Complex Sleep Apnea - Mayo Clinic

dsm · Post by **dsm** » Mon Oct 16, 2006 9:14 pm

This topic came up recently in another thread started by somone who had bought a Bipap S/T.

Here is a link to the medical details of what seems to be a new classification of Sleep Apnea, called Complex Sleep Apnea.

5th Sept 2006.
http://www.medicalnewstoday.com/medical ... wsid=51105

The article says 2 types existed previously (I thought we had three ?)

OSA - Obstructive
CA - Centrals
(My 3rd would be MA - Mixed, maybe this is really what they mean ?)

Another article on this
http://www.medpagetoday.com/Pulmonary/S ... rs/tb/4034

Here is an extract from the 1st link ...
>>
Patients with complex sleep apnea at first appear to have obstructive sleep apnea and stop breathing 20 to 30 times per hour each night. But unlike typical obstructive sleep apnea patients, their breathing problem is not completely alleviated by a CPAP (continuous airway pressure) machine, which functions like a pneumatic splint to open a patient's airway. Instead, once the CPAP is applied to complex sleep apnea patients, the obstruction seems to dissipate, but still they do not breathe properly. Symptoms of central sleep apnea then appear and fragmented sleep results, due to frequent pauses in breathing.
"All of us in our sleep lab have observed for years that there are patients who appear to have obstructive sleep apnea, but the CPAP doesn't make them all that much better -- they still have moderate to severe sleep apnea even with our best treatment and subjectively don't feel they're doing very well," says Timothy Morgenthaler, M.D., Mayo Clinic sleep medicine specialist, pulmonologist and lead study investigator. "When they put on a CPAP machine, they start to look like central sleep apnea syndrome patients. This phenomenon has been observed for years, but this study is the first attempt to categorize these people."
<<

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I am wondering if Mixed Apnea is any different from Complex Apnea or is it just a new name for what was already known ?
If yes, why ? (somone seeking medical glory ?)

Interesting ...

DSM

#2 - I just found this 1986 article that makes a different type of reference to 'Mixed Apnea'

http://www.chestjournal.org/cgi/content ... t/89/6/800

D
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CPAPopedia Keywords Contained In This Post (Click For Definition): cpap machine, bipap, CPAP

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CPAPopedia Keywords Contained In This Post (Click For Definition): cpap machine, bipap, CPAP

Ms Piggy · Post by **Ms Piggy** » Tue Oct 17, 2006 2:06 pm

I found this one today when looking for info on central Apneas

//en.wikipedia.org/wiki/Sleep_apnea#Mixed_Apnea_and_Complex_Sleep_Apnea

dsm · Post by **dsm** » Tue Oct 17, 2006 4:38 pm

I just posted a reply to your post in the other thread re BiPap.

Just repeating the bit I added about Mayo clinic claims. The info in the link gave me an explanation as to why Mayo Clinic were claiming this is a new category.

Prior to their research, it *was* known but had not been categorised to the point that they have now achieved. 'Complex' is now a legitimate new form of Sleep Apnea that appears to not respond to CPAP (or APAP), or non-timed BiLevels.

DSM

whatrdreamsmadeof · Post by **whatrdreamsmadeof** » Tue Oct 17, 2006 5:55 pm

wHAT WOULD BE THE BEST TREATMENT FOR SOMEONE WHO FALLS INTO THIS CATEGORY? i AM GOING FOR A REPEAT TITRATION AND MY LAST ONE HAD BOTH CENTRAL AND MIXED APNEAS. THANKS A BUNCH

GoofyUT · Post by **GoofyUT** » Tue Oct 17, 2006 6:21 pm

Generally, ResMed's VPAP ADAPT ASV is thought to be the state-of-the-art in treatment for CSDB or mixed apnea. It does bear an FDA indication for these disorders.

Hope this helps.

Chuck

whatrdreamsmadeof · Post by **whatrdreamsmadeof** » Tue Oct 17, 2006 6:35 pm

i KNEW i COULD COUNT ON YOU GOOFYUT,,,,,,,,YOU ROCK BUD

GoofyUT · Post by **GoofyUT** » Tue Oct 17, 2006 6:44 pm

Thanks!!!

But you really ought to try to correspond with Doug (DSM) or Steve (SWS). They are both TREASURE TROVES of GREAT information! Doug knows the VPAP ADAPT ASV better than anyone on this forum, and Steve has SO MUCH KNOWLEDGE to share on CSDB.

Good luck Ellen, and keep us posted! There IS LIGHT at the end of the tunnel, and its GLORIOUS on this side!

Chuck

Guest · Post by **Guest** » Tue Oct 17, 2006 7:51 pm

The jury is still out on whether the Adapt SV will be effective in treating CSDB.

StillAnotherGuest wrote:These studies pertain to patients with chronic heart failure and CSR. And I'm sure ASV will work quite well in virtually all those cases (ignoring any operator error).

Applying this technology in other disease states may not necessarily give the desired results. The Adapt SV algorithm is set up to achieve 90% of recent minute ventilation as it blows through CSA/CSR. This not only achieves the immediate effect of overcoming CA, but after a brief period of time, NREM breathing stability is attained, and (apparently) the tendency for CA to occur disappears.

Whether or not ASV can achieve this same breathing stability in CSBD, sleep-onset periodic breathing, neurological CA, etc. remains to be seen.
SAG

Complex Sleep Apnea - Mayo Clinic

Complex Sleep Apnea - Mayo Clinic

iS tHERE

Tx

i KNEW

Grazie!