A Question regarding Central Apnea

[MagsterMile]

My original DX is for Complex Sleep Apnea with Centrals and OSAs during the sleep study. My question is, if SleepyHead readings are just showing mostly Hypopneas and a few Apneas and nothing in the OSA category in the 'Events Graph', can I assume that the Apneas I'm getting are actually Centrals? In reviewing my past data, I've never had an 'event' in the OSA category. I've never seen Centrals indicated anywhere on the graphs - only Hypopneas and Apneas. I'm confused. Or, if I'm getting Centrals, would they likely show up under 'Clear Airway'?

[Pugsy]

The S9 Adapt doesn't flag centrals so Sleepyhead can't report them (if they are happening).
ResScan wouldn't show any of them either.

SleepyHead does call "centrals" clear airway events because it was originally written for PR S1 machines and that's what Respironics chose to use as the terminology instead of "central" ...ResMed was okay with calling them "centrals".

If your machine flagged centrals...yes, Sleepyhead would call them "clear airway" but your machine doesn't flag centrals.
It only flags Apneas and Hyponeas.
It's been discussed in the past...and I don't know where any centrals might get lumped ...AI or HI...I don't remember if it was ever figured out. I think the assumption is that if the Adapt does its job there won't be any centrals to flag but I can't swear to that being the final end result of those discussions.

I will see if I can find that past discussion thread if I have time as it included some reference material from ResMed as to why there are no centrals being flagged...
The regular bilevel machine the S9 VPAP...yeah it flags centrals separately but the high end units like you use they don't.

[remhunter]

My original DX is for Complex Sleep Apnea with Centrals and OSAs during the sleep study. My question is, if SleepyHead readings are just showing mostly Hypopneas and a few Apneas and nothing in the OSA category in the 'Events Graph', can I assume that the Apneas I'm getting are actually Centrals? In reviewing my past data, I've never had an 'event' in the OSA category. I've never seen Centrals indicated anywhere on the graphs - only Hypopneas and Apneas. I'm confused. Or, if I'm getting Centrals, would they likely show up under 'Clear Airway'?

Have you asked you DOCTOR about this issue? I'd be more than curious to learn what he or she had to say about CSA. You see... I have never heard about a single case of CSA without some sort of obstruction in the airways, have you? Well... not exactly. I could think of a case of someone suffering from CSA without OSA.... But that exceptional case has to be a surgical-made case and not a natural one. Assuming you have both apneas and you go through a surgical procedure and they get ride of the cause for obstruction in the nose or mouth. Now you can breath again but you still have some degree of CSA...WHY? Well logic dictates that because you had OSA for a long time untreated the brain was damaged to some degree and that is the result you get but this could be a very unique case.

Once you fix the pressure in your PAP to a good setting you should be able to sleep well. If this is not the case I suggest the alternative I'm looking for my case: AUTO PAP. I could only guess that the only solution for combined CSA and OSA sufferes [like myself] is the use of a smart machine capable of playing with the right pressure at the right time.

[Pugsy]

I have never heard about a single case of CSA without some sort of obstruction in the airways, have you?

Yes... I have and lots of them.

3 potential diagnoses available in terms of sleep apnea types
This is the shortened explanation as I don't have time for the long one.
DIY...do it yourself dial a wingin

1.. OSA Plain jane vanilla Obstructive Sleep Apnea....DIY when no other complicating factors can be successful .

2.. CompSA Complex Sleep Apnea where there is a mixture of obstructive sleep apneas and central apneas. Often when someone has no centrals to speak of during the diagnostic sleep study and a truckload of them with the introduction of cpap pressure when used to try to prevent the original problem...OSA. This diagnosis...might lend to DIY treating but only if a person happens to get lucky and there is a line where staying below so and so pressure keeps the centrals from popping up. I really don't advocate DIY stuff with this diagnosis but sometimes it can be manage with some DIY stuff...caution and lots of education are very important and only if someone is totally comfortable doing it.

3.. CSA...Central Sleep Apnea...primarily central apneas only for whatever reason and there are lots of reasons to idiopathic. This diagnosis I feel is best handled by the medical profession and not something that I advocate dial a wining DIY stuff unless there is absolutely no other way. Too many possible complicating factors IMHO.
Plain cpap/apap machine would be NOT the thing to advise someone to try. It won't help at all and could potentially create massive more problems.

CSA almost always needs one of those ASV types of machines to deal with the breathing issues.
CompSA can sometimes be treated with cpap/bipap machine if there is enough of a difference between where the obstructives can be prevented and not trigger the central breathing instability. If that can't be found...the high end machines have to be used.

For further CompSA education..have you seen this video?
https://www.youtube.com/watch?v=CU-XTcf ... e=youtu.be

[BlackSpinner]

. You see... I have never heard about a single case of CSA without some sort of obstruction in the airways, have you? Well... not exactly. I could think of a case of someone suffering from CSA without OSA.... But that exceptional case has to be a surgical-made case and not a natural one. Assuming you have both apneas and you go through a surgical procedure and they get ride of the cause for obstruction in the nose or mouth. Now you can breath again but you still have some degree of CSA...WHY? Well logic dictates that because you had OSA for a long time untreated the brain was damaged to some degree and that is the result you get but this could be a very unique case.

