CPAP causing Central Sleep Apnea?

Hello! While checking out how to tell the difference between normal leaking and leaking that hinders myCPAP treatment, this comment from the Mayo Clinic popped up. If this is true, then it's very disconcerting. Has anybody developed central sleep apnea as a result of using the CPAP machine? Best.

Doubt it Your very first post indicated that your AHI was very low. With an AHI that low, it wouldn't matter if ALL your events were Centrals. You wouldn't have Central Apnea.

No. It's best not to randomly Google stuff because soon you will convinced you have cancer and have weeks left to live. Treatment should only be guided by data, and empirical evidence, that is put into context.

Machines are made to compensate for leaks and maintain your pressure up to a point. If you have large leaks beyond what the machine is designed to compensate for, your treatment could be affected. Your data should tell you how you are doing with leaks. As for pressure causing central sleep apnea, it can happen. A friend of mine needed a pressure of 25, and that caused him to have central events. He uses a machine designed to treat both the obstructive and central events. I'm guessing those having this problem with average pressures are few and far between. Now, that won't matter much to one who is the exception. I remember reading on here years ago of someone with a low pressure (5 or 7 ???) who was sensitive to the pressure in this manner. Again, most machines will pick up on this and the data will help you recognize and address these issues should they arise. It's good to be aware of potential problems, but I wouldn't worry too much unless you know you have cause. For me, monitoring my data gave me a sense of security so I didn't have to wonder.

If you're not having "Clear Airway" events, don't worry about this. It does not apply to you.

If you are, then you need to start asking about this.

I was diagnosed with central and obstructive sleep apnea and hypoxia by the CO sleep inst, and have a cpap machine. It turns out that even after using the cpap for 2 months, I still had hypoxia (I knew this because I also had an SPO2 vibe). First response was auxiliary o2 concentrator with cpap, and ive used that for some time now, however, considering my age (57) and activity level/diet/weight/blood sugar/triglycerides (pretty good), i also asked why i had hypoxia. Anyway, long story short, he referred me to a pulmonologist who got a full pulmonary function test, and they did find some constricted airway, probably exacerbated by age-onset allergies, so i now have a 2x daily inhaler and a rescue inhaler, and my o2 is probably improved enough to stop supplementary o2, and just use cpap, after CSI confirms that with an official nighttime O2 test.

Anyway, my pulmonologist said that hypoxia may cause central sleep apnea, and i know in my early days of my cpap treatment, I knew (spO2 vibe again) that the starting pressure level was so low that I was actually getting less o2 starting up than i got without using the cpap at all. So I told CSI that, and they raised the starting pressure, and turned off the ramp. This also had the side effect of making me feel like i could breathe better at beginning of treatment, and if i hadnt had the spo2 vibe, i might have attributed that to claustrophobia. So, yes, use of cpap did lead to lower oxygen at start of treatment, and i feel like this could exacerbate central apnea. YMMV. No warranties expressed or implied.

There is a relatively small percentage of people who start cpap therapy for OSA and they had no issues with a large number of central apneas prior to starting cpap...that will develop central apneas in numbers worth worrying about.
It doesn't have to be higher pressures either...it can be with as little as 5 cm pressure.

First of all seeing an occasional central apnea flag doesn't mean a person has central sleep apnea. It's normal to have a handful of centrals during the night anyway. Like it's normal to have what is called a sleep onset central or sleep stage transition central.
Not to mention sometimes the machine will flag awake breathing pauses as a central and awake stuff isn't real and doesn't count.

If someone does develop central apneas in numbers that are a concern there are some options available.
Sometimes the body learns to adjust and the centrals go away on their own without any special treatment. Sometimes they don't and a person needs a different machine.

If a person's AHI on cpap was 3.0 and 2.0 of that average was centrals...even if they were all the real deal it's not enough to earn the central apnea diagnosis or worry about. Doctors won't normally even raise an eyebrow until they see at least 5 central apnea average per hour...every night and for most of the hours during the night.

So yes, cpap pressure can cause centrals to pop up when none were present before. Last I read maybe 10 to 15 % of the people who start cpap will have centrals pop up in numbers that are worth worrying about. Everyone will have a few centrals here and there...it's normal and not a problem. Centrals only become a problem when in large numbers and causing problems. When in doubt...run your concerns by your doctor.

Once again, thank you all for such helpful comments! After seeing 2 nights' worth of CSA results, I was scared - until the posters on this site put my numbers into perspective (usually 0.1 and 0.2 now, had gone to 0.9 once). Clearly, my scared reaction was unwarranted. Many thanks for your replies. Best.

laprof wrote: ↑

Fri Jul 13, 2018 7:54 am

Once again, thank you all for such helpful comments! After seeing 2 nights' worth of CSA results, I was scared - until the posters on this site put my numbers into perspective (usually 0.1 and 0.2 now, had gone to 0.9 once). Clearly, my scared reaction was unwarranted. Many thanks for your replies. Best.

For some reason, central apnea has a bad reputation, and people think, like you did, that even a single central is 'bad news'.

Not sure where that comes from... maybe it's the "these machines don't treat central apneas"... I don't know.