Cervical Spine Issues and Central Apnea - poss. connection?

[retrodave15]

I have a question for the esteemed group members out there: Is there a possible connection between cervical spine issues and central apnea?

Yesterday I went to the orthopedic urgent care in Columbus (a rather novel concept) - as both my shoulders were bothering me, last weekend I had replaced the AC compressor in my wife's car and I thought I had just over done it. When the sympoms of pain in may neck, shoulders and upper back would not resolve, and 550 mg of naprosyn would no longer touch it, I decided to go in. After a pretty complete history and physical I had related to the orthopedic a lengthy history of shoulder problems, headaches and upper back and neck pain. I also indicated a family history of osteoarthritis and cervical spondylosis in both my mom and dad. In addition to a right and left shoulder series they ordered a A/P and lat c-spine



This xray indicated (see above), as he dictated his report in the room, severe cervical spondylosis at the C5-7 levels. Additionally there are bone spurs and degenerating discs between C5-C6 and C6-C7. From my anatomy classes I know the some of the phrenic (breathing) nerves come out between C4, C5, and C6. What is the possibility that the swelling and pinching in this area have something to do with my rising central apnea? Over the past two weeks, as my neck has been getting worse, my central apneas have been going through the roof- normally my AHI is about 1.5 to 2.5, now it is 12.5 to 15 with most of it being central apnea's.

I am going to try to get in with my wife's neurosurgeon this week and possible my sleep doctor if warranted. Currently the orthopedic put me on prednisone for inflammation and told me to follow up with my primary care and possibly a neurosurgeon or spine specialist as well. Anyone else experienced anything similar?

[Pugsy]

The pain and discomfort could sure be responsible for the increase in AHI. Makes for a very restless night and lots of tossing and turning and such.
Are you asking if the degenerative changes themselves could be causing it? I don't know. I don't think so though other than causing pain and discomfort which will affect AHI. So maybe in a second hand way.
I think the breathing nerves that go to the diaphragm are at C3 level. That is why people with fractures up in that area end up on ventilators. I don't remember which nerves might be pinched at your worst levels. Best to talk to neuro doc about it to make sure. I had C 4 and 5 removed due to severe just what you have except my vertebrae were unstable and sliding into the spinal cord. I didn't have any OSA symptoms until about 2 years after my neck surgery. The doctors think that the trauma of the surgery may have affected the airway tissues. I had an anterior incision due to the magnitude of the work involved.

Anyhow, probably would be a good idea to see a neuro doc and see what he says. He may want to do a MRI to make sure that none of those spurs are poking on the spinal cord. He would be in the best position to evaluate the possibility of the bone spurs and the shifting of the normal curve of the spine encroaching on any nerves that might be related to breathing.

Even if it isn't related to the increase in AHI other than second hand pain restlessness.....see a specialist and see what can be done to help relieve the pain. I had a burning hot poker in my neck 24/7 for several years before I had the surgery. That burning hot poker was the bones pressing on the spinal chord itself. No amount of narcotics would touch the pain.
I spent too many years with the docs telling me it was just "arthritis" "take a motrin". Come to find out since mine was pushing on the spinal cord at C3 level that a minor whiplash injury could have be ending up like Christopher Reeves or dead.

[Kenneth P.]

I had c-5,6,7,8 replaced in May..Feel 100% better..Haven't noticed much Event's decrease,etc..I do sleep better now&feel better..I do suggest you get a second opinion with a nero-surg...They spec. in Brain&Spine...I had problem's for the past 3 yrs.& did alot of study on the prob..Anything above the shoulder you should see this type of Doctor..The %of good result's will be higher..They went in the front of my neck.Cut wasn't but a couple inch's&now you can't even see the place if you didn't know it was there.Good Luck

[Kenneth P.]

I'm sorry for not reading your post all the way.You seem to ba already on the right track..I do know some who did have the shot's in the neck&has help'd..

I had c-5,6,7,8 replaced in May..Feel 100% better..Haven't noticed much Event's decrease,etc..I do sleep better now&feel better..I do suggest you get a second opinion with a nero-surg...They spec. in Brain&Spine...I had problem's for the past 3 yrs.& did alot of study on the prob..Anything above the shoulder you should see this type of Doctor..The %of good result's will be higher..They went in the front of my neck.Cut wasn't but a couple inch's&now you can't even see the place if you didn't know it was there.Good Luck

[retrodave15]

Thanks for the replies. Going to try to get in with the surgeon who did my wife's back fusion in may. I have united healthcare and I will have to play the game to get to surgery. I was looking for some Co morbididities that might get me there a little quicker.

[cynthiafreedom@hotmail.com]

I am dealing with same issue. Bone spur in spinal canal for over 2 years and now sleep apnea, so I do believe its connected possibly. Blood supply with oxygen is being interrupted so it only makes sense to me.

[SewTired]

It's really hard to get in early for an initial consult unless directed right from hospital because the condition isn't considered acute (or you would be in hospital). But do call them at least once a week for possible cancellations.

Also, if you think you may need a different machine, make appointment with your sleep doc now as it likely will be two months out. You can always cancel.

[CarpeNoctum]

Dave,
Sorry that you're having these problems. I have some personal experience with a somewhat related issue. The phrenic nerve branches off to left and right...enervating the diaphragm. If any part of the nerve signal is blocked, it prevents the diaphragm from functioning properly. That nerve blockage can occur from inflammation of the nerve...or more permanently from damage during surgery or neck trauma.

There is a very high correlation between suffers of phrenic nerve palsy and sleep apnea. The exact reason is unknown.

I personally have a left phrenic nerve palsy and related diaphragm dysfunction. The shortness of breath I started experienced lead to a Pulmonary MD visit where it was also discovered that I had sleep apnea (through home sleep study).

This condition if fairly uncommon, but probably much more common among people who have neck issues like you do.

Somehwere along the line, you have probably had a Chest X-ray. If you get a chance to look at it, or discuss it with your Doc...have him carefully observe the countour of the diaphragm. The effected side of the diaphragm weakens and is pushed upward by intra-abdominal pressure.

Treatment for inflammation can improve the condition...obviosly only if it's inflammation related. Just thought this info may be useful.
CN

[rhuszar]

I was diagnosed with sever sleep apnea in 11/2008 having both obstructive and central apnea.

In 2010 I was diagnosed with a spur at C5-C6. I ended up with a fusion. It cleared up my pain in my neck, shoulder and down my are. It did nothing for my sleep apnea.

I my case it appeared to have no influence on my sleep apnea.

[EdNerd]

While the info concerning spinal nerves and breathing is good to have, please be aware that the original post was in 2012, and retroDave hasn't been on the forums since 2015. Trying to reply directly to him probably isn't going to get there.

Ed