People who smoke tobacco have sleep apnea at three times the rate of people who have never done so.Central sleep apnea is more often associated with any of the following risk factors:

being male
an age above 65
having heart disorders such as atrial fibrillation or atrial septal defects such as PFO
strokeHigh blood pressure is very common in people with sleep apnea. Mechanism
When breathing is paused, carbon dioxide builds up in the bloodstream. Chemoreceptors in the bloodstream note the high carbon dioxide levels. The brain is signaled to awaken the person, which clears the airway and allows breathing to resume. Breathing normally will restore oxygen levels and the person will fall asleep again. This carbon dioxide build-up may be due to the decrease of output of the brainstem regulating the chest wall or pharyngeal muscles, which causes the pharynx to collapse. People with sleep apnea experience reduced or no slow-wave sleep and spend less time in REM sleep. Complication
It is considered that OSA is a serious medical condition. Daytime fatigue and sleepiness, cardiovascular problems and eye problems are also be considered as a potential complications of OSA. OSA may also be a risk factor of COVID-19. It is found that people with OSA have a higher risk of developing severe complications of COVID-19. Diagnosis
Despite this medical consensus, the variety of apneic events (e.g., hypopnea vs apnea, central vs obstructive), the variability of patients physiologies, and the inherent shortcomings and variability of equipment and methods, this field is subject to debate.
The description of Joe, "the fat boy" in Dickenss novel The Pickwick Papers, is an accurate clinical picture of an adult with obstructive sleep apnea syndrome.The early reports of obstructive sleep apnea in the medical literature described individuals who were very severely affected, often presenting with severe hypoxemia, hypercapnia and congestive heart failure. Treatment
The management of obstructive sleep apnea was improved with the introduction of continuous positive airway pressure (CPAP), first described in 1981 by Colin Sullivan and associates in Sydney, Australia. The first models were bulky and noisy, but the design was rapidly improved and by the late 1980s, CPAP was widely adopted. The availability of an effective treatment stimulated an aggressive search for affected individuals and led to the establishment of hundreds of specialized clinics dedicated to the diagnosis and treatment of sleep disorders. Though many types of sleep problems are recognized, the vast majority of patients attending these centers have sleep-disordered breathing. Sleep apnea awareness day is April 18 in recognition of Colin Sullivan. See also
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