Re: Question about CPAP-induced Centrals
Posted: Mon Aug 12, 2013 10:45 am
So lets start with a discussion about what a CPAP induced central apnea is. The pressure of CPAP makes it easier to inhale. Our exhale muscles are usually strong due to talking and all so the usual result is that we use more air while using CPAP. If we have some “nerve” issues going into the night (in my case “nerves” say from the anniversary of a traumatic assault upon my person) this adds to the tendency to breath more. At a certain point it would appear that this tendency “runs away” to the point were an arousal occurs likely due to the excessive respiratory effort from all that breathing. By this point we have breathed too much oxygen into our blood stream and blown off too much carbon dioxide. There is no reason to breath and good reason to not breath and so we do not breath for a time.
One of the issues brought into the picture by the above event is that with the arousal comes an increase in our stress hormone levels. So it is more likely that there will be another event.
A second issue that I have noticed for myself is that breathing too much tends to stuff up my nose, it tends to make my mouth dry and to otherwise cause inflammation in my upper airway. So I tend more toward obstructive events.
If obstructive events occur they ratchet up the stress hormones, which tends more toward over breathing. If the start of the tendency to over breath is caused by an obstructive event then increasing pressure will tend to help. But increasing pressure will tend toward using more air and causing hypocapnic central apnea events (like the CPAP induced apnea events) to be more intense.
So then, the major factors involved:
Chemoreflexes
Stress levels
Inflammation
Lets start with those little things we can do to help with inflammation:
Eat less inflammatory foods and more anti-inflammatory foods
Raise the head of your bed a few inches (less blood pressure in the airway passage due to gravity).
Next lets look at Stress Level control:
I moved away from a high crime city. I have found this a very wise choice
I have found it useful to use music or audio books to help with the process of going to sleep. If the early night goes well the rest of the night is helped.
Many find meditation useful. I find that seeking beautiful things (in sight sound taste or smell) to be helpful.
And finally some little things to help with chemoreflexes:
Aerobic exercise and especially doing 85% of your maximum heart rate interval training seems to help me with this (note: you need to get in shape to try the interval training stuff).
Spending time with the machine during the day, learning to breath quietly as you should be while sleeping at night and with light distraction such as a book, light TV, music can help get the body used to what is going on and help to develop good response.
I have found pulse oximeter guided eucapnic breathing helpful.
HTH
Todzo
One of the issues brought into the picture by the above event is that with the arousal comes an increase in our stress hormone levels. So it is more likely that there will be another event.
A second issue that I have noticed for myself is that breathing too much tends to stuff up my nose, it tends to make my mouth dry and to otherwise cause inflammation in my upper airway. So I tend more toward obstructive events.
If obstructive events occur they ratchet up the stress hormones, which tends more toward over breathing. If the start of the tendency to over breath is caused by an obstructive event then increasing pressure will tend to help. But increasing pressure will tend toward using more air and causing hypocapnic central apnea events (like the CPAP induced apnea events) to be more intense.
So then, the major factors involved:
Chemoreflexes
Stress levels
Inflammation
Lets start with those little things we can do to help with inflammation:
Eat less inflammatory foods and more anti-inflammatory foods
Raise the head of your bed a few inches (less blood pressure in the airway passage due to gravity).
Next lets look at Stress Level control:
I moved away from a high crime city. I have found this a very wise choice
I have found it useful to use music or audio books to help with the process of going to sleep. If the early night goes well the rest of the night is helped.
Many find meditation useful. I find that seeking beautiful things (in sight sound taste or smell) to be helpful.
And finally some little things to help with chemoreflexes:
Aerobic exercise and especially doing 85% of your maximum heart rate interval training seems to help me with this (note: you need to get in shape to try the interval training stuff).
Spending time with the machine during the day, learning to breath quietly as you should be while sleeping at night and with light distraction such as a book, light TV, music can help get the body used to what is going on and help to develop good response.
I have found pulse oximeter guided eucapnic breathing helpful.
HTH
Todzo
