Central Apnea Issues - Who knows about central?

Hi, "Newcomer" here.

As suggested in one of the posts under "Another Newbie - Cpap woes", I am starting a post about central apnea.

So far, there is much great info on central spread between the two threads, "Newcomer" and "Another Newbie - Cpap Woes".

I joined this site just a few days ago and have already learned so much. One thing I have learned is that many of the issues between Obstructive apnea and Central apnea are different. I have central. I have also learned that I may be using the wrong machine.

Anyway, thank you thank you thank you all so much. This forum is such a blessing.

I know very little about them, except that I didn't have any in my initial study, and I did have them in my titration study -- in fact, the number of incidents doubled in REM sleep, which makes me a person with Complex Sleep Disordered Breathing. I am on a Bipap Auto SV, which is working very well for me. I've been having only hypopneas except when I get stressed out. THe number of hypopneas has significantly decreased, as well.

I'm new at this, but quite willing to learn more.

Thanks for starting this Katny!

I had originally posted under the heading "Another Newbie-- CPAP woes" so rather than repeat everything, my history can be found there. I do have some questions about central apnea as well and I will transfer them over here:

I've been trying to differentiate between my central vs obstructive hypopneas. Can anyone enlighten me as to whether or not polysonography does differentiate? My study just splits the different events into central apnea, obstructive apnea, and hypopneas-- why aren't the hypopneas categorized as to what is causing them (i.e. central hypopnea or obstructive hypopnea)? My first study was largely hypopneas then during the titration study the hypopneas all went away and I had mostly central events. Now with my CPAP I see that the hypopneas are once again dominating. As I'd said in my thread, I do have some neurological problems aside from my apnea and I suspect that this is a factor in my CSA issues but it would be helpful to figure out just how heavily I weigh on the central side vs the obstructive side.

I do feel that the VPAP Adapt SV type of treatment may be the best for me (and maybe for you too, Katny) so that will be my next thing to try. I was also wondering if you need to be titrated to these machines at a sleep lab or do you just take it home and it works right off the bat? I also wonder who the best sleep specialist would be for me to see-- do all of them address Comp SA and treat it accordingly?

Thanks all for your input.

don't know if these threads might help - as I mention there - christinequilts and lubman are the two that come to my mind with centrals - we have several posters with other complex issues

some people have centrals show up during titration from too high of pressure that were not there during the diagnostic part



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The machines cannot differentiate between centrals and other events (tho' sleep lab testing does so), so that's why it's REALLY important to know if your problem is REALLY centrals, or whether they are just the few often registered on PSG's that so many of us have, only to realize later that they were unimportant in the larger picture of our apneas and may never make a return of any consequence (Katny see my last post on the other thread). If you are found on a new test to really have centrals as the central issue, then you'd need the other machine... but I still wonder why if in fact your MD really thought your centrals mattered, he prescribed a regular C/Apap machine.

I have just lost about an hours work on a response, twice due to an internal server error.
I give up, but try this source for openers: http://www.chestjournal.org/cgi/reprint/131/2/595

O.

Links to Central Apnea discussions
viewtopic.php?p=22702

Very interesting Chest article, ozij. Good find. Thanks!

Great chest article, ozij, thank you.

I have had the same experience a couple times on this site during the past week. I have typed away for a good long time only to have all my typing lost. So now, if I think my reply is going to be longer than a sentence or two, I open a text document, type into that, and then copy and paste from there to here. Low-tech, true, but prevents a lot of frustration!

mcaimless wrote: I do feel that the VPAP Adapt SV type of treatment may be the best for me (and maybe for you too, Katny) so that will be my next thing to try. I was also wondering if you need to be titrated to these machines at a sleep lab or do you just take it home and it works right off the bat?

From the Respironics Auto SV FAQ:

Q: Can an identified candidate w/ Complicated Breathing Patterns, Central, and/or Mixed Apneas or Periodic Breathing (CSR), be put on the device w/o coming into the sleep lab?

A: If the CPAP or BiPAP pressure is already determined in lab, the patient can be put directly on BiPAPautoSV. To assure that the patient is being properly treated it is a good idea to download the SmartCard data after 7-10 days.

Q: What settings should be used in this case?

A: For the set up of these patients it is advisable to use the CPAP or BiPAP pressure from the “old” unit,set the IPAPmax 10cmH2O above the CPAP or BiPAP pressure and set the back up Rate to Auto.

http://bipapautosv.respironics.eu/faqs.asp

Well in Jan of 07 I was diagnosed with SA and after another sleep study I was started off on CPAP, it didn't help so later on I had an at home 24 O2 sat study done, and supplemental O2 at 2 lpm was added, it didn't help much either, another sleep study and was put on BiPAP and then several more sleep titration studies and increased pressure, still no good. All along I had been having centrals, and just about everything they did was making them worse. Finally this past May, ( My old sleep doc got sick and I was sent to a new one) had me have another sleep study the 6th one in 18 months, this time a ASV trituration study. Was then put on the ResMed VPAP Adapt SV with supplemental O2 at 3lpm and Bingo! What a Godsend this machine has been! Found out after this last study that the sleep lab I had been going to, had been recommending the VPAP ASV since my second study back in Jan 07, but my then sleep Doc didn't believe in the ASV, said the technology was to new and not proven so he wouldn't order it! So for a year and a half I had to fight with the system to finally get the proper treatment. For me, with centrals, I think the ASV is the only way to go!

katny wrote:I have had the same experience a couple times on this site during the past week. I have typed away for a good long time only to have all my typing lost. So now, if I think my reply is going to be longer than a sentence or two, I open a text document, type into that, and then copy and paste from there to here. Low-tech, true, but prevents a lot of frustration!

So far I've never had that problem on this site *but* I used to have that with my other computer (Lenovo ThinkPad with Windows Vista) and after I'd had it for about a year (felt ready to smash it by then) they suddenly came out with a fix for the hard drive that took care of the problem. I originally thought it was this site because it never happened during any other surfing but I don't post elsewhere so in my case, at least, it was a specific function that apparently kicked off the problem. Same thing occurred with Mozilla Firefox. With computers the problem isn't always what it appears to be

Mindy

WhiteBeard wrote: Found out after this last study that the sleep lab I had been going to, had been recommending the VPAP ASV since my second study back in Jan 07, but my then sleep Doc didn't believe in the ASV, said the technology was to new and not proven so he wouldn't order it! So for a year and a half I had to fight with the system to finally get the proper treatment. For me, with centrals

That's terrible. Sadly I am not surprised to hear this story.