If you have been told you might have sleep apnea, or if someone has noticed you stopping breathing during sleep, it is worth understanding that "sleep apnea" is actually an umbrella term. There are two distinct types, and they work quite differently.

Getting the right diagnosis matters because the treatments, while similar in some ways, are not identical. The wrong approach can leave symptoms unresolved.

What Sleep Apnea Is

Sleep apnea is a condition where breathing repeatedly stops and starts during sleep. These pauses, called apneas, can last from a few seconds to over a minute, and they can happen dozens or even hundreds of times a night.

Each time breathing stops, the brain sends a signal to wake the body enough to resume breathing. The person usually does not remember these micro-arousals, but they prevent deep, restorative sleep. The result is excessive daytime tiredness, poor concentration, and over time, increased risk of cardiovascular problems.

Type 1: Obstructive Sleep Apnea (OSA)

Obstructive sleep apnea is by far the more common type, accounting for roughly 80% of cases. The cause is mechanical: the soft tissue at the back of the throat collapses during sleep and blocks the airway, either partially or completely.

The brain still sends the signal to breathe. The lungs still try to respond. But the blocked airway prevents airflow, causing the characteristic gasping and snoring sounds that partners often notice first.

Risk factors for OSA include:

• Excess weight, particularly around the neck
• A naturally narrower airway
• Sleeping on your back
• Alcohol consumption, which relaxes throat muscles further
• Menopause, which reduces the protective effects of certain hormones on airway muscle tone
• Age

Symptoms of OSA typically include loud snoring, witnessed breathing pauses, waking with a dry mouth or headache, and significant daytime sleepiness despite what seems like adequate time in bed.

Treating OSA

The most effective treatment for moderate to severe OSA is CPAP therapy, which stands for Continuous Positive Airway Pressure. A CPAP machine delivers a gentle, steady stream of air through a mask worn during sleep. This air pressure keeps the airway open, preventing the collapse that causes apneas.

Many people find CPAP life-changing once they adjust to it. The adjustment period can take a few weeks, and mask fit matters a great deal. There are now many different mask styles available, making it easier to find one that is comfortable.

For mild OSA, or for those who cannot tolerate CPAP, alternatives include:

• Mandibular advancement devices (custom mouth guards that reposition the jaw)
• Positional therapy (preventing back sleeping)
• Weight loss, which in some cases resolves OSA entirely
• Surgery in selected cases

Type 2: Central Sleep Apnea (CSA)

Central sleep apnea is less common, affecting around 20% of sleep apnea cases. Unlike OSA, the airway is not physically blocked. The problem is neurological: the brain intermittently fails to send the correct signal to the breathing muscles.

In plain terms: the person knows how to breathe, the airway is clear, but the brain periodically forgets to tell the body to do it during sleep.

CSA is associated with several underlying conditions:

• Heart failure
• Stroke
• Use of opioid pain medications, which can suppress the breathing drive
• High altitude
• Brainstem injury

Unlike OSA, loud snoring is not always present with CSA. Symptoms can be subtler, which sometimes makes it harder to identify. Daytime fatigue, frequent waking, and witnessed breathing pauses are still common.

Treating CSA

Standard CPAP is sometimes helpful for CSA, but it is not always sufficient because the problem is not a blocked airway but a missing signal.

A more tailored device called ASV (Adaptive Servo-Ventilation) is often used for CSA. An ASV machine monitors your breathing pattern in real time and adjusts the pressure it delivers to compensate when your breathing slows or pauses. In effect, it fills in the gaps when the brain's signal is absent.

Treatment of the underlying cause, such as heart failure management or reducing opioid use where possible, is also part of the approach for many CSA patients.

How Sleep Apnea Is Diagnosed

Diagnosis requires a sleep study. This can be done either at home with a portable monitor or overnight in a sleep clinic (polysomnography). The sleep study records breathing, oxygen levels, brain activity, and other data to confirm whether apneas are occurring and how severe they are.

If you have been told you snore loudly, stop breathing during sleep, or you feel unrested despite sleeping enough hours, a sleep study is worth pursuing. Both types of sleep apnea are treatable, but neither improves on its own, and the long-term effects of untreated sleep apnea on heart health and cognitive function are well documented.

Start with your doctor. They can refer you for testing and help determine which type you are dealing with.

Also on this site: Snoring vs sleep apnea: what is the difference  |  How to stop snoring: 5 natural remedies  |  Lack of sleep and its health consequences

External resource: Sleep Foundation: Sleep Apnea — in-depth guide to both types of sleep apnea, risk factors, and treatment options

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If you are exploring natural ways to support better sleep alongside medical treatment, the Health Bandit guide is worth a look.