central sleep apnea

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
lastlib
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central sleep apnea

Post by lastlib » Sat Feb 10, 2018 11:13 am

My doctor now thinks I have Central sleep apnea. What is central sleep apnea? Is it treatable?

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ChicagoGranny
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Re: central sleep apnea

Post by ChicagoGranny » Sat Feb 10, 2018 11:29 am

lastlib wrote:My doctor now thinks I have Central sleep apnea. What is central sleep apnea? Is it treatable?
----------> https://www.mayoclinic.org/diseases-con ... c-20352109

We have members who are receiving therapy for central sleep apnea.
My doctor now thinks I have Central sleep apnea.
What evidence brought him to this conclusion? What did he prescribe?

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Pugsy
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Re: central sleep apnea

Post by Pugsy » Sat Feb 10, 2018 11:35 am

Yes...it's treatable.

Central apnea...the airway is open but no air movement. The brain doesn't send the signal for the body to breathe for any number of reasons.

vs obstructive apnea where the person tries to breathe and makes the effort but can't move the air because the airway tissues are blocking the airway and restricting air movement.

Treatable with bilevel machines that will breathe for you or force a breath if you don't breathe enough on your own.
The machine of choice might be auto adjusting or fixed pressures but they will have back up rates available so if you don't breathe enough on your own then the machine will do it for you.

The ResMed AirCurve 10 ASV is one example (but not the only model) that will treat central and even obstructive apneas at the same time.
https://www.resmed.com/us/en/commercial ... 0-asv.html
If obstructive apnea isn't involved and there's no need for auto adjusting pressures to deal with obstructive stuff the doctor might choose a fixed bilevel with a back up rate.
https://www.resmed.com/us/en/commercial ... 10-st.html

Respironics has similar models

So it is fixable and fairly easy with several different models of machines that can do the job...and which one gets used might depend on exactly what the doctor wants to fight and also the patient's history.
ASV models like the AirCurve 10 ASV might be contraindicated if a person has a history of congestive heart failure with ejection rates below 45. Even if that is a factor the fixed bilevels with back up rates can safely be used. So multiple options.

You might watch this video...while it talks about complex sleep apnea and cpap pressures themselves triggering the centrals...the treatment side of things is still pretty much the same.
https://www.youtube.com/watch?v=CU-XTcf ... e=youtu.be
There's probably a similar video for just central apnea but I don't have it bookmarked and I did have this one.
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mesenteria
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Re: central sleep apnea

Post by mesenteria » Sat Feb 10, 2018 11:35 am

If your physician is correct, and we can't agree with him based on what we know and understand about you, central apnea is simply the brain ignoring elevated levels of CO2 in your blood and forcing you to breathe again. While many of us have obstructed airways that cause apnea, those with central apnea also 'forget' to breathe. Beyond that, I don't want to say anything that may alarm you, but I would encourage you to go to the Mayo Clinic's site and read up on it.

springman946
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Re: central sleep apnea

Post by springman946 » Sat Feb 10, 2018 2:44 pm

central sleep apnea is a sleeping disorder when you stop breathing at night much like osa your airway remains open but your brain does not send the right signals to tell your muscles to breath while sleeping

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metsfan302
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Re: central sleep apnea

Post by metsfan302 » Sat Feb 10, 2018 3:07 pm

What they all said above. Pugsy gave some nice links. She also helped me in figuring out that I indeed had Central Sleep Apnea in addition to Obstructive. An ASV (once you jump thru all the Insurance hoops and testing hoops) will help you a ton, it has for me that is for sure - it looks just like an CPAP.
This is my Orig Post "The start of my venture to find proper therapy" - http://www.cpaptalk.com/viewtopic.php?f ... &sk=t&sd=a

lastlib
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Re: central sleep apnea

Post by lastlib » Mon Feb 12, 2018 3:09 pm

I thank everybody for their help! Does anyone if my Fisher and Paykel Icon will do the trick? I am trying to avoid resmed and respironics because if the market declines to everything but two companies it will not be good for us.

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Pugsy
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Re: central sleep apnea

Post by Pugsy » Mon Feb 12, 2018 3:16 pm

No, your Icon won't be able to do the trick and F & P doesn't make the type of machine that you will most likely need.

You need to get happier with the 2 choices in brands...ResMed or Respironics. They are pretty much the only game in town for central apnea treatment.
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Julie
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Re: central sleep apnea

Post by Julie » Mon Feb 12, 2018 3:22 pm

Being philosophical about the market does not help your medical needs.

