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[CPAP] Doctor says Central Apneas only occur in older people
#1
I saw my doctor yesterday because my AHI had become elevated, 8.7 for the last week. I had a feeling that the apneas I was experiencing were central for various reasons. When I told my doctor this, he chuckled and said that central apneas didn't occur in younger patients, only in older patients, so he continued to increase my pressure from 6.0 to 8.0. Last night on the new setting, I had trouble getting to sleep. It felt as though my body couldn't tell whether it was time to inhale or exhale. I could only wear the mask for four hours because of constantly interrupted breathing.

Should I be looking for a new doctor? I wanted to trust his opinion, but I'm afraid I'm not going to wake up one morning if I continue to take his advice. Don't central apneas occur across the spectrum of ages?
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#2
Why do you think you were having centrals? I know they can occur if the CPAP pressure is set too high, or if you have a more serious health problem. Your previous pressure of 6.0 is rather low, so I would have to agree with your doctor's decision to increase your pressure. Even if it's not the ultimate solution, it's the next logical diagnostic step. If you are truly having centrals your doctor will need to do something about them later on.

It may take a week or two to adjust to the new pressure. The F&P Icon has a feature known as SensAwake that reduces the pressure to improve comfort while awake, increasing to the therapy pressure once asleep. Have you turned on SensAwake or the ramp? I can't give you more details since I use a different machine.

I suspect that your doctor's style of communication does not mesh with your own. You won't have to spend much time with him, so it's too soon to look for a new doctor. Give him a chance to do his job.
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#3
Hi agribah and welcome
Is your doctor one of those who dislike using auto-pap in auto?
Does an Icon Auto distinguish between types of apnea (OB or CA)?
After a while you would not notice the pressure any more (have to put hand in front of the mask vents just to check)
If finding the air is cold ... tweak with the humidifier and get the heated hose

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#4
Another thing have you got the clinical manual ...if not its available (scroll down to section threee)
http://www.apneaboard.com/adjust-cpap-pr...tup-manual

Icon Auto setup
http://vimeo.com/20560260
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#5
Your physician is nuts.

There is a growing theory that SIDS ('crib death') is central apnea events in infants.

Since central apneas cause is a huge range of things, to say it only happens in older folks is very wrong. Brain injury, Cheyne-Stokes, etc.

That said, unless you have a data capable machine, you don't know if you are having central events or obstructive. Unless someone sits there and watches you sleep, you don't know and there's not really a way for you to tell otherwise. You're going to feel just as crappy. Added to that, I don't think central events happen when you are awake, only when you sleep. So if you feel as if your breathing is messed up as you are trying to fall asleep, it's because you're thinking about it.

Does the Icon have any sort of exhale pressure relief? Like Resmed's EPR and Respironics x-Flex? It could be that the change in pressure changed how it reacts (same drop/rise, but different kinda) and you are noticing the difference.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.




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#6
Hi agribah, WELCOME! to the forum.! Hang tight for more suggestions and best of luck.
trish6hundred
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#7
(10-04-2012, 05:39 PM)PaulaO2 Wrote: Your physician is nuts.

I agree with Paula. Lolabove
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.
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#8
agribah... I wouldn't throw your Doctor out with the dishwater just yet. (My meaning is) You have put a trust in him/her which is probably deserved and is certainly going to help your therapy by having a good relationship with the Doc. I think his/her decision to lower your AHI by increasing your pressure is the appropriate thing to do. Your..part of the therapy efforts will be to learn to adjust to the new pressure, which is not that great of an increase. Yes, it will take an effort at first. The part of interrupted breathing is possible something that can be remedied by an adjustment to your machine. Your body will breath in and out, but with the CPAP pressure it takes some adjustment/
Your statement that>>>"I'm afraid I'm not going to wake up one morning if I continue to take his advice".<<<..is foolhardy. Central apneas normally appear within all age spectrums...(((See the post that was entered today 10-5-2012 by "Extrospect"..Young man in his early 20s..
Your Doc's remark may just be his efforts to keep you from worrying about the centrals so much..
Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
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#9
Remember that if you are having centrals, it still shows up as apneas. Look and see if your AHI goes up.

Apnea isn't likely to kill you in short order unless your AHI gets really high. Presumably, you were a lot higher in AHI before CPAP.

It's a shame you didn't get a ResMed S9 where you could check your own CPAP data and see if you have centrals.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#10
(10-04-2012, 03:36 PM)agribah Wrote: I saw my doctor yesterday because my AHI had become elevated, 8.7 for the last week. I had a feeling that the apneas I was experiencing were central for various reasons. When I told my doctor this, he chuckled and said that central apneas didn't occur in younger patients, only in older patients,

I'd say your doctor is full of stool samples.
Then again when I first had trouble sleeping I researched it and that's where I learned the concept of sleep apnea. My doctor said there was nothing wrong with me. When I finally found my soul mate she told me I stopped breathing at night. I got a second opinion, was diagnosed with "mixed" apnea and fired my doctor.
Yeah he didn't lose his job (I wish) but he lost me as a patient. Back then there were still a few doctors who were accepting new patients - it's a rarity now so I just lucked out. So I would have been in my mid to late twenties when I started having trouble. How old does your doctor imagine a person has to BE?

Quote:Should I be looking for a new doctor? I wanted to trust his opinion, but I'm afraid I'm not going to wake up one morning if I continue to take his advice. Don't central apneas occur across the spectrum of ages?

As I said, once it was confirmed by a specialist I found a new doctor.
But... don't sell yourself short. Make sure you can find a doctor accepting new patients BEFORE ditching this guy. At least around here they are hard to come by and when a newly-graduated doctor announces his/her existence, the patient roll call fills up fast.
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