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[CPAP] CENTRAL APNEA
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Kate Offline

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Post: #1
CENTRAL APNEA
Hello All,

I don't really understand how the a CPAP machine works. I guess it just blows room air under pressure to keep your airway open. But 90% of my apnea events are central not closed airway. Will the auto pressure (ResMed 9) machine take care of those or do you have to have ASV? The sleep disorder doctor that I was seeing said that it would, but I'm not sure. Thanks.

Kate

:Using cpap then vpap since Feb.2013,
Kate
12-06-2013 03:30 AM
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Tez62 Offline

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Post: #2
RE: CENTRAL APNEA
Kate, it really depends on how many centrals you are getting, I have complex sleep apnea or both centrals and obstructive, my obstructives are treated by the auto CPAP and in turn don't get as many centrals. If you have straight central sleep apnea you have the wrong machine, what is the break up in ResScan between the two? If you total AHI is under 5 you should be ok.
(This post was last modified: 12-06-2013 04:33 AM by Tez62.)
12-06-2013 04:33 AM
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DeepBreathing Offline
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Post: #3
RE: CENTRAL APNEA
(12-06-2013 03:30 AM)Kate Wrote:  I don't really understand how the a CPAP machine works. I guess it just blows room air under pressure to keep your airway open.

Hi Kate

Yes, the machine basically works by pressurising your airway to keep it open. It detects the difference between an obstructive (blocked airway) and central (open airway) apnea by sending little pulses of pressure when it detects the apnea. It then measures the presence of "echos" which tell it if the airway is open or closed.

I had mainly central apneas and the therapist tried me on an autoset machine at first to see if it could control them. Unfortunately it didn't and I then changed to an ASV which has pretty much eliminated all apneas.

There's no harm in trying an autoset first, but if that doesn't work then change to the ASV. (Obviously you need to consider cost and your insurance situation).

Good luck.

DeepBreathing
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-06-2013 04:41 AM
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PaulaO2 Offline
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Post: #4
RE: CENTRAL APNEA
A regular CPAP machine, such as an autoPAP, will not treat central events. It is normal for a person with Obstructive Sleep Apnea (OSA) diagnosis to have a few central events during the night.

Central Sleep Apnea (CSA), if the primary diagnosis, requires the ASV unit to treat.

Mixed Sleep Apnea can sometimes be treated with a regular CPAP unit but usually requires the ASV unit. It depends on the reason for the central events.

Some people experience an increase in central events when they first start using the CPAP. These events almost always decrease with time and go away after only a few months, if that long.

PaulaO2
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
12-06-2013 04:00 PM
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vsheline Offline

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Post: #5
RE: CENTRAL APNEA
(12-06-2013 03:30 AM)Kate Wrote:  Will the auto pressure (ResMed 9) machine take care of those or do you have to have ASV? The sleep disorder doctor that I was seeing said that it would, but I'm not sure.

Hi Kate, welcome to the forum!

Centrals are sometimes caused by the Positive Airway Pressure itself (which is needed to prevent obstructive events). This is called Complex Sleep Apnea (CSA).

I suppose what the doctor had in mind is that our pressure needs vary throughout the night but a fixed pressure CPAP machine usually needs to be set to a relatively high pressure all night, even though we may need high pressure for only a small portion of the night

APAP machines are usually adjusted to provide a lower PAP until collapse or partial collapse of the airway is detected. An APAP machine automatically adjusts only as high as needed to treat obstructive events. The lower average pressure produced by the APAP machine may reduce the number of centrals significantly, especially after we get accustomed to sleeping every night with the machine.

(12-06-2013 04:00 PM)PaulaO2 Wrote:  A regular CPAP machine, such as an autoPAP, will not treat central events. It is normal for a person with Obstructive Sleep Apnea (OSA) diagnosis to have a few central events during the night.

Central Sleep Apnea (CSA), if the primary diagnosis, requires the ASV unit to treat.

Mixed Sleep Apnea can sometimes be treated with a regular CPAP unit but usually requires the ASV unit. It depends on the reason for the central events.

Some people experience an increase in central events when they first start using the CPAP. These events almost always decrease with time and go away after only a few months, if that long.

What PaulO2 said.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
12-07-2013 05:30 AM
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Kate Offline

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Post: #6
RE: CENTRAL APNEA
I have ten central apneas an hour with one or two obstructive apnea during the night. I guess that means that I don't have the right machine. I had a second sleep study last week and I'll see the doctor next Monday. If I have to have another machine, they better move fast because I was one of the lucky ones that will loose their insurance Dec. 31.

:Using cpap then vpap since Feb.2013,
Kate
12-09-2013 01:57 AM
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me50 Offline

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Post: #7
RE: CENTRAL APNEA
(12-09-2013 01:57 AM)Kate Wrote:  I have ten central apneas an hour with one or two obstructive apnea during the night. I guess that means that I don't have the right machine. I had a second sleep study last week and I'll see the doctor next Monday. If I have to have another machine, they better move fast because I was one of the lucky ones that will loose their insurance Dec. 31.

what did your sleep study show? how long have you been using your CPAP? are you still using a set pressure or are you using an autoset?
12-09-2013 02:22 AM
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vsheline Offline

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Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #8
RE: CENTRAL APNEA
(12-09-2013 01:57 AM)Kate Wrote:  I have ten central apneas an hour with one or two obstructive apnea during the night. I guess that means that I don't have the right machine. I had a second sleep study last week and I'll see the doctor next Monday. If I have to have another machine, they better move fast because I was one of the lucky ones that will loose their insurance Dec. 31.

Hi Kate,

Some private insurance companies require the CAI (number of Central Apneas per hr) to be at least 5 and require that Central Apneas outnumber the Obstructive Apneas and require that an ASV titration be done which shows ASV treatment substantially improves the treatment success. Other companies require the CAI be at least 10. Others require the CAI to be at least 15.

If your insurance is ending at the end of the month then I suggest it may be best to ask for an ASV machine with heated hose. Both ResMed and PR System One ASV machines are great. Of course it wouldn't be surprising if coverage for an ASV machine is denied but it wouldn't hurt to ask.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
12-09-2013 06:43 AM
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Kate Offline

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CPAP Software: ResScan

Other Comments: VPAP always makes me feel like my avatar.

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Location: Poulsbo, Washington

Post: #9
RE: CENTRAL APNEA
I have been using my CPAP machine for nine months now, every single night. I normally have 9-13 central apneas an hour. I have no problem with purchasing it myself (just what I wanted for Christmas) if I have to but you need a doctor's prescription for one, don't you? If I don't, I'll get it tomorrow.

Kate

:Using cpap then vpap since Feb.2013,
Kate
12-10-2013 11:08 PM
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me50 Offline

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Post: #10
RE: CENTRAL APNEA
Which Resmed machine do you have? What does your data show other than the centrals? Have you had the centrals for the 9 months that you have used your machine? What are your leaks like?

I would suggest that you try not to worry about it until you see what your recent sleep study shows. I know that is easier said than done. I don't know for sure where you live, but, if you are in the U.S., you will be required to be insured in the marketplace or have some kind of insurance coverage.

Will wait for your answers to see if I, or anyone else, can offer other suggestions.
12-10-2013 11:31 PM
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