central obstruction

tansey · Post by **tansey** » Mon Aug 04, 2008 10:01 am

I gather that this is the nurilogical part of sleep apnea instead of the physical part. What if anything can be done to improve this, kind of scary. Any thoughts on the subject would be appreciated.
Tansey

ozij · Post by **ozij** » Mon Aug 04, 2008 10:56 am

It not an obstruction. It's actually an open airway apnea, when your mind forgets to instruct your lungs to breathe.

The appearance of central apneas under cpap, once the obstructive have been taken care of, is one of the indicators of a condition called "complex sleep apnea " (compsa) or complex Sleep Disordered Breathing.
Click on the compsa link, above, to see an educational brochure from Resmed.

It is thought that about 15% of the people diagnosed initially with OSA have complex sleep apnea.

Treatment is done with using a different kind of positive air pressure machine.

Don't be too frightened - this may just be your central nervous system responding to the admittedly weird experience of being on cpap.

O.

birdshell · Post by **birdshell** » Mon Aug 04, 2008 10:57 am

This is one probably best answered by a sleep tech, but...

As far as I know:

Centrals are caused by the message to breathe not getting through the neurological pathways to the body. Technically, those nerves are a part of our physical bodies, but they are the "electrical system". A better way to express that "physical" part might be to call it anatomy (which means structure) that causes apnea.

Centrals seem to me to be a problem with physiology, or function, of the body. Centrals have more to do with the operation of the body. All problems are classified as "sleep disordered breathing".

There isn't so much that one can do, except to use one's CPAP [or other prescribed device(s)]. It will take up the job of breathing for you when your body decides to take a break from that!

That is my understanding, but I don't have centrals. Maybe someone else will have more information or will correct me.

Karen,

ozij · Post by **ozij** » Mon Aug 04, 2008 11:03 am

No, not exactly. A central sleep apnea is the result of the message not being sent from the brain to those pathways. I think that if the message is sent, and does not get through, that would be a peripheral problem.

We must have been composing our replies at the same time:

Resmed in the above mentioned link wrote:The difference between central, mixed and complex sleep apnea
CSA is a form of sleep-disordered breathing (SDB) caused by the temporary absence of a signal from the brain’s respiratory center. Without this signal, there is no effort to breathe. Mixed sleep apnea is fairly common and consists of both central and obstructive components. On the other hand, CompSA consists of all or predominantly obstructive apneas which convert to all or predominantly central apneas when treated with a CPAP or bilevel devices.

O. who is by no means a sleep tech...

tansey · Post by **tansey** » Mon Aug 04, 2008 11:16 am

Thanks all, i've kind of been diagnosed with Central, damn it Before I increased my pressure I would wake up because I had stopped breathing and have to make an extreme, concious mental effort to force my self to breathe a gain, usually with a huge gasp. Not pleasant!
So I guess my "Mind ain't right" any more. There are no drugs for this condition?

ozij · Post by **ozij** » Mon Aug 04, 2008 12:37 pm

Have you had your PSG already?

I don't know of any drugs for either CSA or COMPSA.
Are you OK now with the increased pressure?

O.

tansey · Post by **tansey** » Mon Aug 04, 2008 1:12 pm

I am waiting for the sleep clinic to phone me for an appointment. I guess I won't really know until then. The doctor asked me not to stay alone on my boat anymore, but I don't think I can comply with that, it's just such a big part of my life. It is very upsetting to me that he said that.

jnk · Post by **jnk** » Mon Aug 04, 2008 1:26 pm

I was told my driving of any vehicle should be "restricted" (whatever that means) until my OSA therapy was going well. I took it to mean that my doctor cared, AND that he had to cover his behind if I had an accident in which someone got hurt from my driving drowsy, and so it was best for someone aware of my condition to be next to me when I drove, if possible. I tried to look at it as a basic common-sense reminder and tried not to take it personally. Do you think your doc might have meant something like that?

Snoredog · Post by **Snoredog** » Mon Aug 04, 2008 1:33 pm

what do they have your pressure currently set at on the Pro?

they don't really KNOW the cause of Central Apnea, they are only guesses and theory.

