What is central sleep apnea ?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: What is central sleep apnea ?

Post by Pugsy » Fri Jun 24, 2022 6:00 am

Architect wrote:
Thu Jun 23, 2022 10:15 pm
So is tech sharing, pressure drops by 6 on inhale pressure 25 = 19. If I drop PS by 3 then pressure 22 ? If I need more pressure on inhale.
I am sorry but I don't understand your question.
When your reduce PS on a bilevel machine then IPAP gets reduced.
As everyone has point out PS gets added to EPAP to give you IPAP whereas EPR gets taken from IPAP to give you EPAP.
The end result in both situations is X amount of difference between inhale and exhale.

If your bilevel machine is in auto mode and if you decide to reduce PS and if the max IPAP is 25 cm it is still going to auto adjust within the established parameters if the machine deems such auto adjustment necessary.
Reducing PS to 3 would actually allow the EPAP to come up more than it can with PS of 6......if it deems it necessary.
EPAP does the bulk of the work preventing the airway from collapsing anyway.
With PS of 6 IF (big if) your machine went to 25 IPAP then your max EPAP is going to be 19.....with PS of 3 then the max EPAP is going to be 22. In theory... there are probably some situations where 22 EPAP might be better for holding the airway open than 19 EPAP might be.

Remember the regular BiLevel auto machines won't/can't do anything for central apneas anyway. They only auto adjust for obstructive apneas/hyponeas. They do absolutely nothing when a central apnea occurs.
I don't know why your sleep tech opted for 6 PS. I don't know if you had enough centrals during your sleep study to warrant addressing them and while increased PS is what is done to force a breath when a person simply isn't breathing, I once asked a sleep tech how much PS is actually needed to do what is needed to force a breath to deal with a central and he told me that he felt 8 cm minimum PS and ideally 10 cm PS.
Unfortunately when we start going over 6 cm PS (and for some people even less) then we run the risk for actually triggering the very thing we are wanting to avoid and make things a LOT worse in terms of the number of centrals as well as frequency of centrals. With the regular bilevel machine and a high PS we can potentially end up causing a truckload of centrals that could potentially cause desats and be a problem. It's why I cringe when I see people using the ST model bilevel with high PS with each and every breath to treat complex sleep apnea. PS of 10 is pretty much going to trigger a truckload of centrals when we have that much PS with each and every breath. It's going to trigger a large number of events that it is supposed to be "fixing". I feel it is better to have the ASV only do the higher PS needed to deal with a central when needed as opposed to doing it with each and every breath.

PS of 6 on a regular bilevel machine isn't adequate to deal with centrals...it just isn't unless someone is using ASV bilevel where the PS can auto adjust upwards as needed.

Now higher PS can potentially be used to increase oxygenation and as long as it doesn't cause the carbon dioxide washout which causes the centrals then it probably is fine to use. So a lot depends on why a higher PS is chosen and does that higher PS cause a problem or not.

Now here's the other monkey wrench that confuses a lot of people in the whole bilevel causes centrals in some people thing....regular bilevel is usually the first thing tried when people have treatment emergent central apnea and sometimes it works as long as the cause of the centrals popping up isn't from the wash out thing. The wash out thing isn't the only cause for central apneas. Heck, sometimes regular cpap actually helps with central apnea that was seen on the diagnostic sleep study....rare for it to help but not totally impossible.. That's why most insurance companies require all the trials with other machines before they will pay for the high dollar ASV machine.

I don't understand all this panic about central apnea.
1...it's normal to have an occasional central for one thing
2...centrals are only a problem when they are numerous enough to create a problem either with desats or in the case of sleep onset centrals the person has so many of them they keep bouncing out of sleep and don't get the sleep they need
3...if present in numbers that are a problem centrals are easily dealt with ....regular cpap/bilevel sometimes will fix the problem...rare but not impossible and if it doesn't then there is ASV which will very nicely auto adjust to deal with both obstructive apnea AND central apneas if needed.
4...and remember awake/arousal centrals don't count other than when we have a lot of them it means we aren't sleeping so great which of course is unwanted but when that is what we see then the centrals are a symptom of a problem and not the cause of the problem. The cause of the problem has to be addressed.

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Re: What is central sleep apnea ?

Post by Architect » Fri Jun 24, 2022 9:08 pm

Hi Pugsy, thanks so much for central apnea education. Sleep clinic, shared with me today that during sleep study approx 3 years ago, I had 0 central apnea.

At first, believed I was having pap therapy issues, reason for Fitbit, and many discussions with sleep clinic, discover no issues.

Something medically was causing me not to sleep very well, in terms of hours. This month, 14 nights I slept more then 7 hrs, 10 nights I slept under 7 hrs. Sleeping under 7 hrs, my energy varies, from active to not wanting to get out of bed.

6 months ago, I complained of being super hot/sweating, my pillow/shirt would be drenched, even though room temp is 65,. Was told hot flash. I began Testosterone 3 months ago, the symptoms stopped.

Then a month ago, I began having hot burning body sensation occassionally, which awakens me less then 7 hrs sleep.

Endo clinic labs 2 days ago, my Testosterone level is still on the low side. Appt next week.

Hormone imbalance, can disrupt sleep.....

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Re: What is central sleep apnea ?

Post by SleepGeek » Fri Jun 24, 2022 9:17 pm

Architect wrote:
Fri Jun 24, 2022 9:08 pm

Endo clinic labs 2 days ago, my Testosterone level is still on the low side. Appt next week.
They say testosterone also feeds prostate cancer so beware.
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Re: What is central sleep apnea ?

