Another question about Centrals

[Underdog]

Is it possible to read an EEG? My Nuerologist ordered one and he told me "everything looked normal or at least it did until you fell asleep." So then I asked him "what about the abnormal part when I was sleeping" and he said sleep portion was consistent with an EEG for someone with a sleep disorder"
So a few months later I'm at my sleep Dr's office and I mention this EEG issue and he said he's not familiar with a correlation between irregular EEG and sleep apnea.
So I'm left in the middle and don't know where to turn. But I don't want to brush this under the rug. I went the hospital and picked up a copy of the EEG. It came with a program that lets you read the data. But of course I don't know what I'm looking. The squiggily lines do bounce all over the place when I start to fall asleep.
So my question is: Are EEG's relevant in diagnosis or trea ... disorders?

[robysue]

Are EEG's relevant in diagnosis or treatment of sleep disorders?

EEGs are used to determine when you are actually asleep and also which sleep state you are in when you are asleep. So they play a critical role in the diagnosis of certain sleep disorders---including sleep apnea.

In diagnosing sleep apnea, the EEG is used to determine both whether an individual apnea/hypopnea (central or obstructive) occurred when you were asleep or when you were awake since when we're awake we can consciously control our breathing and there are times when we don't take nice regular breaths at a constant rate of say 12--16 breaths per minute. For sleep apnea, the apneas/hypopneas that count are those that occur when the EEG says you are really and truly asleep.

Now the classic thing that would be "abnormal" in an EEG of a patient with sleep disordered breathing (SDB) of some sort (which includes OSA, CSA, CompSA, and UARS) is that throughout the night, instead of a nice, clean progression through the sleep cycles with little or no fragmentation, you keep getting the brain wave patterns that indicate the person is "arousing" and "awakening" for very short periods of time (often no more than a few seconds) many, many times each hour, and these arousals and awakenings are interrupting and fragmenting the deeper levels of sleep in the sleep cycle. If the patient has suffered from SDB long enough or if their SDB is severe enough, the sleep EEG data might also display such abnormalities as

• NO or very little REM sleep at all during the sleep cycles
  very long latency to REM
  NO or very little stage 3/4 (slow wave) NREM sleep
  very long latency to stage 3/4 sleep
  much higher than normal percentage of Stage 1 and Stage 2 sleep

I'm sure that other sleeping disorders have their own characteristic patterns in the EEGs of the sleep cycles.

[JohnBFisher]

... We (sleep clinic staff and I) were finally able to get my AHI to drop down into the 10-12 (occasionally 15) range by dropping the pressure. I would drop the pressure (Dr said it was ok to do it on my own) and wait and watch for a week, then do this again and each time the pressure dropped the centrals dropped. I was running at 4.5 for months and staying down in the 10-12 range. But I still felt (feel) terrible and the centrals clustered just after going to sleep and just before wakein up. in the a.m Then I was given a prescription for Larazepan and that eliminated all of the centrals during the first hour of sleep. But I was left with the last hour. I dont have that situation figured out.

This is just me, but as I emphasized in your response, these are classic symptoms of Complex Sleep Apnea (CompSA). In which case, a CPAP is not the best xPAP device to administer therapy. A BiPAP may help, but possibly not. Normally the solution for CompSA is an ASV unit. Underdog, I would go back to your doctor and request to speak with the doctor, not just the physician's assistant. You feel terrible for a reason. A Central Nervous System depressant (potentially addictive at that) is probably not the solution to your situation. Sure, it helps. But it does not solve the morning problems. Remember, I don't even pretend to be a doctor. I'm just telling you what I would do in your shoes.

Best wishes.

[mdboze]

I have Complex Sleep Apnea (CompSA)
Like myself, Underdog needs a Bi-Pap machine to handle the centrals.

A constant airway pressure can actually trigger centrals in some people (like myself).

The BiPap machine that I use provides a different pressure for inhalation and exhalation, and has Auto-Breathing capabilities. For me, these features have nearly eliminated the centrals.

I now feel rested again.

[JohnBFisher]

Before jumping to an ASV machine, your doctors will probably try an incremental increase in therapy. Jumping to an ASV machine (EXTREMELY expensive) is not a good idea if a BiPAP device will do the job. A BiPAP is lighter and much, much less expensive. But if that does not do the trick, the ASV unit does provide proven relief for CompSA, as mdboze notes.

[Underdog]

Before jumping to an ASV machine, your doctors will probably try an incremental increase in therapy. Jumping to an ASV machine (EXTREMELY expensive) is not a good idea if a BiPAP device will do the job. A BiPAP is lighter and much, much less expensive. But if that does not do the trick, the ASV unit does provide proven relief for CompSA, as mdboze notes.

How expensive is expensive? Right now I'm looking at the possibility of loosing my job, wrecking a great marriage and destroying my health. If I have to take out a loan I don't think I would live to regret it.

[mdboze]

my Respironics BiPap auto sv costs about $3500, some of which was paid by insurance.

Edit: My Part was about $3500 , insurance paid the rest.

I did my own research and picked the machine I wanted, and asked my docctor to write a perscription for it. Don't forget to include the humidifier option.

Best decision i ever made. I probably would have lost my job from my sleep deprived short temper. Now, i have a clear head, and feel healthy and normal again.

invest in your health. invest in your future.

[jbn3boys]

my Respironics BiPap auto sv costs about $3500, some of which was paid by insurance.

cpap.com has PR S1 BiPap S/T for $5000. The BiPap ASV machines run $5,800 on cpap.com (PR S1 or RemStar).

[OutaSync]

Keep an eye on cpapauction.com. You can sometimes find a new or slightly used ASV for a much reduced price.

[JohnBFisher]

... How expensive is expensive? Right now I'm looking at the possibility of loosing my job, wrecking a great marriage and destroying my health. If I have to take out a loan I don't think I would live to regret it.

Your costs depends on your insurance. Mine pays 100% of my DME costs, but prior authorization is required for items over $1,000. But as you can see from other posts, the DME costs often have a co-pay component. Check with your insurance. However, remember all you might need is a BiPAP. If you need an ASV machine, you can find them online for around $4,000 to %5,000. But as also noted, CPAPauction.com often provides a MUCH lower price (sometimes under $400 for older models).

Hope that helps.