About the only headway they have made in addressing it is stabilizing your breathing and it goes away on its own.

tansey · Post by **tansey** » Mon Aug 04, 2008 2:59 pm

JNK, I took it that he was concerned I might die in my sleep, he did not mention driving. Before I got on cpap I slept sitting at a table with my head on my arms as I stopped breathing so long and so often I feared i might not wake up. He also said it would be best not to sleep alone. Snoredog, I have the pro set on 10, since I went to that higher setting I have not stopped breathing, at least not that I am aware of, that gives me hope that I can lead the life I wish to, but with cpap.
Tansey

jnk · Post by **jnk** » Mon Aug 04, 2008 3:44 pm

tansey,

Oh, sorry, I must be confused. In fact I must be misunderstanding all of what you are saying, because I read:

i've kind of been diagnosed with Central

I increased my pressure

I went to that higher setting

It sounds to me like you need to double-check with your doctor exactly what your pressure setting is supposed to be at and that then you should have someone help you to make sure that is what your machine is set at. Then listen very carefully and closely to everything your doctor says.

tansey · Post by **tansey** » Mon Aug 04, 2008 4:07 pm

OK, to be more precise: I saw the doctor and he said he "thought" it might be central, I set my own machine higher and higher until I no longer stopped breathing, I did this because I could not get an appointmant and had no other option I could see, I told him this and he was fine with it, I am awaiting my night at the sleep clinic. They will find out what my setting should be, he also mentioned bipap. I guess until I have that night, all is speculation. I was just worried and upset.
I will not allow myself to worry.
Just deal with the reality of the diagnoses when I get it.
Thanks to all, Tansey

jnk · Post by **jnk** » Mon Aug 04, 2008 4:16 pm

Don't worry--after all, you're going in for a study!! I am sure you will get just what you need from the sleep study. I hope my attempt to be helpful didn't make you upset. It just worried me that it sounded for a minute there like you were raising your pressures to deal with centrals, and I don't think that's ever the thing to do, from what I understand.

If you know already what sleep clinic you are going to, call them and volunteer to come in on short notice if anyone cancels, if you are in a position to do that. That got me in early twice--both for my diagnostic study and my titration study. And the schedulers thanked ME for doing THEM that favor! Hey, it's worth a shot, right?

tansey · Post by **tansey** » Mon Aug 04, 2008 4:22 pm

jnk wrote:Don't worry--after all, you're going in for a study!! I am sure you will get just what you need from the sleep study. I hope my attempt to be helpful didn't make you upset. It just worried me that it sounded for a minute there like you were raising your pressures to deal with centrals, and I don't think that's ever the thing to do, from what I understand.

If you know already what sleep clinic you are going to, call them and volunteer to come in on short notice if anyone cancels, if you are in a position to do that. That got me in early twice--both for my diagnostic study and my titration study. And the schedulers thanked ME for doing THEM that favor! Hey, it's worth a shot, right?

___no, not at all. you made me realize I was jumping the gun a bit and just need to have my study and go from there. I thank you for that. It took me 6 months to get my appointment with the doc, so frustrating. thank you again, Tansey______________

CPAPopedia Keywords Contained In This Post (Click For Definition): Titration

birdshell · Post by **birdshell** » Mon Aug 04, 2008 4:38 pm

jnk wrote:I was told my driving of any vehicle should be "restricted" (whatever that means) until my OSA therapy was going well. <snip>

My sleep lab had a form for me to sign after my first PSG. It stated that I understood that I had apnea and my driving could be impaired unless treated. Thus I could not say I had not been informed, and the lab would not be responsible for any accidents that might ensue.

Now, THAT really tops off a PSG and being told that you have apnea and need to return.

Further, going way back:

Thank you, ozij, for a more correct version of a central event. I was assuming that there could be something wrong ANYWHERE along the electrical impulse pathway. It is good to know that it is a brain problem.

I love this forum because we are all better together than we are alone.

Karen,
Who thinks OSA is enough!