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200 AHI and Brain Damage? Newbie Here
#1
200 AHI and Brain Damage? Newbie Here
I was given 200 AHI on my first study, 99% central sleep apnea and none of the machines they tried that night helped. 

I have a crazy history with sleep (a lot of sleep walking/talking/terrors and excessive daytime sleepiness to the point I’d pass out and feign awake actions in my sleep).

After the first sleep study my doctor ordered an MRI and echocardiogram to make sure there is nothing serious present. Heart checked out fine and no chiari in my brain (often a sign of those in sleep apnea). 

But 6 years ago after a run in with encephalopathy  I formed a spot on my pons of my brain. Ever since then I have had a noticeable change in my ability to think and articulate. My affect has flattened and didn’t really recover in speech therapy. 

I was wondering if anyone here had some form of brain damage and believe it could be connected to their sleep apnea. My doc said she can’t confirm it.

Oh and I did get a second sleep study and matched with a BiPap that I get small (hopefully soon to be big) comfort from.
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#2
RE: 200 AHI and Brain Damage? Newbie Here
G'day angelineelise. Welcome to Apnea Board. I think you may have set a new record for AHI!

This is not something most of us would have much (if any) experience with, but we do understand CPAP machines in their various forms and hopefully we can help you with that. When I saw you had 99% centrals my immediate thought was that some form of brain or nervous system anomaly might be in play. The pons is very important in controlling many bodily functions. From Healthline:
Quote:As part of the brain stem, the pons also impacts several automatic functions necessary for life. A section of the lower pons stimulates and controls the intensity of breathing, and a section of the upper pons decreases the depth and frequency of breaths. The pons has also been associated with the control of sleep cycles.

For the treatment of central apnea you need an adaptive servo-ventilator, which your machine is. Many people on the forum have had a better experience with the Resmed ASV rather than the Philips, so this may be an option to consider if your current machine doesn't work out. The Philips has a number of controls such as trigger, cycle, Ti-min and Ti-max, all of which have to be set manually, and all of which will affect both the comfort and efficacy of the machine. On the Resmed, these functions are controlled by software, and many people find it's a lot more comfortable machine. You'll need to work closely with your respiratory tech to ensure you get the best out of the machine.

To help understand your machine's settings you can download a copy of the clinical manual from here: https://www.apneaboard.com/adjust-cpap-p...tup-manual

Good luck with your treatment!
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#3
RE: 200 AHI and Brain Damage? Newbie Here
(08-14-2019, 01:03 AM)angelineelise Wrote: I was given 200 AHI on my first study, 99% central sleep apnea and none of the machines they tried that night helped. 

I have a crazy history with sleep (a lot of sleep walking/talking/terrors and excessive daytime sleepiness to the point I’d pass out and feign awake actions in my sleep).

After the first sleep study my doctor ordered an MRI and echocardiogram to make sure there is nothing serious present. Heart checked out fine and no chiari in my brain (often a sign of those in sleep apnea). 

But 6 years ago after a run in with encephalopathy  I formed a spot on my pons of my brain. Ever since then I have had a noticeable change in my ability to think and articulate. My affect has flattened and didn’t really recover in speech therapy. 

I was wondering if anyone here had some form of brain damage and believe it could be connected to their sleep apnea. My doc said she can’t confirm it.

Oh and I did get a second sleep study and matched with a BiPap that I get small (hopefully soon to be big) comfort from.

The only way I can think of that sleep apnea damages the brain that can be seen on a regular MRI is if you get a stroke. Other then that sleep apnea does affect oxygen saturation so a fMRI would show hypoperfusion.

A 'spot' on the other hand? Don't think so, it might be a lesion though, so maybe schedule some more MRI's in the coming months to see if any other lesions don't pop up here and there.

