Central Sleep Apnea

Hey there....long time reader, first time poster....

I was diagnosed with OSA as well as Central Apnea, more than 4 years ago! I have been on a couple different machines during this time (my insurance is pretty good about updating the machine). The Dr put me on oxygen for the Central Apnea, as well as for my O2 levels going low...but the insurance company would not renew my oxygen contract....? I have no idea, but that is not what my question is about.

I have gone to a couple different Drs throughout the past 4+ years, and each one has said something different about the Central Apnea. One told me not to be too concerned, another told me that Central Apnea is a sign of a nurelogical issue. I have surfed the web for some answers, and find different beliefs there as well...

I get concerned when I read stuff like:
"Central sleep apnea usually occurs in people who are seriously ill. For example, it can occur in people with a variety of severe and life-threatening lower brain stem lesions. The brainstem controls breathing. As a result, any disease or injury affecting this area may result in problems with normal breathing during sleep or when awake."

OK....I have never been seriously ill, I believe that my health is in better than average (I am in the military).


"Conditions that can cause central sleep apnea include:
Bulbar poliomyelitis, Encephalitis affecting the brainstem, Neurodegenerative illnesses, Stroke affecting the brainstem.
Other causes include complications of cervical spine surgery , secondary radiation in the region of the cervical spine, severe arthritis and degenerative changes in the cervical spine or the base of the skull, or primary hypoventilation syndrome."

Uhhhh.....no? I have never been diagnosed with any of these, or as far as I am aware, have any of these issues....

"There is a form of central sleep apnea that commonly occurs in people with congestive heart failure."

No there as well...(lol)...so then I find this:

"Finally, idiopathic central sleep apnea is when the apnea is not associated with another disease."

What does that mean?? I guess I am just asking if there is anyone with any ideas, suggestions, etc. on Central Sleep Apnea. BTW, the sleep clinic says that my Central Apnea is just as prevelant as my OSA.......is that bad too??

Thanks for listening!

As I understand it Central Sleep Apnea can be brought on simply by having used a Cpap machine over a number of years - thats probably what is causing yours. There are cpap machines that handle the Centrals.
Ken

gtrump wrote:"Finally, idiopathic central sleep apnea is when the apnea is not associated with another disease."

What does that mean??

Idiopathic just means that the cause is unknown. In a medical context, that translates to, "we've looked at all of the usual causes, and nothing applies. We have no idea why you've got this problem, but here's how to treat it." Idiopathic isn't a judgmental word. It's a descriptor that covers the cases where somebody may have a condition but nobody can figure out why.

Doug.

Kenv wrote:As I understand it Central Sleep Apnea can be brought on simply by having used a Cpap machine over a number of years

I have never heard that.

"Central Sleep Apnea" is a sleep breathing disorder of its own - completely different from the much more prevalent "Obstructive Sleep Apnea" that most of us have and different even from the CompSAS that some people have.

Ken, are you sure whoever told you that is not confusing "Central Sleep Apnea" with "CompSAS?" And furthermore, misunderstanding CompSAS? Complex Sleep Apnea Syndrome...also referred to as CSBD...complex sleep breathing disorder.

People with CompSAS will have central apneas pop up in massive numbers when they are put on cpap, but it will show up right then and there during the sleep study cpap titration -- if the sleep tech and sleep doctor are familiar with it at all (which they SHOULD be.)

As far as I know even CompSAS is not something that develops over the years DUE to cpap use. It's there from the get-go, but doesn't become apparent until cpap is applied -- right there at the sleep study titration night.

Even CompSAS should not be confused with temporary centrals that might pop up occasionally during a cpap titration and will subside on their own during the titration, as the body gets used to the change in pressure.

As far as I know, people for whom CPAP use does not cause centrals are not going to develop "Central Sleep Apnea" simply from using CPAP, no matter how many years they use it. I've just never heard that or read that anywhere. But, hey, I'm not a doctor or anything at all in the health care field.

Then there are "sleep onset centrals" which are normal to have when drifting off to sleep, and are not a sleep breathing "disorder" at all, nor are they supposed to be treated.

Links to Central Apnea discussions
viewtopic.php?p=22702

gtrump wrote:Hey there....long time reader, first time poster....

I was diagnosed with OSA as well as Central Apnea, more than 4 years ago!

...

What does that mean?? I guess I am just asking if there is anyone with any ideas, suggestions, etc. on Central Sleep Apnea. BTW, the sleep clinic says that my Central Apnea is just as prevelant as my OSA.......is that bad too??

Welcome to the confusing world of sleep disorder information gathering. If you are an inquisitive type, you will be doubly confused trying to makes heads and tails out of bits and pieces of info you'll pick up here and there.

How many sleep studies have you had?

I ask because I've had two PSG's (polysomnographs). The first showed central apneas out the ying yang (over 50% of apneas) before and during CPAP titration. In fact, while on CPAP, all my apneas were centrals.

I'm not sure what the second PSG showed because getting information out of my sleep medical practitioners is like pulling teeth. But since I was scheduled for a possible ASV (adaptive servo ventilation device) titration (for central apnea) during the second PSG and that didn't occur, and they simply retitrated me on CPAP, which I continue to use, I now assume the central apneas are either completely gone or are reduced to a level below the original concern and below required treatment.

I hope to find out more from the summary PSG info I've requested, and in a couple weeks at my follow-up visit, but until then I can only speculate, which may give you some food for thought, but likely won't help you much. Anyway...

If you haven't had a second sleep study, you can't know if your central apneas are gone or not. So...

How many sleep studies (PSG's) have been performed on you?

If one, I'll share my layman's theory than might include you. If two or more, I've wasted a lot of words.

Hi:

I was using a cpap machine for some years. When I told my doctor that I thought the machine was not helping me any more, he ordered another sleep test. This new test showed central and obstructive sleep apneas and my doctor said that the cpap would not help me with the central apneas.. Now I have a BiPAP machine set to control the central sleep apneas.
It is true that the central's developed after some years on CPAP. My doctor said they can develop if you have had a stroke. I was very sick as a child and I could have had a mini stroke.
I dont know what caused my central sleep apneas but I do know that a Bipap machine is needed,

gtrump

As you can see from the recent posts, there are many opinions on central apneas and there can be many causes.

Although it is true that some CPAP settings can bring on centrals, as
RestedGal said, a good lab would see that during a PSG.

BiPaPs are usually the first attempt to correct centrals, or have been.

Cases of idiopathic CSA, which I have, are sometimes best dealt with using
the ResMed ASV (which has a broader user base) or the Respironics unit that works slightly differently - but both were designed initially to help CSA
users that had heart failure.

The machines have broad applicability to tougher cases.

The advice that you received, to have more than one PSG, is excellent.
And if the lab hasn't had at least 10 or so cases similar to you and experience with all the various machines, then find a new lab.
Not everyone has the skills to properly treat complex sleep cases, in
my opinion.

I have had 6 PSGs over the years, (all with lots of centrals) and am having good luck with the
ResMed ASV, external ox and some extra things prescribed by a specialist.

Lubman[/b]