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Apnaes: difference between Central / Obstructive ?
#1
Apnaes: difference between Central / Obstructive ?
Hello,
I have understood that when sleeping , the muscles also relax. So, as the tongue is also a muscle, it tends to slide in the way of the air passage; this seems to be Obstructive apnea, ok.
But.. what exactly is the Central apnae? 
What causes it? 
Can the CPAP correct ?
Just some beginner questions. Is there a thread in which I can find the answers?
In my case I have far more CA's than IA's, so that is why I ask.
Thanx in advance,
Hugo
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#2
RE: Apnaes: difference between Central / Obstructive ?
The CPAP will flag events CA or clear airway as the air passage isn't blocked. CA can be caused by a newly too efficient exhalation of CO2- carbon dioxide. 1st type of CA is the PAP treatment causes this too low CO2, and should diminish within 3 months of PAP therapy. This would be the likely diagnosis if CA were absent or very low on your sleep study but you've got some now according to OSCAR. This CA can be managed by CPAP, typically modifying things like lower EPR and no Ramp.

A second type of CA is pre-existing, this has CA on your sleep study at 50% or more vs obstructive. A CPAP may be OK for lower levels of this CA, but mostly an ASV is best. A BPAP without backup rate would be the worst thing you can use here.

3Rd there's a version of CA called idiopathic, means not certain of cause. This type is a maybe on CPAP/APAP, bad or worse on BPAP, and treatable via ASV. The ASV I'd recommend is the ResMed AirCurve 10 ASV.

Post your sleep study redacted with apnea event and count, and OSCAR data and we can help out.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Apnaes: difference between Central / Obstructive ?
Hugo, a few more comments to add to Dave's post. The machine doesn't know whether you're awake or asleep. Awake breathing is less regular than asleep breathing and can include pauses between breaths. If one of those pauses lasts for 10 seconds or more, you'll get a CA flag. If you're actually awake, however, it is meaningless.

Also, obstructive apnea comes about largely through relaxation and enlargement of the tissues in the wall of the pharynx, though additional factors may contribute. More here:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6733731/

Others can correct me if I'm wrong, but I believe CPAP doesn't generate enough pressure to move the tongue if it has slid back and is blocking the airway.
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#4
RE: Apnaes: difference between Central / Obstructive ?
Thank you for your answer.
My CPAP is a WM 090 TD , the data from the card does not seem compatible with OSCAR on my MAC.
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#5
RE: Apnaes: difference between Central / Obstructive ?
(01-01-2021, 01:42 PM)Dormeo Wrote: Others can correct me if I'm wrong, but I believe CPAP doesn't generate enough pressure to move the tongue if it has slid back and is blocking the airway.

Thank you Dormeo,
So the machine is there to prevent the blocking by increasing pressure I suppose.

I am going to try this night with no ramp and low pressure raised from 5 to 6.
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#6
RE: Apnaes: difference between Central / Obstructive ?
I will post my sleep report Monday after receiving a digital copy from my doctor.
I have been measured with 59 apneas/hour!
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#7
RE: Apnaes: difference between Central / Obstructive ?
(01-01-2021, 01:52 PM)Hugosnel Wrote: Thank you for your answer.
My CPAP is a  WM 090 TD , the data from the card does not seem compatible with OSCAR on my MAC.

It appears your machine is partially supported by Oscar.  It might be worth seeing what you could do in Oscar with the data on your SD card.
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#8
RE: Apnaes: difference between Central / Obstructive ?
Excuse me please for talking about my machine being CPAP
The Loewenstein  WM 090 TD is both CPAP and APAP
Just for the good order, I have had it prescribed as APAP (5-12)
Tomorrow I will see if I can import data into OSCAR.
Good night !
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#9
RE: Apnaes: difference between Central / Obstructive ?
I'd agree any PAP isn't powerful enough to move the tongue.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
Wink 
RE: Apnaes: difference between Central / Obstructive ?
it would take a high pressure cleaner I guess LOL

I had a terrific sleep this night.
The first part was ok but ended with the face mask out of place.
I took a break without.
Afterward was real reconstructive sleep, WOW!
The only thing that is bothering me is the enormous amount of Centra Apnaes.
Please advice...


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