Also you are 99% Central, if pap's not working ask around for a diaphragm pacemaker.
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#4
RE: 200 AHI and Brain Damage? Newbie Here
A quick glance at Wikipedia on the word encephalopathy  (any disease or disorder of the brain).......cheynes-stoke respiration can be a common neurological symptom of encephalopathy.
Sleep-well
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#5
RE: 200 AHI and Brain Damage? Newbie Here
I don't know from brain damage but isn't it a given that the source of central apnea is neurological? failure of the brain signals for respiratory effort (resorting to a layman's over-simplification, no doubt). seems to me that brain issues may affect (cause?) apnea and apnea may affect (cause?) brain issues (particularly cognitive; idk about other issues). these are assumptions, common sense assumptions, I hope, but I have no particular knowledge or authority to back them up.
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#6
RE: 200 AHI and Brain Damage? Newbie Here
Apnea, either Obstructive or Central, can cause oxygen depletion in the blood and subsequent frequently misdiagnosed cause with symptoms such as depression, etc.
Central Apnea is not always, though frequently is neurological in cause. The Chemoreceptors that detect the amount of CO2 in the blood are at times at fault, and then there is the idiopathic or no known cause for Central Apnea.

"Brain issues", stroke, seizure, circulation, drugs, etc,. insufficient oxygen, depending on the region of the brain impacted can conceivably cause apnea.

Cognitive issues no, cannot cause apnea, because breathing is not controlled in the cognitive areas of the brain, though loss of cognitive function can be a symptom of apnea.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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#7
RE: 200 AHI and Brain Damage? Newbie Here
To qualify, an event has to last for at least 10 seconds. Using 10 seconds X 200 AHI = 2000 seconds. Since an hour is 3600 seconds, this would leave 1600 seconds (26.6 minutes) per hour for you to breathe. Could you post a copy of your sleep study? I find this very intriguing. Please omit your name and any personal data prior to posting it.

Thanks!
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#8
RE: 200 AHI and Brain Damage? Newbie Here
Here are pics of 1/3 pages of my report with some graphs.

Here are pics of 2/3 pages of my report with some graphs.

Here are pics of 3/3 pages of my report with some graphs.


Attached Files Thumbnail(s)
           
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#9
RE: 200 AHI and Brain Damage? Newbie Here
(08-14-2019, 03:56 AM)crowtor Wrote:
(08-14-2019, 01:03 AM)angelineelise Wrote: I was given 200 AHI on my first study, 99% central sleep apnea and none of the machines they tried that night helped. 

I have a crazy history with sleep (a lot of sleep walking/talking/terrors and excessive daytime sleepiness to the point I’d pass out and feign awake actions in my sleep).

After the first sleep study my doctor ordered an MRI and echocardiogram to make sure there is nothing serious present. Heart checked out fine and no chiari in my brain (often a sign of those in sleep apnea). 

But 6 years ago after a run in with encephalopathy  I formed a spot on my pons of my brain. Ever since then I have had a noticeable change in my ability to think and articulate. My affect has flattened and didn’t really recover in speech therapy. 

I was wondering if anyone here had some form of brain damage and believe it could be connected to their sleep apnea. My doc said she can’t confirm it.

Oh and I did get a second sleep study and matched with a BiPap that I get small (hopefully soon to be big) comfort from.

The only way I can think of that sleep apnea damages the brain that can be seen on a regular MRI is if you get a stroke. Other then that sleep apnea does affect oxygen saturation so a fMRI would show hypoperfusion.

A 'spot' on the other hand? Don't think so, it might be a lesion though, so maybe schedule some more MRI's in the coming months to see if any other lesions don't pop up here and there.

Also you are 99% Central, if pap's not working ask around for a diaphragm pacemaker.
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#10
RE: 200 AHI and Brain Damage? Newbie Here
Sorry my update to the post didn’t go through. I’ve had this lesion (I call it a spot) since 2013. No more have popped up but with the cognitive effects I still suffer it makes me wonder if that could be a factor in my apnea.

I was just was wondering if anyone else had brain damage and possibly attributed their sleep apnea to it?

Thanks for all the reply’s you guys it’s giving me a lot of thought.
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