Central Apnea Clarification

JPO · Post by **JPO** » Tue Dec 04, 2007 9:32 pm

I am looking for some clarity on central apneas. When I had my sleep study the doc said I had severe OA plus central apnea. He told me that the CPAP would not help the CA. He told me about the ST machines that were needed to handle the central apnea, but we would try the CPAP and see how that did. I got a CPAP and later a BiPap and have been compliant for a year. My readings have been good from the beginning with my AHI running around or below 5 with snoring and leaks under control. I tape my mouth and I use Encore Pro to capture the data.

But, I get very tired during the day and and can't focus and it has been getting worse. I saw the sleep doc Monday to talk about the central apnea, thinking that it was causing my problem. He told me that my results indicated that the central apnea was under control because the AHI was low. He said that central apnea will appear as apneas in the program reports. What he says has some logic but I was fixated on his original comments that central apnea was a condition of severity one level higher than OA . His comments led me to believe that the central apnea could not be treated by the CPAP or BiPap. But now he is saying that it has been successfully treated and is under control.

He said come back for another sleep study and they would see if they missed anything the first time. I told him no thanks.

Is the doctor correct? Do I have to look somewhere else to find the cause of extreme tiredness?

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CPAPopedia Keywords Contained In This Post (Click For Definition): bipap, Encore Pro, CPAP, AHI

Wulfman · Post by **Wulfman** » Tue Dec 04, 2007 9:47 pm

Do you have one of the programs "MyEncore" or "Encore Pro Analyzer" to determine the duration of your apneas?

Also, I would think that your doctor would want you to do an overnight pulse-oximetry to determine if you're desaturating to non-satisfactory levels.
You might ask him about having one done.....it's free through a local DME.

What are your Bi-PAP settings?

Den

ozij · Post by **ozij** » Tue Dec 04, 2007 10:26 pm

The doctor is right. Sometimes, after apneas are handled, perilodic limb movements appear. These can fragment your sleep leaving you exhausted, without causing low oxygen saturation.

And AHI of "around or below 5" is kind of borderline. When a person's obtsructive apneas are treated, and there is a residual number of 5 or more central apneas, they are considered to have complex sleep apnea, also know as CSDB.

http://www.resmed.com/en-au/clinicians/ ... apnea.html

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JPO · Post by **JPO** » Wed Dec 05, 2007 7:42 am

[quote="Wulfman"]Do you have one of the programs "MyEncore" or "Encore Pro Analyzer" to determine the duration of your apneas?

Also, I would think that your doctor would want you to do an overnight pulse-oximetry to determine if you're desaturating to non-satisfactory levels.
You might ask him about having one done.....it's free through a local DME.

What are your Bi-PAP settings?

Den

Gerald · Post by **Gerald** » Wed Dec 05, 2007 7:57 am

I suggest that you do a series of overnight Oximeter studies....say, about an month's worth. That'll give you a good picture of what your O2 levels are at night. I'm betting you'll be shocked at how low they are.

I've been very pleased with the SPO Medical 7500 PulseOx....and the software that comes with it gives you the necessary info. Cost is about $500 and is worth every penny.

Gerald

JPO · Post by **JPO** » Wed Dec 05, 2007 2:39 pm

Gerald wrote:I suggest that you do a series of overnight Oximeter studies....say, about an month's worth. That'll give you a good picture of what your O2 levels are at night. I'm betting you'll be shocked at how low they are.

I've been very pleased with the SPO Medical 7500 PulseOx....and the software that comes with it gives you the necessary info. Cost is about $500 and is worth every penny.

Gerald

Gerald, what therapy would I have to raise O2 levels?

Snoredog · Post by **Snoredog** » Wed Dec 05, 2007 3:20 pm

Your doctor is correct, central apnea WOULD show up to your conventional machine as obstructive events. As long as your AHI from the machine remains below 5 you have nothing to worry about as far as centrals go.

However, those same Central events will cause most autos (with 420e being the exception) to increase pressure which can make them worse in frequency.

So if you are are still feeling like no sleep at all, you need to look at sleep architecture (like the lack of SWS) and or other parasomnias and items like spontaneous arousals. That would include chronic muscle pains such as back pain.

JPO · Post by **JPO** » Wed Dec 05, 2007 8:01 pm

[quote="Wulfman"]Do you have one of the programs "MyEncore" or "Encore Pro Analyzer" to determine the duration of your apneas?

Also, I would think that your doctor would want you to do an overnight pulse-oximetry to determine if you're desaturating to non-satisfactory levels.
You might ask him about having one done.....it's free through a local DME.

What are your Bi-PAP settings?

Den

JPO · Post by **JPO** » Wed Dec 05, 2007 8:03 pm

[quote="ozij"]The doctor is right. Sometimes, after apneas are handled, perilodic limb movements appear. These can fragment your sleep leaving you exhausted, without causing low oxygen saturation.

And AHI of "around or below 5" is kind of borderline. When a person's obtsructive apneas are treated, and there is a residual number of 5 or more central apneas, they are considered to have complex sleep apnea, also know as CSDB.

http://www.resmed.com/en-au/clinicians/ ... apnea.html

R E I M B U R S E M E N T S E R V I C E S
HELPFUL HINTS
FOR FILING
BIPAP® AUTOSV™ SLEEP THERAPY SYSTEM
O.

JPO · Post by **JPO** » Wed Dec 05, 2007 8:18 pm

[quote="Snoredog"]Your doctor is correct, central apnea WOULD show up to your conventional machine as obstructive events. As long as your AHI from the machine remains below 5 you have nothing to worry about as far as centrals go.

However, those same Central events will cause most autos (with 420e being the exception) to increase pressure which can make them worse in frequency.

So if you are are still feeling like no sleep at all, you need to look at sleep architecture (like the lack of SWS) and or other parasomnias and items like spontaneous arousals. That would include chronic muscle pains such as back pain.

Wulfman · Post by **Wulfman** » Wed Dec 05, 2007 8:36 pm

JPO wrote:I use Encore Pro Analyzer and the average duration of the apneas are 12 seconds. There are a total of 20 apneas and 20 hypopneas with 5.9 AHI the latest week. Variable breathing, which I don't understand, averages 50%, moving from 30% to 60%.

The BiPap is set at 8 and 12 with no auto or flex.

I appreciate your help, Den.

Well, your AHI is a bit high (should be less than 5.0), but your durations are pretty normal. If you're having any Centrals, it doesn't look like they're of any lengthy duration. Don't know about your tiredness during the day, but maybe there are some other issues, too. I would imagine that if my AHI was at 5.0 or above, I'd still be tired.

By the way.....how much sleep ARE you getting?

Den