Centrals

I know this has probably been discussed to death on here but I'm so exhausted that I can't search for the answer. When I first started cpap a few months ago I was reaping the benefits from the therapy, my ahi was around 1.3 every night. Then I got bronchitis and it threw me for a loop. Well fast forward to now....I'm getting lousy sleep, ahi ranges from 3.5 to 5 now and the big thing that has changed too is the central apneas. They have tripled to 20 a night. One lasted 42 seconds. When I wake up I can immediately tell I didn't do well as my legs are numb and hurting from the knees down. There has been one major change in my life, my husband was diagnosed with Cancer in the nerve in the side of his head. The nerve leads directly into his brain so we are fighting for his life, chemo, surgery, radiation. Every day is a struggle and I can't keep the stress at bay. I don't even know what I'm asking help for, I'm so down and tired. We need your prayers and I guess if anyone can help me with the sleep apnea too. Thank you.

Teresa, are you up to answering a few questions?

Yes

How many months have you been on CPAP, and at what point did the centrals begin to increase?

Since your husband's diagnosis have you started any new medications, for anxiety or insomnia for example?

I'm so sorry about what you two are going through. I hope we can help you at least protect your sleep.

kaiasgram wrote:How many months have you been on CPAP, and at what point did the centrals begin to increase?

Since your husband's diagnosis have you started any new medications, for anxiety or insomnia for example?

I'm so sorry about what you two are going through. I hope we can help you at least protect your sleep.

Thank you Kaiasgram, well I started Cpap in January, it took about a month to get used to then in March I got the bronchitis and went off the machine in April because I just couldn't tolerate it with the bronchitis. Thats when my husband got diagnosed and I never got back on it until June. Since I started back on cpap it's been a struggle getting used to it again and with the situation with my husband. I started using Ambien to help me sleep. The centrals began to increase in June with going back on the cpap. I hope it's not the Ambien because I can't sleep without it, sigh.

OK, so the things that are different now are 1) You've had some time off treatment because of the bronchitis so you're now trying to readjust; 2) You are doing so during a period of extraordinary stress (your husband's illness); and 3) You're taking a new medication for sleep.

I just wonder if stress isn't the biggest culprit here -- fitful sleep can involve irregular breathing patterns. And that can mean more centrals.

As far as whether the Ambien is a factor, I don't know but one way to explore this question would be to look at some nightly graphs with SleepyHead. Ambien has a pretty short half life -- if your centrals are more concentrated in the first hours after taking it, then there's a question to ask your doctor about. If there's no particular pattern and they're scattered throughout the night then it seems less likely (to me) to be related to the Ambien but it would still be worth asking your doctor about. Just so you'll know what is and is not a concern.

Another reason the machine flags centrals is bad mask leaking -- that, too, can be looked at with SleepyHead.

If your AHI has not gone above 5 I don't know how concerned your doctor would be, even if most of your apnea events are centrals, though it's worth checking in with your doctor about this. It is possible to develop complex sleep apnea (CompSA) after being on CPAP for a period of time, so you want to keep your doc posted in any case. Again, I'm not sure if your AHI warrants concern about that possibility.

If you're up for loading SleepyHead and taking a closer look at what's going on, let us know. What is the make and model of your machine, and what mask are you using? If you can also tell us your pressure setting(s) and whether you use any exhale relief feature.

Thank you for your feedback, I will try to post some information from sleepyhead tomorrow. Again thank you for trying to help me.

Teresalf wrote:Thank you for your feedback, I will try to post some information from sleepyhead tomorrow. Again thank you for trying to help me.

You're very welcome. I have links at the bottom of my posts in my signature box to machine video tutorials and to the SleepyHead download page.

Stay with us.

