Central apnea from CPAP therapy?

Hello!

I am not a native speaker, so I apologize for my English. I try my best and I hope you can understand me and my question/problem.

I wondered about the report from the sleeping laboratory. It did say that I don't have any obstructive apnea. But the AHI was between 9 and 10 in both nights. So there have been about 50 central apnea each night.
The doctor now explained me that this can be from the CPAP therapy and that this is accepted in the CPAP therapy. Can that be true?
If I understand my doctor correctly it means that the CPAP kills the obstructive apnea (in my case completely), but develop some central apnea?

Best regards
Trabbi

Using Cpap at a pressure setting that is quite high (15-20) or higher than was prescribed by the doctor has been known to cause centrals, but that's not common, and I would talk to your doctor again if you're worried. Why would you be on Cpap if you don't have sleep apnea anyway? Or do you mean just the night you were being tested and wearing a mask? I would think it would be very unlikely to have caused central apnea just on 1-2 nights of even a high pressure setting used just for testing. But if you are tested again, and central apnea does seem to be there, there are special machines that are more effective to use than just the "regular" cpap machines and they work slightly differently. They are called bi-pap, or vPap machines and your doctor should know about them (or learn, if he doesn't).

Thanks for your reply, Julie

My machine (CPAP; Respironics Somnia 2) is working with the air pressure 10. The central apnea was measured when I was in the sleeping lab (for 2 nights). But I got already the CPAP machine before I was in the sleeping lab (I had some other kind of machine at home for one night; that machine did notice a lot of "breath stops"[sorry again for my English, I hope you can guess what I mean]). Could this machine I had at home really find out what kind of machine I need (BiPAP/CPAP)? The machine had 2 plugs that I did put into my nose and some sensors I had on my breast area and something around my body at the belly area.

Actually I am worried. I don't want to suffer by a wrong therapy. I am still new to this and I am using the machine at home since less than 2 weeks.

Regards
Trabbi

First you should know that a lot of us have some centrals register on our sleep studies. It doesn't necessarily mean anything, certainly nothing to worry about. It's only if you continue to have them while on Cpap at home, and have a lot of them that you should do something about them. Breath stops could be apneas, depending on how long they last, or hypopneas if they're like very small and short apneas. If you have a copy of your test report in English, why not post it here so we can see what it said?

If I understand your story correctly, it sounds as if you were given a CPAP machine for an at-home sleep study. You did that and the results showed that you have obstructive sleep apnea. You went to the sleep lab for two more studies, at least one of which was for a CPAP titration. The purpose of a titration is to determine the pressure needed to eliminate the obstructive apneas and hypopneas. During your titration, the pressure was increased until your obstructive apneas and hypopneas disappeared. And during that process, it sounds as if central apneas appeared above a certain pressure. If that is what happened, then it's likely you have complex sleep apnea.

I have complex sleep apnea. My first sleep study was done in a sleep lab rather than at home, and I was found to have obstructive sleep apnea. During the second study (the CPAP titration study), the CPAP pressure was titrated (this means it was slowly increased, unit by unit) to 9 cm H20. At 6 cm H20 and higher, I had CPAP-emergent central apneas. A pressure high enough to eliminate the obstructive apneas/hypopneas caused central apneas. Of course, both obstructive and central apneas are apneas--"breath stops" as you called them. A good description!

There is no need to fear complex sleep apnea. It is more complex and therefore more difficult to treat, but the technology for treating this form of sleep apnea is improving. Your doctor may decide to give you something other than a CPAP machine. I was told I might eventually have a BiPap S/T or an ASV (auto servo ventilation) machine. I recently got an ASV. I had another titration study to determine the correct pressures for this machine.

Julie's suggestion that you post a copy of your test report (if it's in English) is a good one. Then maybe we could give you some more specific information.

wearysoul

My first night on CPAP and I must have had a dozen centrals or more. I could sense myself slowing my breath to a stop and waking up to breath. If you just started, you might get better.

Hello and welcome. I agree that having the specifics of the reports would be helpful. Until then, I have a couple questions. Was your first night in the sleep lab with or without wearing a cpap machine? If it was without, and you had a lot of centrals, that's a different picture than not having centrals until using the cpap. If the centrals are cpap induced, they may improve as you adjust to the treatment. However, there really should be a plan in place to confirm that they don't continue to be an issue, and to monitor their impact. There are machines that can recognize and report centrals, and as has been stated, ones that can even treat them. Wearing a recording oxygen monitor overnight could be useful. Start compiling a list of questions for your doctor.

kteague wrote:Was your first night in the sleep lab with or without wearing a cpap machine? If it was without, and you had a lot of centrals, that's a different picture than not having centrals until using the cpap. If the centrals are cpap induced, they may improve as you adjust to the treatment. However, there really should be a plan in place to confirm that they don't continue to be an issue, and to monitor their impact.

Good questions, kteague. I guess I skipped over the possibility that the centrals might not be CPAP-induced. wearysoul

I had quite a few centrals during the titration portion of my sleep study (a one-night or 'split study', where the first half of the night was diagnostic, and the second half CPAP titration). The recommendation was that I be re-titrated, but my doctor wisely decided to just start therapy and see what happened. Using an auto adjusting CPAP (called an APAP here), the therapy worked well, and the centrals were very low. Oddly, as I have slowly worked up to the correct pressure (which I am having to titrate myself because I get widely varying results), my occurrence of centrals has actually decreased. Go figure!

Thank you very much for all the replies! I will try to answer all questions (and give more informations soon).

wearysoul wrote:If I understand your story correctly, it sounds as if you were given a CPAP machine for an at-home sleep study.

It was not a CPAP machine. I don't know the name, but I think they called it "sleep screening". It was a machine that could measure if I breath or not. The machine did find out, that I have a lot of breath stops while sleeping.

wearysoul wrote:Julie's suggestion that you post a copy of your test report (if it's in English) is a good one.

I am sorry, but I only have it in German language. But I can try to translate some part of it. Today I don't have a lot of time, but I think I can post some part tomorrow.

kteague wrote:Was your first night in the sleep lab with or without wearing a cpap machine?

It was with a CPAP machine (Respironics Somnia 2 C-Flex).

Regards
Trabbi