An article on Central Sleep Apnea

[JohnBFisher]

Here's a decent article that describes Central Sleep Apnea:

http://www.cpap-supply.com/Articles.asp?ID=331

Yes, it's done by another company than the one that sponsors this forum. But I think they will agree an open exchange of information is always good for the patient and thus for the companies that work with them.

Hope it helps.

[ameriken]

Excellent John, thanks. This was of interest to me since I was writing about it in my 'methadone' thread:

"When a person is awake, the breathing system is under "behavioral control", with particular areas of the brain providing non-chemical stimuli to induce respiration. When a person is asleep, the breathing system is under "chemical control', with the level of arterial carbon dioxide tension becoming the primary stimulus for ventilation during sleep. When there's a problem with the chemical control mechanism, breathing can stop."

I've wondered about this with my own centrals...if the body has stopped inducing respiration and the ASV is forcing a breath, are the lungs even exchanging gasses? Or is it just pushing in air and the same air gets pushed out without 02 being absorbed?

Could explain why my AHI has been so good yet the net result of feeling like crap is because nothing is really happening...my lungs are inflating and deflating but I'm not getting 02 and may have excess CO2 resulting in no real improvement in function and cognitive ability. Just a thought.

[NateS]

Thanks, John.

Regards, Nate

[JohnBFisher]

Excellent John, thanks. This was of interest to me since I was writing about it in my 'methadone' thread:

"When a person is awake, the breathing system is under "behavioral control", with particular areas of the brain providing non-chemical stimuli to induce respiration. When a person is asleep, the breathing system is under "chemical control', with the level of arterial carbon dioxide tension becoming the primary stimulus for ventilation during sleep. When there's a problem with the chemical control mechanism, breathing can stop."

I've wondered about this with my own centrals...if the body has stopped inducing respiration and the ASV is forcing a breath, are the lungs even exchanging gasses? Or is it just pushing in air and the same air gets pushed out without 02 being absorbed?

Could explain why my AHI has been so good yet the net result of feeling like crap is because nothing is really happening...my lungs are inflating and deflating but I'm not getting 02 and may have excess CO2 resulting in no real improvement in function and cognitive ability. Just a thought.

Amerikan, it's possible that the ASV unit is not helping enough. Unfortunately, if that is the case, you might need with a AVAPS system or a ventilator. For example, if you are quite overweight the extra weight can make it hard for an ASV to be effective. In that case, the AVAPS may be a better choice.

https://www.cpap.com/productpage/respir ... avaps.html

If you suspect your problem is that your O2 levels remain low, you might be better served by seeing a pulmonologist that specializes in sleep medicine. It's possible supplemental O2 would be the answer. Or an AVAPS system. Or ... That's why you see a specialist.

Hope that helps.

[ameriken]

Thanks John...the ASV did a great job, with the right pressure I was at a consistent 5 and under. I'm overweight but not excessively, and I can feel it blowing up my lungs. I could be wrong, but I strongly believe that what the methadone was doing to my respiratory system was beyond the capability of any machine.

Rather than go to a different machine, the ASV is doing fine now that I am almost off methadone. I hope to be off the machine sometime down the road when my body is cleared of the drug.

[apnea2142]

I've lost hope of curing my central apnea, OSA. I have a resmed adapt but the pressure is too high. I don't know how I got central apnea on my one study with 72% O2 (10secs). some of the other studies show that my O2 is ok (I took restoril 15mg though)
can you get sleep apnea from prednisone/asthma meds, pregnenelone or a pituitary tumor? thanks!

[sandman19]

Thank you John. I always appreciate reading your blog. It's interesting that Teri and I have no other medical problems as a cause for our CSA. We do live at 8,000 feet on a mountain. I have never been able to find an explanation for why that makes a difference. I've asked my pulmonologist-an extremely bright and competent sleep doc-and he doesn't know what the exact mechanism is. (he's the doc that diagnosed the blood clots to my lungs and saved my life!) Maybe someday we will know. Anyway, I enjoy putting my Mirage Quattro mask on and feel my ASV pumping that air and Ox to me.

[Pugsy]

I've lost hope of curing my central apnea, OSA. I have a resmed adapt but the pressure is too high. I don't know how I got central apnea on my one study with 72% O2 (10secs). some of the other studies show that my O2 is ok (I took restoril 15mg though)
can you get sleep apnea from prednisone/asthma meds, pregnenelone or a pituitary tumor? thanks!

Are you related to Sleepwithapnea17? Sounds like you could be his twin.

[apnea2142]

I tried theophylline but it didn't seem to do much except give me a headache. I read online somewhere that it can help central apnea
anyway what an awful disease we have that has no cure and just cripples us and destroys our minds

[JohnBFisher]

[ jbf wanders onstage, pulls over the soapbox, unsteadily climbs onto it and begins ... ]

... anyway what an awful disease we have that has no cure and just cripples us and destroys our minds ...

No! Wrong!

Proper therapy will address the central sleep apnea. If you are not willing to work with your doctors to get it diagnosed and properly treated, then you are the only one that can be blamed.

Let me quote Frank Herbert here:

Fear is the mind-killer.

If you face your fear and deal with it, you will grow as an individual. Failing to face your fear and deal with it will leave you crippled. Many of us chose to face our problems and work with our doctors to address them. We are anything but crippled. You have that choice to make. But having central sleep apnea is NOT a reason for despair. It can be effectively treated.

[ jbf stumbles off his soapbox, pulls it over to the side for the next person, and wanders off-stage ... ]

[Blindrage]

Excellent John, thanks. This was of interest to me since I was writing about it in my 'methadone' thread:
I've wondered about this with my own centrals...if the body has stopped inducing respiration and the ASV is forcing a breath, are the lungs even exchanging gasses? Or is it just pushing in air and the same air gets pushed out without 02 being absorbed?

Could explain why my AHI has been so good yet the net result of feeling like crap is because nothing is really happening...my lungs are inflating and deflating but I'm not getting 02 and may have excess CO2 resulting in no real improvement in function and cognitive ability. Just a thought.

Not withstanding the earlier reply to this, and admitting I am not a doctor... if fresh air is getting into your lungs and there is no damage to the membranes that move O2 into the bloodstream and there is no chemical in the blood preventing release of CO2 and binding of O2, and if these things existed you would see it during the daytime as well, then the body can not help but absorb the O2. There is no regulating method that tell the blood to not export the CO2 and import the O2; it acts as the equivalent of a mechanical process within the tiny sacs inside the lungs.

The earlier reply talked about the ASV not being able to get that fresh air into the deep pockets that actually exchange CO2 for O2, and in the case of very large people that can be an issue, but in general that would not be the issue. In your case the drugs may be having a greater effect during sleep due to the decreased blood flow and respiration rate.