Sleep HealthFebruary 4, 2026·5 min read
By the CIRRUS Editorial Team — how we write and source this
Central vs. obstructive sleep apnea: the difference that changes treatment
Part of the series: The Complete CPAP GuideOne is a plumbing problem. The other is a signaling problem. The distinction changes which device actually helps.
Obstructive sleep apnea happens when the physical airway collapses or narrows during sleep despite the brain still sending a normal signal to breathe — CPAP works here because positive pressure physically props the airway open.
Central sleep apnea is a different mechanism entirely: the brain intermittently fails to send the signal to breathe at all, even though the airway itself is open. Standard CPAP can be far less effective here, since there's no obstruction to splint open.
Central events are more often associated with heart failure, opioid use, or high-altitude exposure than with the anatomical risk factors typical of obstructive apnea, which is part of why the two require different diagnostic attention.
Some patients have both patterns, sometimes revealed only after starting standard CPAP — this is one of the more common reasons a physician moves a patient from a standard CPAP to an adaptive servo-ventilation or bi-level device after an initial trial.
This article is general health information, not medical advice, and doesn’t replace evaluation by your own physician. Talk to a doctor about anything specific to your own diagnosis or treatment.