Post by Architect » Sat Jun 25, 2022 1:13 pm

SleepGeek wrote:
Fri Jun 24, 2022 9:17 pm
Architect wrote:
Fri Jun 24, 2022 9:08 pm

Endo clinic labs 2 days ago, my Testosterone level is still on the low side. Appt next week.
They say testosterone also feeds prostate cancer so beware.
Very true, but don't have prostate cancer :wink:

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SleepGeek
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Re: What is central sleep apnea ?

Post by SleepGeek » Sat Jun 25, 2022 3:03 pm

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Last edited by SleepGeek on Sun Jun 26, 2022 6:42 pm, edited 1 time in total.
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dmartinez76
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Re: What is central sleep apnea ?

Post by dmartinez76 » Sun Jun 26, 2022 7:44 am

I’ve heard the use of a CPAP machine can lead to you eventually having central sleep apnea as well, is this true?

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Pugsy
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Re: What is central sleep apnea ?

Post by Pugsy » Sun Jun 26, 2022 8:09 am

dmartinez76 wrote:
Sun Jun 26, 2022 7:44 am
I’ve heard the use of a CPAP machine can lead to you eventually having central sleep apnea as well, is this true?
No. Absolutely not true at all.

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Re: What is central sleep apnea ?

Post by palerider » Sun Jun 26, 2022 4:43 pm

dmartinez76 wrote:
Sun Jun 26, 2022 7:44 am
I’ve heard the use of a CPAP machine can lead to you eventually having central sleep apnea as well, is this true?
One hears a lot of untruths (lies? ignorance? stupidity?) on the internet, that's a prime example.

In other words, no, that's absolutely not true.

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Re: What is central sleep apnea ?

Post by Architect » Sun Jun 26, 2022 5:01 pm

SleepGeek wrote:
Sat Jun 25, 2022 3:03 pm
Architect wrote:
Sat Jun 25, 2022 1:13 pm
Very true, but don't have prostate cancer
Not yet.

Don't you want to keep it that way?
It seems if you live long enuff you will.
Thanks Nostradamus, oh I mean SleepGeek :lol: Well if Androgel, doesn't cause, puffing on cigs will, if I live long enough :shock: :wink:

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Re: What is central sleep apnea ?

Post by SleepGeek » Sun Jun 26, 2022 6:27 pm

Architect wrote:
Sun Jun 26, 2022 5:01 pm
Thanks Nostradamus, oh I mean SleepGeek Well if Androgel, doesn't cause, puffing on cigs will, if I live long enough
You're welcome. I think.

You prob don't wanna know that my doc told me that smoking will kill you before prostate cancer.

So after all you may not have to worry at all :wink:
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Re: What is central sleep apnea ?

Post by Architect » Mon Jun 27, 2022 12:11 am

SleepGeek wrote:
Sun Jun 26, 2022 6:27 pm
Architect wrote:
Sun Jun 26, 2022 5:01 pm
Thanks Nostradamus, oh I mean SleepGeek Well if Androgel, doesn't cause, puffing on cigs will, if I live long enough
You're welcome. I think.

You prob don't wanna know that my doc told me that smoking will kill you before prostate cancer.

So after all you may not have to worry at all :wink:
You doc is wrong, time to get a 2nd opinion :) my family history has no prostate or lung cancer, 3 members have passed from colon cancer though. As for your T-shirt ad, I don't eat donuts. Ice cream will do, thanks... :lol:

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Re: What is central sleep apnea ?

Post by SleepGeek » Mon Jun 27, 2022 8:35 am

Architect wrote:
Mon Jun 27, 2022 12:11 am
You doc is wrong, time to get a 2nd opinion my family history has no prostate or lung cancer, 3 members have passed from colon cancer though. As for your T-shirt ad, I don't eat donuts. Ice cream will do, thanks...
You unwittingly agreed with the doc - Low T then No P.

But smoking could have something to do with the other problem too.

YOU WIN - Ice Cream it is.
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Re: What is central sleep apnea ?

Post by Architect » Mon Jun 27, 2022 3:33 pm

SleepGeek wrote:
Mon Jun 27, 2022 8:35 am
Architect wrote:
Mon Jun 27, 2022 12:11 am
You doc is wrong, time to get a 2nd opinion my family history has no prostate or lung cancer, 3 members have passed from colon cancer though. As for your T-shirt ad, I don't eat donuts. Ice cream will do, thanks...
You unwittingly agreed with the doc - Low T then No P.

But smoking could have something to do with the other problem too.

YOU WIN - Ice Cream it is.
:lol: thanks friend, you certainly are entertaining. All you share is true, no doubt. Just gotta do the best I can :wink:

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SleepGeek
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Re: What is central sleep apnea ?

Post by SleepGeek » Mon Jun 27, 2022 6:16 pm

Architect wrote:
Mon Jun 27, 2022 3:33 pm
thanks friend, you certainly are entertaining
Just trying to make sure future readers don't take things the wrong way.

Architect wrote:
Mon Jun 27, 2022 3:33 pm
All you share is true, no doubt. Just gotta do the best I can
I'm rootin for ya. There is no magic bullet - just keep tryin til it works.
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Re: What is central sleep apnea ?

Post by zonker » Mon Jun 27, 2022 10:03 pm

SleepGeek wrote:
Mon Jun 27, 2022 6:16 pm
Architect wrote:
Mon Jun 27, 2022 3:33 pm
thanks friend, you certainly are entertaining
Just trying to make sure future readers don't take things the wrong way.
??? what is the right way?
people say i'm self absorbed.
but that's enough about them.
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