Disclosed herein, among other things, are methods and apparatus related to apnea therapy. One aspect of the present subject matter provides a method for apnea directed therapy. The method includes receiving a signal indicative of a real-time determination of type of an apnea event for a patient during the apnea event, and using the signal to select appropriate therapy to be applied to the patient during the apnea event to treat the apnea event, and to withhold inappropriate therapy. The therapy is applied in a closed loop system, in various embodiments. In various embodiments, the signal includes a determination of whether the apnea event is primarily an obstructive sleep apnea (OSA) event or primarily a central sleep apnea (CSA) event.