obstructive vs. central apnea

[sleepydave]

I just found this forum today and it is great! One thing that I haven't seen discussed is central sleep apnea. Most of the discussions deal with obstructive apnea. It's my understanding that only about 10% of people diagnosed with apnea have the central type. Is central sleep apnea more serious than obstructive? I have been told by my sleep specialist that I have central apnea. When I first went to my PCP for this problem I told him that I thought I had sleep apnea and he said it wasn't likely because I didn't fit the profile. He referred me to a specialist who also poopooed the idea that I had apnea because I "didn't fit the profile". He scheduled a sleep study and when the results came back he said he was very surprised that I have very severe sleep apnea. I'm using a CPAP but I'm still experiencing fatigue during the day. Is central apnea more difficult to treat?

Sorry this is so long. I'll try to keep future postings shorter. I'm just curious about obstructive vs central apnea. Thanks.

[Guest]

Hello Dave,

What cpap do you have? I also have many central apneas. I was using a resmed Spirit for 2 years before I learned to get the results out of the machine. Didnt feel so well either. Then I got lucky . The resmed broke !

I borrowed a PB 420E and I started feeling better. And the AHI & HI proved it.. Less than 1. Spirit was 10-20 !

What Im telling you is all cpaps arent the same just like us people . Different manufactures have different ways of solving the problem..Get a PB 420E . Its cheap at $549. Free delivery and you will feel better soon.


Irving

[RestInSeattle]

From what I understand, Central Apnea is more serious than obstructive related apnea and may be related to congestive heart failure.

In any case, those that suffer CA typically are perscribed BiPAP ST systems (The ST checks the timing and attempts to force the patient to breathe, if I understand correctly).

Here's a link for some information that shows that correlation.

http://content.nejm.org/cgi/content/short/341/13/949 (note that this is a summary and very technical).

Do a Google search for other info as well.

I hope that CA sufferes work much closer with their pulmonary specialists to ensure that there is not an ongoing problem of heart damage.

[wading thru the muck!]

Welcome sleepydave,

A standard "c"-pap can do nothing to "treat" central apneas. It may actually make them more frequent. RestInSeattle is correct, a special type of Bi-pap that controls the inhalation and exhalation cycle can be used to treat central apneas. this machine controls your breathing to keep it going. A cpap only provides an air splint to keep the airway open and in the case of centrals the airway is already open. There are also some meds that can be used to help.

Good Luck!

[BetterBreathinBob]

Sleep apnea profiles were thrown away years ago by knowledgable physicians. Obstructive apnea occurs in the throat, central occurs in the brain and is pretty rare unless you have a heart or neuro condition. There is also mixed apneas which is a combonation of the previous other 2 types but actually most mixed events are really obstructive in nature and can be treated with CPAP.

Keep learning and asking questions, it's your health.

BOB

[Fifi]

How are centrals diagnosed?

Is there a simple way do determine from the results of one's machine if one is having centrals?

[-SWS]

How are centrals diagnosed?

Is there a simple way do determine from the results of one's machine if one is having centrals?

During a PSG sleep study they place a belt around your midsection to measure diaphragm respiratory effort. Lack of airflow with no respiratory effort measured via that belt indicates a central apnea. Lack of air flow with respiratory effort (including spastic heaving) amounts to an obstructive apnea.

AutoPAPs don't have respiration-effort belts to rely on, so they use a variety of algorithmic tricks to either avoid and/or discern (within the bounds of statistical probabilities) whether the patient is experiencing a central apnea versus obstructive.

[Fifi]

Thank you SWS.

That is what I was afraid of. So Unless someone has a proper sleep study it is impossible to find out.

No other signs one can look out for, I suppose?

[BetterBreathinBob]

Fifi

No airflow through the mouth or nose and no respiratory effort to breathe is called central apnea. While watching a bed partner sleep who has untreated OSA, you could observe that there is no airflow going in but you still see them moving their stomach and or chest. They are attempting to breathe against a closed airway and when the effort becomes big enough they will open that collasped airway and breathing will resume. That's the big snore that is usually heard. This is what happens during obstructive apnea.

With centrals- no effort and no airflow.

Bob

[bsleep]

Hello, I was diagnosed with mild central apnea a few years ago. I then took a test for narcolepsy and the doctor wanted to give me drugs. My husband has osa and a bipap. My only problem, as I saw it, was no good sleep...that's why I was sleepy on the narc. test. The doctor treated me with a bipap after some discussion. It has helped. I got a copy of my sleep apnea test so I know that I have mild central apnea...otherwise they never would have told me. Just a bit of ranting, and the fact that I know the bipap therapy works. I shallow breath, so little they thought it was one long apnea on the sleep test. Have to have a bipap, with just enough pressure to trigger my brain to breath correctly, I guess. It does work, though.

[-SWS]

Yes, Bsleep. While AutoPAPs and CPAPs are not machines of choice to treat centrals, BiLevel machines like yours are. Some patients with centrals even seem to do okay with the BiLevel running in spontaneous mode (purely breath triggered without timing triggers engaged). Many central apnea patients, however, also require timing mode to be activated to provide a timed backup for those missed breaths. Yet other central apnea patients will have to run their BiLevel machines in a purely timed mode (versus spontanously triggered with or without a timed backup).

Thanks for sharing!