Mixed sleep apnea is a dangerous combination of both obstructive sleep apnea (OSA) and central sleep apnea (CSA). This means that individuals suffering from this disorder have the simultaneous challenge of both upper airway obstruction as well as control related fluctuations in breathing. When left untreated, this combination can be lethal. It’s important to seek out diagnosis and treatment as soon as possible if you suspect you may be suffering from any form of sleep apnea.

Mark Levy DDS is leading the charge against sleep apnea. He is a long term advocate for treating this potentially deadly disorder. He has undergone extensive training through several organizations to become one of the foremost experts on the subject. Dr. Levy also shares his knowledge with colleagues in hopes that patients suffering from these awful sleep disorders have another treatment option.

What is Mixed Sleep Apnea?

Mixed sleep apnea is a combination of both OSA and CSA. This means there are difficulties breathing during sleep associated with airway blockages as well as the brain’s ability to signal the body to breathe. This disorder occurs most often in the non-rapid eye movement phase of sleep. This is contrary to OSA which typically presents during the rapid eye movement phase of sleep.

To fully understand mixed sleep apnea we must understand how our bodies work to breathe while we sleep. There are small structures in the middle of the neck called carotid bodies. These are located next to the carotid arteries and detect oxygen and carbon dioxide in the blood. This information is relayed to the brainstem where breathing and blood pressure are controlled. Your brainstem then sends information to the heart and breathing muscles.

When we sleep, our breathing becomes shallower. This causes an increase in CO2 and a lower blood oxygen level which stimulates the carotid bodies. Ultimately, this leads to balanced breathing during sleep. However, abnormalities can lead to increases or decreases in CO2 and oxygen levels outside the normal fluctuations. High CO2 and low O2 levels result in hypoventilation. While low CO2 slows the breathing pattern until CO2 levels are high enough to trigger a new breathing response. If this cycle continues to become more and more unbalanced then the breathing efforts may stop completely. This is typical of central apnea.

With mixed sleep apnea, not only does the individual suffer from central apnea issues, they also have OSA. The abnormal breathing patterns can also result in a more easily obstructed airway, which causes further breathing problems.  Many forms of research show how much of an impact abnormal breathing patterns have on the muscles around the airway.

Facts about Mixed Sleep Apnea

Mixed sleep apnea isn’t nearly as common as typical OSA. However, studies show that anywhere between 5% and 15% of apnea patients suffer from mixed sleep apnea. Many of these patients have a family history of mixed sleep apnea. It’s also more common for patients to be male. Often times, patients who’ve suffered heart failure, renal failure, or stroke are at a higher risk for developing this form of the sleep disorder. The primary contributor to mixed sleep apnea is genetics.

Currently, the only way to truly know if you have mixed sleep apnea is to undergo an extensive sleep study. While home monitors are currently being developed, it remains to be seen if they’ll be able to detect which type of sleep apnea is most prevalent. If you’ve been diagnosed with OSA but feel like you’re fighting the CPAP machine, that it doesn’t help, or that it makes things worse, you should ask your health care provider to test you for mixed sleep apnea. This also stands true for other apnea treatment methods. If you don’t feel like your treatment is effective then there’s a good chance the OSA is being treated but the CSA is not. We must treat each aspect of the disorder for effective results.

Treating Mixed Sleep Apnea

Currently, the only mixed sleep apnea treatment option approved by the FDA is adaptive serv-ventilation or ASV. This device tracks your breathing rhythm while creating air pressure equal and opposite to the patient’s own breathing. This treatment is very effective as long as the rhythm properly matches the patient. If not, use of the machine may become intolerable. It’s also not recommended for those who suffer from specific types of extreme heart failure.

As with any treatment, it’s best to discuss the treatment options with your health care provider to weigh the benefits and risks. There are other treatment options available such as oral appliances made by dentists certified in treating sleep disorders. However, with mixed sleep apnea you may need more than one treatment plan.

If you do suffer from mixed sleep apnea and have a hard time tolerating your CPAP machine, please seek alternate methods of treatment. Choosing not to treat the sleep disorder at all can have deadly side effects.

Research continues on the most effective ways to treat mixed sleep apnea effectively. In the meantime, it’s important you continue to work with your health care provider in an effort to find the best possible treatment for your specific form of this dangerous sleep disorder. A complete lack of treatment can lead to high blood pressure, heart disease, stroke, and even death. You’re also at a much greater risk for being involved in a motor vehicle accident or a workplace accident.

When CPAP Therapy Isn’t for You

There are some cases of OSA where patients don’t tolerate their CPAP machine without the added problem of mixed sleep apnea. These are patients who only suffer from OSA but are unable or unwilling to use their CPAP machine for a variety of reasons. For these people, we recommend seeking an alternate form of treatment. While CPAP therapy is very effective in treating OSA, it becomes ineffective if the patient refuses to comply   with their treatment plan. Instead, consider using an specially designed oral appliance to prevent your airway from becoming obstructed.

Call Mark Levy DDS today at (614) 777-7350 for more information about treating OSA and mixed sleep apnea.