What Type of Apnea Do I have?

[Sleepless in New Mexico]

I've been using a cpap for about 20 months now with about 50% success rate. By that I mean that the CPAP definetley helps but I'm not waking as refreshed as I should be and I know that I still have episodes of apnea throughout the night. I've learned a lot over the past few months by following this forum. Recently in my reading, I've been paying a lot of attention to the symptoms associated with Central Sleep Apnea vs Obstructed Sleep Apnea. I've gone through 3 sleep studies and waiting for an appointment with my third doctor. My question is: Should he be able to tell from my sleep study results whether my Apnea is CSA or OSA?
The reason I suspect that I might have CSA is because of the way I stop breathing at night. I've never been a loud snorer but before cpap my wife always complained about the noise I make. The cause of the noise is the way that I hold my breath after I inhale and then make a low moaning sound while the air is trying to escape from my lungs while holding my breath. That's the best way I can explain it. I realize that that CSA is much rarer than OSA but I would really like to learn more about it. Are there different treatments for CSA vs OSA? What questions should I ask my doctor to help him determine the type of apnea I have?

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, CSA

[ozij]

CSA can be identified on you sleep study data - and the sleep doc and techs - it they're worth anything - should find that distinction very simple.
Central apnea is a cessation of breathing, without any indication of you muscles attempting to breath. With CSA you don't struggle to breath, because there's no obstruction to struggle against.

I you want good treatment, try to get a machine with software that will let you monitor you nightly results. By following your results nightly you will be able to see if the pressure you were originally titrated at is right, too high or too low. And if you can get an automatice machine, you will be able to see if your pressure needs are stable, or if they vary.

You said "third doctor" - what happened with the first 2?


O.

[Sleepless in New Mexico]

O,
Thanks for the reply. As for the first two doctors: I changed insurance companies making it necessary to change doctors as the first one didn't work with my new insurance company. My primary care physician gave me a recommendation for a doctor with the new insurance company. After about 3 visits with him, I came to the realization that he wasn't going to be a lot of help. I later found out that he is a psychiatrists that took a test to become state board certified in sleep medicine. He seemed to be pretty clueless in reviewing my sleep study results with me. I'm still waiting for my appointment with number three. Each one has ordered a sleep study for me and I hope this next one will be able to help me.

[rested gal]

Sleepless in NM, as ozij said, the sleep studies you already had would easily reveal what kind of sleep apnea you have. True Central Sleep Apnea as the main problem would be so obvious (and is, as you mentioned, so rare) surely any of the doctors you've seen so far would have zeroed in on that without any trouble at all.

During the sleep study, the belts that were around your chest and waist were measuring "effort". Apnea with no heaving of the chest and abdomen to try to get air in would mean the brain had simply not sent the signal, "Breathe." Central apnea.

For some very interesting reading about Central Apnea as a syndrome and central apneas as random occurences that really aren't significant, check out the excellent posts by christinequilts who does have Central Sleep Apnea:

Links to Central Apnea

I agree with ozij that you'd do well to get an autopap. Let the machine find the right pressure for you throughout the night. Get the software for it and monitor your own treatment.

When you see your new doctor, ask him if you can have a trial on autopap. As for helping him find out what kind of apnea you have, he already knows the answer, if he's looked at the reports from your previous studies. Those studies would have had to be botched unbelievably badly to not show clearly what kind of apnea you have. I don't think you need to be worried at all about having CSA.

[Sleepless in New Mexico]

Rested Gal,
You always have such good and sensible advice. Thanks for your response and I will push my new doctor to get me on an autopap with the software so I can monitor my own sleep results. I had my third sleep study back in October and the doctor can't see me until the end of Feb. I've been trying to find solutions to why my cpap hasn't been as effective as I hoped it would be although it does help a lot. Even on my best nights, I still wake less than fully refreshed.
Mark