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ShinRyoku
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Re: central sleep apnea

Post by ShinRyoku » Mon Feb 12, 2018 3:46 pm

lastlib wrote:I thank everybody for their help! Does anyone if my Fisher and Paykel Icon will do the trick?.
I haven't read your other posts in other threads, so maybe I missed something. But if all we know about you is that you have central sleep apnea, then yes, it is possible that your CPAP machine will do the trick. Not everyone with CSA needs ASV or BPAP-ST.

"CPAP is usually the first treatment given for central sleep apnea."

Source: https://www.mayoclinic.org/diseases-con ... c-20352114

"Nasal CPAP has been shown to be effective in some patients with ICSA [idiopathic CSA]."

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2287191/

"The preponderance of evidence on the treatment of CSAS [central sleep apnea syndromes] supports the use of continuous positive airway pressure (CPAP)."

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3242685/

"CPAP is the preferred first-line therapy for symptomatic patients with hyperventilation-related CSA."

Source: https://www.uptodate.com/contents/centr ... ntributors

In fact, ASV and BPAP-ST are typically reserved for patients who have already been tried on CPAP for their CSA.

"Although there is not a universally accepted definition of continuous positive airway pressure (CPAP) "failure" in a setting of treatment of central sleep apnea (CSA), we define it as the residual apnea-hypopnea index (AHI) of 5 or above, with >50 percent of residual events of central origin. Options for positive airway pressure (PAP) therapy in this population are limited to adaptive servo-ventilation (ASV) and bilevel PAP (BPAP) in a spontaneous/timed (S/T) mode. Typically, ASV is preferred because in comparative studies, it achieved a better control of CSA than did BPAP-S/T"

Source: https://www.uptodate.com/contents/mode- ... ntributors
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Pugsy
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Re: central sleep apnea

Post by Pugsy » Mon Feb 12, 2018 3:54 pm

ShinRyoku wrote:I haven't read your other posts in other threads, so maybe I missed something. But if all we know about you is that you have central sleep apnea, then yes, it is possible that your CPAP machine will do the trick. Not everyone with CSA needs ASV or BPAP-ST.
Since OP has been on CPAP for at least the past 4 years (joined here in 2013) it's highly unlikely that regular cpap will do the job because OP has already been using cpap for some years now.
That's why I didn't go down the "cpap might fix it" road.

Now if he was brand new to sleep apnea and/or cpap apnea therapy...then yeah, cpap might do the job but I don't see it happening if someone has either developed centrals since original diagnosis for some reason or had them all along and they are just now wanting to do something about them and for the past at least 4 years they have been using the Icon and still has enough centrals to earn the diagnosis.
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lastlib
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Re: central sleep apnea

Post by lastlib » Mon Feb 12, 2018 4:06 pm

Will the implant that shocks you when you stop breathing work? Or does just finish the started when you stopped breathing

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Pugsy
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Re: central sleep apnea

Post by Pugsy » Mon Feb 12, 2018 4:11 pm

You might talk to your doctor about the implant. I thought it was mainly for central only apnea and then only with some other conditions. From my understanding several conditions need to be met for a person to be a good candidate for the implant.
You would need to run all that by your doctor and whomever might be doing the implant in your area.
It's a possibility but its success depends on several factors and I am not up to snuff on all those factors.
One factor is your diagnosis...is it central apnea only or a mix of both centrals and obstructives.
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ChicagoGranny
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Re: central sleep apnea

Post by ChicagoGranny » Tue Feb 13, 2018 7:54 pm

lastlib wrote:
Mon Feb 12, 2018 4:06 pm
Will the implant that shocks you when you stop breathing work? Or does just finish the started when you stopped breathing
If you are thinking of the implant from Inspire Medical, the answer is "no". This implant stimulates the hypoglossal nerve which controls the movement of your tongue and other key airway muscles. In central sleep apnea, your muscles are already holding your airway open. Stimulation of the hypoglossal nerve is not necessary.

Now, if your apnea has an obstructive component, the Inspire medical might help. But, you still need to use a machine/mask to control your central apneas, so it wouldn't make sense to have the Inspire implant.

BTW, for anyone else reading this thread, the Inspire implant does not shock you. It just provides an imperceptible electrical stimulation of the nerve.

Woody
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Re: central sleep apnea

Post by Woody » Wed Feb 14, 2018 6:09 am

For most of us with a problem with centrals this probably doesn't apply but ....
I saw an article about patients with heart failure who also had mixed sleap
apnea After they went through cardio rehab which is just some aerobic exercise.
They experienced about a 50% reduction in centrals but one funny thing was
they didn't show any reduction in OSA .

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