. Much more often and earlier, OSAS syndrome is diagnosed in men. Women have the same risks, but the diagnoses are made 5-6 years later than men, which poses a high risk of complications in women.

The association of obstructive sleep apnea syndrome with increased morbidity and mortality has long been known through hundreds of studies. OSAS causes diseases of the cardiovascular system, increases the risk of accidents, leads to impotence and increases the risk of getting type 2 diabetes mellitus up to 60%. Another leading syndrome of OSAS is the pronounced daytime fatigue and the microsleep.

How do you recognize a sleep apnea syndrome as a layman?

Characteristic is persistent recurring snoring sounds with pauses. Apnea in Greek means the calm or absence of the wind.

In addition to the snoring sounds, the predictors include sleep breathing, depression, insomnia, nightmares, diabetes, hypertension, heart disease, eg right heart failure, stroke and general drowsiness or daytime tiredness.

Especially the foreign observation leads many people to the sleep laboratory or to a specialist. If you are sleeping alone you can use one of the modern sleep monitoring apps to record any snoring sounds.

By the way: There are now quite a few apps that you can support at this point.

Central sleep apnea syndrome

The central sleep apnea syndrome differs from the obstructive sleep apnea syndrome by an open airway and a lack of respiratory drive. That is, the control mechanism of the respiratory center is partially disabled. Various neurological diseases, metabolic disorders, degenerative diseases of the nervous system and damage to the neuronal system can be triggers. There is evidence that years of excessive untreated snoring favors the development of a central sleep apnea syndrome. The exact relationships are not fully understood and understood. One theory is that the loud snoring sounds and vibrations damage the sensitive nerve endings in the orophargus. Patients often have some form of mixed sleep apnea. that is, Parts of the night are characterized by a change between central and obstructive sleep apnea. At a certain severity of central sleep apnea CPAP (continues positive airway pressure) therapy with a stored respiratory rate is used. You can think of it as a pacemaker, which only intervenes in case of problems. If you come under a certain respiratory rate, for example under 10 x per minute, it supports the therapy device and gives you security. if it comes to problems. If you come under a certain respiratory rate, for example under 10 x per minute, it supports the therapy device and gives you security. if it comes to problems. If you come under a certain respiratory rate, for example under 10 x per minute, it supports the therapy device and gives you security.

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Is sleep apnea inherited?

Although a sleep apnea-inducing gene has not yet been identified and there are only certain associations to the chromosomes 1p, 2p, 12p, 19p and the ApoE4 complex, there is evidence that the disease is inheritable. About 35% of the variability of OSA (obstructive sleep apnea) can be attributed to genetic factors. If one parent has an OSA, the risk of offspring increases by a factor of 2-3 compared to those with parents without sleep apnea.