Hi Teresa, I'm very sorry to hear about your husband's recent diagnosis. You will both be in my thoughts and prayers. I'm sure that this has been a difficult time for you, and your concerns about increased central apneas probably doesn't make this any easier for you. Although few clinical trials have been conducted, the medical research on zolpidem (Ambien) seems to indicate that it decreases the number central apneic events, as long as the patient does not have underlying risk factors for respiratory depression. However, you might want to discuss this with your sleep physician if he was not the prescribing physician. I just wanted to ease your mind at bit as I'm sure you're under a great deal of stress. And do make use of this forum. There are some very knowledgeable people here. Take good care of yourself.

http://www.ncbi.nlm.nih.gov/pubmed/19968044
http://www.ncbi.nlm.nih.gov/pubmed/22923141
http://www.ncbi.nlm.nih.gov/pubmed/18941940

zmbee wrote:Hi Teresa, I'm very sorry to hear about your husband's recent diagnosis. You will both be in my thoughts and prayers. I'm sure that this has been a difficult time for you, and your concerns about increased central apneas probably doesn't make this any easier for you. Although few clinical trials have been conducted, the medical research on zolpidem (Ambien) seems to indicate that it decreases the number central apneic events, as long as the patient does not have underlying risk factors for respiratory depression. However, you might want to discuss this with your sleep physician if he was not the prescribing physician. I just wanted to ease your mind at bit as I'm sure you're under a great deal of stress. And do make use of this forum. There are some very knowledgeable people here. Take good care of yourself.

http://www.ncbi.nlm.nih.gov/pubmed/19968044
http://www.ncbi.nlm.nih.gov/pubmed/22923141
http://www.ncbi.nlm.nih.gov/pubmed/18941940

Thank you very much zmbee. And it's good news to hear about the Ambien.

kaiasgram wrote:

Teresalf wrote:Thank you for your feedback, I will try to post some information from sleepyhead tomorrow. Again thank you for trying to help me.

You're very welcome. I have links at the bottom of my posts in my signature box to machine video tutorials and to the SleepyHead download page.

Stay with us.

Hello again Kaiasgram, sorry for the delay in getting back to you. I used to be post on cpaptalk a couple of months ago but my computer died and I lost all my password info so I re-registered. I also had sleepyhead on that computer and could take screenshots of my data. I just downloaded Sleepyhead on my new computer but when I took the screenshot and opened the file where it was the picture was just all black. Do you have any idea how to fix that problem so I can post a picture of my data for you to review?

Teresalf wrote:

kaiasgram wrote:

Teresalf wrote:Thank you for your feedback, I will try to post some information from sleepyhead tomorrow. Again thank you for trying to help me.

You're very welcome. I have links at the bottom of my posts in my signature box to machine video tutorials and to the SleepyHead download page.

Stay with us.

Hello again Kaiasgram, sorry for the delay in getting back to you. I used to be post on cpaptalk a couple of months ago but my computer died and I lost all my password info so I re-registered. I also had sleepyhead on that computer and could take screenshots of my data. I just downloaded Sleepyhead on my new computer but when I took the screenshot and opened the file where it was the picture was just all black. Do you have any idea how to fix that problem so I can post a picture of my data for you to review?

Gosh I'm not sure -- can you explain what you did step by step? How do you take screenshots? What keys do you use to snap the image? And when you snap the picture does it appear right on your desktop?

I just hit print screen on the sleepyhead view option and it goes to a file in my documents. But when I try to view it there is just a black picture.

Teresalf wrote:I just hit print screen on the sleepyhead view option and it goes to a file in my documents. But when I try to view it there is just a black picture.

I haven't taken screenshots from within SleepyHead. Probably someone can tell you what the problem is there but I don't know. An alternative is to use your Mac like I do, which will put the screenshot right on your desktop. You can use the link in my signature box to see how to take a screenshot on a Mac. Then you upload your image to imgur or Photobucket -- if you want you can do some cropping of the image when you're in imgur or Photobucket. I usually crop with Photoshop Elements (on my Mac) before I upload, but I think you can do some simple editing in both of those photo sites. Hope this helps!

Not sure why SH screenshots wouldn't work. I tested it quite a bit with an older Macbook a couple months ago without any issues.