Central Sleep Apnea - More info?

[morfenmom]

I was diagnosed with central sleep apnea. AHI = 21 but only limited obstructive events. Started on CPAP this week.

I am having a hard time finding out info about central sleep apnea. It seems like all the info is about OSA since it is so much more common. Any ideas on where to look?

[Blindrage]

I was diagnosed with central sleep apnea. AHI = 21 but only limited obstructive events. Started on CPAP this week.

I am having a hard time finding out info about central sleep apnea. It seems like all the info is about OSA since it is so much more common. Any ideas on where to look?

EDIT: Re-read the OP, and I think I understand where I was confused the first time.

A CPAP, in most cases, will not help with central events.

Obstructive events are the most common form of apnea, and the CPAP uses pressure to help support the part of the throat that obstructs the breathing process.

Central events are a failure of the brain to send the signal to breath, and the machine treatment is an ASV (sometime Bi-PAP) machine to force air into the lungs even when the signal is not sent. A newer treatment uses a device much like a pacemaker (embedded in the body and wired up) to help with this.

Having both types (obstructive and central) is commonly referred to as Complex apnea, and I am going through the fight with my DME and insurance right now about them giving me a CPAP when I have complex apnea. Your doc may be in the same boat as mine. The insurance company does not want to pay the hefty cost difference for an ASV machine, so they are forcing me to use a CPAP for a couple of months to prove it does not provide me complete relief. Once they see the open airway events, then they will do a second sleep study with an ASV to prove that improves my treatment.

[chunkyfrog]

Ditto; go back to the control panel and fill in your equipment, text is preferable.
Folks here who have the same situation can advise you on their experiences.

[JohnBFisher]

I was diagnosed with central sleep apnea. AHI = 21 but only limited obstructive events. Started on CPAP this week.

I am having a hard time finding out info about central sleep apnea. It seems like all the info is about OSA since it is so much more common. Any ideas on where to look?

There are not a lot of sites that have information about central sleep apnea. And those that do often connect it to heart problems. Since in the later stages congestive heart failure tends to lead to a type of periodic breathing known as Cheyne-Stokes Respiration (CSR) which includes central apneas during sleep, it is often equated to central sleep apnea. However, there are other causes of central sleep apnea. For instance, I have a progressive, degenerative neurological disorder that impacts my cerebellum and brain stem. Since breathing (during sleep) is largely controlled in the brain stem, central sleep apnea sometimes is a result of the continued degeneration.

As has been mentioned, CPAP does nothing for the central sleep apneas. However, some doctors (and insurance companies) prefer to try patients on CPAP first to see if it helps. If you continue to feel poorly due to a high AHI rate, then you should INSIST on an ASV titration to address the central sleep apnea.

Why do I say "INSIST"? A central sleep apnea places a huge strain on your cardiovascular system. It often leads to uncontrollable high blood pressure. If not controlled that can lead to kidney damage (especially if you take NSAIDs such as Ibuprofen to fight the morning headaches). PLEASE be certain to register your equipment, track your therapy (keeping an eye on the AHI scores and number of CA events) and raise a stink that you should be getting the treatment you need.

By the way, it is possible the CPAP will address the central apneas. It sometimes happens. Rarely, but sometimes.

Best wishes. Hope the information helps.

[sandman19]

I'm sorry for what brought you here, and I'm glad you are here. All if the info above is great-I agree completely. I'll briefly add my experience. I'm lucky, I have a wonderful, competent sleep doc. When my first two-part sleep study showed mild OSA and increasing CAs with increasing CPAP pressure, he sent me back for an ASV titration. My horrible am headaches are gone. I wake up feeling refreshed with energy, not worse than when I went to bed. My brain fog is clearing. Except for when I am in the car all day, I rarely feel sleepy and need a nap. I enjoy putting my mask on, feeling the rush of filtered, humidified air, knowing that when I stop breathing it will get me started again. That has helped my sleep hygiene and relaxing into sleep much faster. I do not have any other medical problems causing the CAs-no neuro problems, high blood pressure, heart disease, etc. I have the latest edition of an excellent textbook: "Fundamentals of Sleep Medicine" by Richard B. Berry, MD-a book for sleep docs. And it has little to say about CAs. It simply discussed how deadly they can be. So, if need be, fight for your right to good medical care, an ASV. I happen to use a Mirage Quartro FFM. Even with the rapid changes from 5 cm water to 25 (to get me breathing), it works well. I am 6 ft. 215 pound guy, and I'm using a samll mask. The bridge of my nose was too small to be able to use the Quattro FX. Correct fitting of you mask is very important. Good Luck!

[teachcsg]

All the info you have received so far has been right on.

Here are some links to respironics website that talks about central sleep apnea and the BiPAP ASV (the older model-newer model is smaller)

http://www.healthcare.philips.com/us_en ... efault.wpd

Here is some info from Resmed:

http://www.resmed.com/us/documents/CSA- ... -sheet.pdf

Hope this helps you some.

[morfenmom]

The insurance has said they will not pay for BiPAP until I try CPAP first. They allready did a second sleep study and said that I need an 18/14 pressure. The CPAP machine I have does 18 with a -3 release (i.e. same as an 18/15 BiPAP pressure). At least that's what the respiratory therapist told me. They seem to think it will do the trick.

The fact that I have central SA surprised the doc but then as he was taking my history (Fibromyalgia, high blood pressure, and epilepsy) he said it made more sense.

I have had morning headaches as long as I acn remember but always blamed it on caffeine deprivation. I cut the caffeine last year but the headaches didn't go away. A lot of these things are finally starting to fall in place.

[JohnBFisher]

... The insurance has said they will not pay for BiPAP until I try CPAP first. ... They seem to think it will do the trick. ...

They HOPE it will work. Sometimes it does. But remember to be insistent if it does not address your problems.

... The fact that I have central SA surprised the doc but then as he was taking my history (Fibromyalgia, high blood pressure, and epilepsy) he said it made more sense. ...

Neurological involvement makes the central apnea more understandable.

... I have had morning headaches as long as I acn remember but always blamed it on caffeine deprivation. I cut the caffeine last year but the headaches didn't go away. A lot of these things are finally starting to fall in place. ...

Be REALLY careful about those morning headaches. They can be a sign of O2 desaturation. And it can be a sign of high blood pressure. If you use NSAIDs (such as Ibuprofen) to calm the headaches it can lead to kidney damage. It is NOT on the warnings on the bottle, but apparently a lot of people have kidney damage due to high blood pressure and NSAIDs. I know that happened to me.

It's VERY important to get the central apneas properly treated. Go ahead and try the CPAP and then the BiPAP and then an ASV unit, if you need. But insist that it be properly treated. (Of course an CA level of less than 5 per hour is considered properly treated ...).

Hope that helps.

[morfenmom]

I agree about the morning headaches. That's how I found out about the apnea was that the headaches didn't go away after the caffeine was eliminated.

I do have HBP but I'm on meds that seem to do the trick except that the morning headaches are still here. I'm hoping that once I get the CSA under control, I'll start to see those diminish.

[JohnBFisher]

Actually, when you get the CSA under control you will start to feel like a new person. If it's severe enough it can rob you of all energy and leave you with untreatable depression and high blood pressure. Even if it is not very severe you will be amazed at how much better you can feel. Of course, that's just my experience, but I think others will agree that it makes a huge difference.