Unknown Hypopnea

[ShadowAngel]

Hello. I was wondering if any of you all have encountered an issue like mine.

I'm currently 26 years old and have had sleep issues since I was 16. Inever knew until recently. The thing is I just barely found out I have sleep apnea which is causing my daytime sleepiness. The thing is my sleep studies mentioned I have sleep hypopnea instead. (No obstructive and no central). A followup sleep study where I tried the cpap caused central sleep apneas and then a further bipap study caused more centrals.

I'm at a loss since I thought cpap was the cure for apnea. The thing is, the doctors can't seem to figure out what is causing this and I am getting very frustrated trying to figure out a cause (mainly for the hypopneas). I figured the centrals were caused by the machine causing my brain to get confused.

The only lead I have at the moment seems to be a deviated septum that my ENT mentioned, but a CT scan revealed that it is not that severe. Do you think that could be it? Any suggestions for me to try? Any advice or perhaps if you have had a similar experience please let me know what you did and /or found. Thanks.

[Pugsy]

https://www.youtube.com/watch?v=CU-XTcf ... e=youtu.be

Check out the above video about Complex Sleep Apnea.

[ShadowAngel]

Well the link that the above poster gave had a video that explains exactly what I was thinking in that complex sleep apnea is sometimes caused by intolerance to cpap machines. My results show that without the machine I have no central apneas. But anyways the following are my results that the sleep center emailed me.


My first study which was without any CPAP and just me resting normally says:
Total sleep time: 156 minutes
Stage 1: 21 minutes
Stage 2: 62 minutes
Stage 3: 53.5 minutes
Stage REM: 19.5 minutes
Obstructive Apneas: 0
Hypopneas: 42
Central Apneas: 0
Mixed Apneas: 0
AHI: 16.2

The second study which included CPAP says:
Total sleep time: 222.5 minutes
Stage 1: 75 minutes
Stage 2: 95 minutes
Stage 3: 52.5 minutes
Stage REM: 0 minutes
Obstructive Apneas: 6
Hypopneas: 22
Central Apneas: 31
Mixed Apneas: 0
AHI: 15.9

The third study which included BIPAP says:
Total sleep time: 246.5 minutes
Stage 1: 118.5 minutes
Stage 2: 52.5 minutes
Stage 3: 69 minutes
Stage REM: 6.5 minutes
Obstructive Apneas: 1
Hypopneas: 75
Central Apneas: 17
Mixed Apneas: 2
AHI: 23.1

[OSAHell]

Hi ShadowAngel,

Here some comments that might help you with your problem.

Hello. I was wondering if any of you all have encountered an issue like mine.

I'm currently 26 years old and have had sleep issues since I was 16. I never knew until recently. The thing is I just barely found out I have sleep apnea which is causing my daytime sleepiness. The thing is my sleep studies mentioned I have sleep hypopnea instead. (No obstructive and no central). A followup sleep study where I tried the cpap caused central sleep apneas and then a further bipap study caused more centrals.

An hypopnea is either obstructive or central in nature and you can have OSA with 100% hypopnea in your diagnosis of those are predominantly obstructive in nature. But if those hypopnea are central in nature it's often a long struggle to find the right therapy because to many doc don't even know/consider that hypopnea can be central. The fact that CPAP "cause" you centrals apnea and Bi-level cause even more centrals apnea might be that you have some kind of periodic breathing that can cause central hypopnea. CPAP might just push those central hypopnea to central apnea. I was like that on CPAP/APAP, I had about 80% hypopnea on diagnostic and more than 80% of my event were central apnea on CPAP/APAP with AHI under treatment similar to my AHI on diagnosis. Also, bi-level are know to something exacerbate periodic breathing and that might also explain why you have higher AHI on that kind of xPAP. Looking at your study results on CPAP and BiPAP, I would strongly suggest you ask your sleep doc about trying an ASV, although if he didn't try it in your study or never mention it before he might not know what it is... It wouldn't be a first. ASV is a special xPAP made to treat central events (apnea, hypopnea and periodic breathing).

I'm at a loss since I thought cpap was the cure for apnea. The thing is, the doctors can't seem to figure out what is causing this and I am getting very frustrated trying to figure out a cause (mainly for the hypopneas). I figured the centrals were caused by the machine causing my brain to get confused.

It's a possibility that xPAP can cause those central but without trying a CPAP for a month or 2 we can't really tell. And if your initial hypopnea are predominantly central in nature, CPAP just can't treat them. With the right xPAP nearly all sleep apnea can be treat with success but xPAP don’t cure apnea like insulin don’t cure diabetes. But if there is an underlying cause to the sleep apnea like drug induced central sleep apnea by resolving the cause you can “cure” it. But most often than not cause is not found or can’t be resolved.

The only lead I have at the moment seems to be a deviated septum that my ENT mentioned, but a CT scan revealed that it is not that severe. Do you think that could be it? Any suggestions for me to try? Any advice or perhaps if you have had a similar experience please let me know what you did and /or found. Thanks.

When I first started CPAP I had really hard time with compliance. Other than still high AHI, I had problem tolerating the mask and it turned out I had a fractured deviated septum (severe nearly blocking 100% one nostril but not physically apparent)... I had a septoplasty and it didn't change a thing for my sleep apnea but I was now able to tolerate the mask without much problem. Before the surgery my ENT said that it would be really unlikely that it would "cure" my sleep apnea but will probably help me with my mask problem.

Hope it help a bit!