Complex Sleep Apnea

Complex Sleep Apnea

Think fast: you hear the word complex, what comes to mind? Complex as in difficult? Complex compound? Complex fraction? I could go on and on about all the things that pop into my head when I think ‘complex,’ but the one thing I for sure don’t think of is complex sleep apnea. I know we have discussed obstructive sleep apnea, and central sleep apnea, but we haven’t touched on complex sleep apnea, so let’s begin with a definition.

According to, “complex [sleep] apnea is a form of sleep apnea where central apneas persist or emerge while attempting to treat obstructive events with a CPAP device.” Again, per the website, complex sleep apnea is diagnosed in a sleep study if: “ you have obstructive sleep apnea, the CPAP or BiPAP machine removes OSA, but…, central sleep apnea shows up once the obstructive apnea is treated with breathing machine.”

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Now to be completely fair, I must inform you that there is still research being conducted on complex sleep apnea. Previous studies, according to, have shown, “the prevalence of this syndrome is somewhat variable in part due to the heterogeneous populations being reported/studied and is significantly affected by factors such as narcotic use, BMI, and other comorbidities specially heart failure.” Being that this is another form of sleep apnea, underlying causes and symptoms are pretty similar to OSA and CSA. Meaning being overweight, smoking, etc., can lead to this form of sleep apnea.

Just as the signs and symptoms are similar to that of OSA and CSA, the treatment for complex sleep apnea is similar as well. As I mentioned before, there is still extensive research being conducted on this topic, so there is no ‘exact cure’ or ‘treatment,’ but there are certain things that can help better the situation you may find yourself in. According to, “one of the best treatments is still CPAP devices, but set at the lowest possible setting that successfully keep the airways free from obstructions, but don’t allow CSA symptoms to develop.”

asv machine

They go on to say, “in some cases where CPAP fails, BiPAP machine and adaptive servo ventilation [ASV] devices are then tried which can better control ventilation. Bilevel positive airway pressure devices are able to deliver pressurized air that can resolve the obstructive component as well as stabilize ventilation during central apneas by forcing breaths (timed breath) during episodes of central apneas. Adaptive servo ventilators have shown successful use as the machine are capable of performing a breath-to-breath analysis and altering its settings accordingly. However, while both BiPAP and ASV machine have shown improvement in therapy over CPAP machines for [complex] sleep apnea there is still no best treatment for it.”

I am, again, leaving you with a short post, but I wanted to share this information with you. It is important to know that we can establish the difference between each type of sleep apnea. While not a whole lot is known about complex sleep apnea, we are well on the way to learning more about it, so for now, the little we know will just have to be enough.

For more information on Complex Sleep Apnea, please see the following links:

For more information on CPAP machines and supplies, please see:

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