CSA and CPAP

[maggie22561]

Hi all. Been away for a while. I have a question. How does CPAP therapy work with CSA or does it? If this subject has been broached before could someone please post a link for me?
Thanks.
Maggie

[JohnBFisher]

CPAP and BiPAP therapies do not deal with CSA (Neither central sleep apnea ... nor complex sleep apnea). I assume you mean central sleep apnea.

The problem wiht CPAP or BiPAP is that they provide a continuous pressure. CPAP provides just one. BiPAP provides two (inhale and exhale pressures). If someone struggles with central apneas, a continuous pressure can actually trigger more central apneas.

In general a central sleep apnea occurs due to an undershoot / overshoot cycle. For whatever reason the body blows off more CO2 than necessary. (This is the overshoot side of the cycle). As a result, the body has less inclination to breathe, since the dissolved CO2 levels triggers breathing. If the CO2 levels are lower than normal, there is less breathing. This is the undershoot side of the cycle. And of course this to an apnea. In response the body then overcompensates and breathes a little faster than normal. And we are back to an overshoot situation. Round and round we go.

There are different reasons why this cycle occurs. Some people are very sensitive to the increased pressure. Some people have cardiovascular problems. And some just have problems with their central nervous system.

Regardless of the reason, the solution is to support breathing via an Adaptive Servo-Ventilation (ASV) algorithm. Essentially, the ASV machine helps maintain breathing (upto 90% of normal) during the central apnea. This helps break the cycle and stop the central sleep apneas.

So, most ASV units are setup as BiPAP machines and the ASV mode kicks in only when it detects a central sleep apnea. Due to the complexity of the unit (and the small number that are sold, comparatively), the ASV units a MUCH more expensive than CPAP or BiPAP units.

Hope that helps explain this.

[maggie22561]

Thanks for the reply and the explanation. I couldn't see how a CPAP would have any effect on central sleep apnea. I don't have CSA. At least i wasn't originally diagnosed with it. I was diagnosed with severe OSA 5 mos. ago. I have had great success with my CPAP. As I was dropping off to sleep last night it seemed to me that I was missing breaths, liked I was forgetting to breath(?). It kept bringing me back to full consciousness. It could have been obstuctive or it could have been my mind playing tricks on me. I managed to fall asleep and as far as i know had no other events. I woke this morning and felt fine. But laying there last night the question came to mind that if I was also developing CSA what would my treatment be? You answered that question thank you.
Should I continue to feel as i did last night while drifting off I'll contact my doctor.
Thanks again,
Maggie