Central apnea?

Arizona-Willie · Post by **Arizona-Willie** » Sun Jul 06, 2008 4:13 pm

How can you tell a central apnea from a run of the mill apnea?

Does the data from your machine < pressure graph > show it?

Snoredog · Post by **Snoredog** » Sun Jul 06, 2008 4:17 pm

you mean like if you suspect your machine is not counting them correctly?

it is akin to T-Rex vibrations seen in the water puddle as he approaches closer or clusters of apnea in higher frequency.

Lee22633 · Post by **Lee22633** » Sun Jul 06, 2008 9:07 pm

Snoredog wrote:you mean like if you suspect your machine is not counting them correctly?

it is akin to T-Rex vibrations seen in the water puddle as he approaches closer or clusters of apnea in higher frequency.

Okay, so if you see 5-6 OA in a short span of time and then nothing for an hour and then you get one OA. At the time you have the cluster of OAs, you have a couple Hy[opneas, and then nothing for another hour, this would be CA?

mindy · Post by **mindy** » Mon Jul 07, 2008 7:22 am

Hi A-W,

I don't know if I had central apneas or not but as I slowly increased pressure up to 14 (my sleep doc's suggestion), my AHI decreased until I hit 14 and then it went up dramatically. I gather it was some form of unstable breathing but whether or not they were centrals I have no idea. I'm interested to see the responses to your question.

Mindy

wlo2008 · Post by **wlo2008** » Mon Jul 07, 2008 5:25 pm

I have Severe Centrals as well as OSA disordered breathing.

I can tell you how I feel when I have them. When I was having my OSA I felt like I was chocking and I could not breath.

With my Centrals I actually wake up just holding my breath. I even do this during the day. I am not sure if all machines keep track of the centrals. I know mine is made for my centrals.

Did you have them during your sleep study? Or do you think you have developed Complex Centrals from Cpap. Regular Cpap made my Centrals so much worse.

Snoredog · Post by **Snoredog** » Mon Jul 07, 2008 5:46 pm

Lee22633 wrote:
Snoredog wrote:you mean like if you suspect your machine is not counting them correctly?

it is akin to T-Rex vibrations seen in the water puddle as he approaches closer or clusters of apnea in higher frequency.
Okay, so if you see 5-6 OA in a short span of time and then nothing for an hour and then you get one OA. At the time you have the cluster of OAs, you have a couple Hy[opneas, and then nothing for another hour, this would be CA?

not really, they appear on the reports sort of like a oscillation, then there are other factors that would play into it such as snoring or FL's driving up the pressure to cause them. If it is a Remstar it will throw up a NR flag every now and then.

a few centrals is nothing to worry about, but if you spot the trend and it is related to pressure you want to avoid the condition that causes it because they are usually related to unstable breathing.

then those where CA is the primary disorder is a completely different situation.

I think these machines score shallow breathing as apnea more often than not. In your case you need to keep your Minimum pressure up a bit higher instead of 5 cm so it gets you through that shallow breathing. When you combine the low pressure you are now using with shallow breathing you simply rebreathe too much CO2 as there isn't enough pressure to flush it out of the mask.

CA's I'm referring to appear at a much higher pressure and related to the higher pressure.

Snoredog · Post by **Snoredog** » Mon Jul 07, 2008 5:48 pm

[quote="wlo2008"]I have Severe Centrals as well as OSA disordered breathing.

I can tell you how I feel when I have them. When I was having my OSA I felt like I was chocking and I could not breath.

With my Centrals I actually wake up just holding my breath. I even do this during the day. I am not sure if all machines keep track of the centrals. I know mine is made for my centrals.

Did you have them during your sleep study? Or do you think you have developed Complex Centrals from Cpap. Regular Cpap made my Centrals so much worse.

wlo2008 · Post by **wlo2008** » Mon Jul 07, 2008 6:02 pm

my average pressure stays between 7 cm and 8cm. But then I have been spiking to almost 14 cm and the machine breaths for me. I think when my breathing gets really shallow it starts doing that. Then it will beep when it has to take a breath for me. I notice it more when I am just falling a sleep. My mom has been over this week. And she was watching me. She said all of a suden several times it will go up and my chest rises and falls like it is working for me and then it will go back to normal a minute or so later. This machine is all new to me. I have been on this one a week.

Lee22633 · Post by **Lee22633** » Mon Jul 07, 2008 8:46 pm

[quote="wlo2008"]I have Severe Centrals as well as OSA disordered breathing.

I can tell you how I feel when I have them. When I was having my OSA I felt like I was chocking and I could not breath.

With my Centrals I actually wake up just holding my breath. I even do this during the day. I am not sure if all machines keep track of the centrals. I know mine is made for my centrals.

Did you have them during your sleep study? Or do you think you have developed Complex Centrals from Cpap. Regular Cpap made my Centrals so much worse.

wlo2008 · Post by **wlo2008** » Tue Jul 08, 2008 1:34 am

Something to check out and ask about. But your sleep study should have picked up centrals or periodic breathing. Sometimes another sleep study will rule out something they missed.

mindy · Post by **mindy** » Tue Jul 08, 2008 5:30 am

My sleep study showed one central early on but I gather that's rather common. The rest of the night I slept so poorly that I had primarily hypopneas and they titrated my pressure as 7-8 and set my machine at 7-12. That wasn't enough.... it turns out that I do best on a straight pressure of 13.

Mindy

echo · Post by **echo** » Tue Jul 08, 2008 7:05 am

On my first PSG, they didn't pick up any central's, but they did during the titration. She looked back on the first PSG and found the central's there too. Not sure if it's "difficult" to find central's in the PSG, or if this doctor just overlooked it, but I'm guessing it's not so straightforward to diagnose. Conventional wisdom seems to be that the higher the pressure the more likely the central's are, but I don't know if that's 100% set in stone. (I personally get just as many of them on 7 cm as on 10cm.. I also got them more often when I first started therapy. Maybe the brain has to get used to the treatment??). I have the same feeling - sort of just holding my breath, though I never felt like choking. And I would jolt awake too.

Guest · Post by **Guest** » Tue Jul 08, 2008 9:23 am

It just really depends Echo. Did they diagnose you with mixed or just strait OSA. To have centrals as an issue you have to meet a certain AHI for the centrals. Seperate from the AHI of OSA

echo · Post by **echo** » Tue Jul 08, 2008 9:31 am

I was diagnosed with Severe (straight) OSA, not central, not mixed. The only reason it came up was because the doc said she didn't know what pressure to prescribe. 7 was too low to get rid of all the apnea's, but 10 was too high and was inducing central's, apparently. I have been trying to find more info on CA's, but I don't think I have enough of them to quality as mixed (but what do I know). I seem to average 2 to 4 CA's a night, not more (even when I use straight CPAP at 10 cm). I get the same number of CA's (on average) when I'm on 7 cm straight CPAP as well! So I don't know exactly what the doc saw. My 9 month "averages" seem to tell a different story than her 1 night titration (in which I of course slept horribly because the mask was crap, it was my first time, etc).

I'm thinking that UARS might actually be a factor for me, but that's for another thread....

wlo2008 · Post by **wlo2008** » Tue Jul 08, 2008 9:37 am

2 or 4 a night wouldn't put you in the catagory for having them as an issue. I was told by my Neurologist. Sometimes untreated SA can cause some centrals because our body is so used to not breathing. That over time the body will adjust. Mine are to many for that. My Neuro doc is still looking into why I have mine. But I am hoping my new Vpap will help them. I have heard from others that it helped their centrals out a lot.