Seems Like I have Central Sleep Apnea - Switch to Bipap Worth it?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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lazarus
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Re: Seems Like I have Central Sleep Apnea - Switch to Bipap Worth it?

Post by lazarus » Tue Aug 22, 2023 5:17 pm

Rubicon wrote: ↑
Tue Aug 22, 2023 1:08 pm
 . . . what a "post-arousal central" is?
Something to be excluded when evaluating the possibility of treatment-persistent CSA?
"In order to prevent misdiagnosis of treatment-persistent CSA, it is crucially important to identify and treat any underlying diseases. Sleep insufficiency, insomnia and arousals can contribute to the transient emergence of CSA. Excessive titration, post-hyperventilation or post-arousal apnoea, and excessive mouth leakage, misclassification of central hypopnoeas, split-night error, and adaptation of the loop gain after resolution of upper airway obstruction have to be excluded, and do not fulfill the diagnosis of treatment-persistent CSA."--European Respiratory Journal 2017 49: 1600959; DOI: 10.1183/13993003.00959-2016 https://erj.ersjournals.com/content/49/1/1600959
Although, when an experienced officer asks a question of one of the other participants in the meeting, I'm never completely sure if someone is about to get in trouble or if it is about to be a pure teaching moment.

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Last edited by lazarus on Tue Aug 22, 2023 5:28 pm, edited 2 times in total.
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dataq1
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Re: Seems Like I have Central Sleep Apnea - Switch to Bipap Worth it?

Post by dataq1 » Tue Aug 22, 2023 5:19 pm

https://www.sciencedirect.com/topics/m ... leep-apnea

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ozij
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Re: Seems Like I have Central Sleep Apnea - Switch to Bipap Worth it?

Post by ozij » Tue Aug 22, 2023 7:43 pm

lazarus wrote: ↑
Tue Aug 22, 2023 5:17 pm
Rubicon wrote: ↑
Tue Aug 22, 2023 1:08 pm
 . . . what a "post-arousal central" is?
Something to be excluded when evaluating the possibility of treatment-persistent CSA?
"In order to prevent misdiagnosis of treatment-persistent CSA, it is crucially important to identify and treat any underlying diseases. Sleep insufficiency, insomnia and arousals can contribute to the transient emergence of CSA. Excessive titration, post-hyperventilation or post-arousal apnoea, and excessive mouth leakage, misclassification of central hypopnoeas, split-night error, and adaptation of the loop gain after resolution of upper airway obstruction have to be excluded, and do not fulfill the diagnosis of treatment-persistent CSA."--European Respiratory Journal 2017 49: 1600959; DOI: 10.1183/13993003.00959-2016 https://erj.ersjournals.com/content/49/1/1600959
Although, when an experienced officer asks a question of one of the other participants in the meeting, I'm never completely sure if someone is about to get in trouble or if it is about to be a pure teaching moment.
Worth emphasising:
  • Sleep insufficiency, insomnia and arousals can contribute to the transient emergence of CSA.
  • Excessive titration,
  • post-hyperventilation or post-arousal apnoea, and
  • excessive mouth leakage,
  • misclassification of central hypopnoeas,
  • split-night error, and
  • adaptation of the loop gain after resolution of upper airway obstruction
have to be excluded, and do not fulfill the diagnosis of treatment-persistent CSA.

And, worth remembering:
Transient emergence
Treatment persistent
Treatment emergent
are 3 different things.

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Forum member Dog Slobber Nov. 2023
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dataq1
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Re: Seems Like I have Central Sleep Apnea - Switch to Bipap Worth it?

Post by dataq1 » Tue Aug 22, 2023 9:30 pm

Rubicon wrote: ↑
Tue Aug 22, 2023 3:44 pm
 Just a brief discourse on post-arousal centrals.
This is the way I understand it. Post-arousal clear airway apnea events are those apneas that are not obstructive (as detected by FOT) that follow a cortical arousal (one in which the patient may not even be aware (conscience) of being aroused).

An example of which could well be immediately following a sigh, or an anxious moment within a dream, or repositioning in bed, or a neighbor's dog barking, or a light being turned on, or, or, or,,,,,

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blaird89
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Re: Seems Like I have Central Sleep Apnea - Switch to Bipap Worth it?

Post by blaird89 » Wed Aug 30, 2023 11:06 am

dataq1 wrote: ↑
Thu Aug 10, 2023 10:01 am
I agree with Rubicon, the short answer to 'should I consider a BiPaP' is "no". Perhaps a more complete answer would be, your doctor may consider a BiPapP trial, before finally prescribing an Auto Servo Ventilator.
This makes a lot of sense thank you.
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