Mixed sleep apnea is a combination between obstructive (absence of airflow but continued respiratory effort) and central (absence of airflow and respiratory effort).
It starts typically with central apnea episodes for about 10 seconds, followed by obstructive apnea events.
A majority of patients with obstructive sleep apnea (OSA) have both obstructive and central apneas.
There is a common misunderstanding relating to the diagnosis of mixed apnea. Many people confuse the term complex sleep apnea with mixed apnea, although they represent different thing.
Complex apnea is diagnosed in a sleep study if you:
In other words, complex apnea is a form of sleep apnea where central apneas persist or emerge while attempting to treat obstructive events with a CPAP device.
However, mixed sleep apnea is diagnosed in a sleep study if you:
Even so, it's pretty common to have central apnea when you the start sleep apnea treatment, so usually the central events are ignored in your early sleep studies when they start out.
In other words, the sleep doctor will not normally score the central events which are a result of moving during sleep or sleep transitions. But if those central apneas persist, then doctors may consider you have mixed apnea.
The cause of mixed apnea is uncertain, but it can appear when the airway closes during a central sleep apnea episode.
In other words, if an obstructive episode happens during a central apnea episode, then you have mixed apnea.
However, mixed apnea can appear due to breathing efforts from obstructive episodes. Here is an explanation of this phenomenon:
Because mixed apnea usually starts with a central apnea episode followed by obstructive events, you will need a more complex breathing machine than a simple CPAP.
At this time, the best therapy for mixed sleep apnea is VPAP Adapt SV, which is a breathing machine that uses adaptive servo-ventilation to adapt to your respiratory needs every time you want to inhale, exhale or if you stop breathing.
The VPAP Adapt SV is a very complex machine, which can treat not only mixed apneas, but also complex apnea, central apnea and Cheyne-Stokes respiration.