Where did you get your degree in Neurobiology? Did you ever hear of epilepsy? Stroke? and about a dozen other medical conditions?

[chunkyfrog]

Central apneas may also be caused by CNS depressants, like alcohol, sedatives, and strong pain killers.

[remhunter]

I have never heard about a single case of CSA without some sort of obstruction in the airways, have you?

Yes... I have and lots of them.

3 potential diagnoses available in terms of sleep apnea types
This is the shortened explanation as I don't have time for the long one.
DIY...do it yourself dial a wingin

1.. OSA Plain jane vanilla Obstructive Sleep Apnea....DIY when no other complicating factors can be successful .

2.. CompSA Complex Sleep Apnea where there is a mixture of obstructive sleep apneas and central apneas. Often when someone has no centrals to speak of during the diagnostic sleep study and a truckload of them with the introduction of cpap pressure when used to try to prevent the original problem...OSA. This diagnosis...might lend to DIY treating but only if a person happens to get lucky and there is a line where staying below so and so pressure keeps the centrals from popping up. I really don't advocate DIY stuff with this diagnosis but sometimes it can be manage with some DIY stuff...caution and lots of education are very important and only if someone is totally comfortable doing it.

3.. CSA...Central Sleep Apnea...primarily central apneas only for whatever reason and there are lots of reasons to idiopathic. This diagnosis I feel is best handled by the medical profession and not something that I advocate dial a wining DIY stuff unless there is absolutely no other way. Too many possible complicating factors IMHO.
Plain cpap/apap machine would be NOT the thing to advise someone to try. It won't help at all and could potentially create massive more problems.

CSA almost always needs one of those ASV types of machines to deal with the breathing issues.
CompSA can sometimes be treated with cpap/bipap machine if there is enough of a difference between where the obstructives can be prevented and not trigger the central breathing instability. If that can't be found...the high end machines have to be used.

For further CompSA education..have you seen this video?
https://www.youtube.com/watch?v=CU-XTcf ... e=youtu.be

Lots of what? I understand that you're talking about lots of apnea events... right? You don't actually know with 100% certainty as neither your doctors as to how many of them were OSA or CSA? Do you?

You see... Ignorance in the medical field is dangerous and when a doctor doesn't know and has no answer he or she will make a "scientific speculation" that will sound complex and will give you a lot of optimism but it's just CRAP.

When the CPAP can't "determine" using a man-made software the actual nature of an apnea event it will report whatever the man who designed the software wrote into its memory circuits and chips. To be able to determine a true CSA you should have had some sort of connection between deep layers of the thalamus (meaning inside your brain) and sorry to say you didn't because so far CPAPs have no such capabilities (yet). All the machines record is apnea and shallow breathings among other things. That is why new AUTOMATIC PAPs are the future, they are able to sense according to your breathing the right amount of air pressure to open the air channels wide enough to allow a better breathing pattern.

[BlackSpinner]

Lots of what? I understand that you're talking about lots of apnea events... right? You don't actually know with 100% certainty as neither your doctors as to how many of them were OSA or CSA? Do you?

That is what a sleep study is for, stupid. That is why they wire you up to watch your brain waves. Of course they can tell the difference.

[Pugsy]

remhunter wrote:I have never heard about a single case of CSA without some sort of obstruction in the airways, have you?



Yes... I have and lots of them.

You asked if anyone had ever heard of a single case of CSA without some sort of obstruction.
What part of "Yes, I have and lots of them" don't you understand.
Yes, I have seen and heard of Lots of cases where a person has CSA without some sort of obstruction.

Lots of what? I understand that you're talking about lots of apnea events... right? You don't actually know with 100% certainty as neither your doctors as to how many of them were OSA or CSA? Do you?

I think you need to continue your research and education...it is far from complete.
There are most definitely ways to determine for sure if a cessation of breathing is obstructive or central in nature.
It's becoming quite apparent that your knowledge base isn't nearly as extensive as you think you do...be careful.

[Drowsy Dancer]

To be able to determine a true CSA you should have had some sort of connection between deep layers of the thalamus (meaning inside your brain) and sorry to say you didn't because so far CPAPs have no such capabilities (yet). All the machines record is apnea and shallow breathings among other things.

Or...you could have a PSG...because it includes EEG.

[MagsterMile]

Pugsy, thanx for the link to the YouTube video. It really explained complex sleep apnea to where I can understand it...sort of. I had such a difficult time with the first cpap machine. It was horrible for me and I couldn't tolerate it. I sort of remember the RT saying something like 'I was throwing a lot of centrals' when she read the sd disk. Heck, I didn't even question her response and was in some sort of denial at that time. So, something in the readings can determine central like symptoms I can assume.