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Central Apnea While Awake
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Jim Bronson Online

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Post: #1
Central Apnea While Awake
While fully awake, I sometimes find myself breathing very shallow or holding my breath for several seconds with no obstruction present. Afterward, I breathe deeply for a breath or two and then get back to a normal breathing pattern. This pattern repeats often during a day. I have been doing this for many years without knowing what to label it. Since I've been using CPAP, I've noticed such a pattern on the Sleepyhead graphs, so it looks like I also have this same pattern while I'm asleep. My AHI is typically less than 4 with centrals usually comprising the majority of events.

It fits the definition of central apnea, and I don't think there's a remedy for it. So now I'm now curious whether other CPAP users also experience this breathing pattern while awake.

There's some evidence to suggest that anxiety may cause such a wakeful central apnea pattern, but I don't find enough evidence to conclude that's the cause. Comments welcome.
08-06-2015 12:37 AM
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vsheline Offline

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Post: #2
RE: Central Apnea While Awake
(08-06-2015 12:37 AM)Jim Bronson Wrote:  While fully awake, I sometimes find myself breathing very shallow or holding my breath for several seconds with no obstruction present. Afterward, I breathe deeply for a breath or two and then get back to a normal breathing pattern. This pattern repeats often during a day. I have been doing this for many years without knowing what to label it. Since I've been using CPAP, I've noticed such a pattern on the Sleepyhead graphs, so it looks like I also have this same pattern while I'm asleep.

Hi Jim

For many years I have occasionally found while awake that I haven't been breathing and consciously take some catch-up breaths.

Before I received an ASV machine I used an Auto bilevel machine (S9 VPAP Auto). My AHI was occasionally above 5, usually from Periodic Breathing (CSR-like pattern) plus a few isolated cental apneas.

I feel better when I use the ASV machine (compared to the bilevel Auto), but it took a little getting used to ASV therapy, since the machine quickly raises the inhalation pressure (IPAP) whenever my fail to adequately breathe.

Auto ASV therapy works by slowly varying the exhalation pressure (EPAP) much like an AutoSet slowly varies the pressure to prevent/minimize obstructive apneas. In addition, ASV therapy will quickly vary the amount the pressure is boosted during inhalation. Within a few seconds the amount of pressure boost during inhalation (which is called Pressure Support) might be raised to 10 or more (for example if EPAP is 10 then IPAP might quickly rise to 20 or higher). This large difference between EPAP and IPAP does for us all the work of breathing, until we again start breathing on our own.

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.
(This post was last modified: 08-06-2015 09:40 AM by vsheline.)
08-06-2015 03:00 AM
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Rob S Offline

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Post: #3
RE: Central Apnea While Awake
i experience the same thing. after my initial sleep study but before my titration it caused me to go to the ER, have dozens of tests and ultimately see a pulminologist. i got half a dozen different diagnosis (heart attack, emphysema, pulmonary hypertension, etc)before i ever got my VPAP. it seems to me most doctors aren't even aware of this.

i found this and it helped me understand a little better, they also mention a Breathing Pacemaker. i didn't even know about those before reading this.

http://www.averybiomedical.com/central-sleep-apnea-awake/

::edit::
after first reading this i started thinking back to when i first started noticing problems with my sleep and breathing.
i came up with.... shortly after i had a major electrical shock at work...18,000 volts, 60 amps. it actually burned holes in my shoes and my legs burned from the knees down.
(This post was last modified: 08-06-2015 06:44 AM by Rob S.)
08-06-2015 06:39 AM
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Aliza Offline

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Post: #4
RE: Central Apnea While Awake
Hi, I'm a Newbie with exactly what you're describing. I have just looked at my CPAP results using Sleepyhead (thanks so much) and it shows the same at night as well. I've only been on a CPAP machine for 10 days and things are settling down nicely with a Resmed S9 Auto. Majority of mine are Central Apnoeas. I am also asthmatic, have been for over 25 years and take seretide 250 2 puffs twice a day. I also have hayfever, allergies etc. Hospital are talking about doing another Alice sleep test soon to check things out. Feeling less exhausted than I was, the original sleeplessness was blamed as nocturnal asthma for the last five years, I was waking up around the times that my data shows my CA's every night.
08-06-2015 08:56 AM
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vsheline Offline

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CPAP Pressure: 15 EPAP, PS 5-10
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Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

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Post: #5
RE: Central Apnea While Awake
(08-06-2015 06:39 AM)Rob S Wrote:  after first reading this i started thinking back to when i first started noticing problems with my sleep and breathing.
i came up with.... shortly after i had a major electrical shock at work...18,000 volts, 60 amps. it actually burned holes in my shoes and my legs burned from the knees down.

To calculate the heating power (wattage) one multiplies the electric pressure (voltage) times the electric current (amperage).

18,000 Volts times 60 Amps would have been 1,080,000 Watts. You are extremely lucky you survived that, even for a fraction of a second.

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.
(This post was last modified: 08-06-2015 10:06 AM by vsheline.)
08-06-2015 09:58 AM
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archangle Offline
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Post: #6
RE: Central Apnea While Awake
Let's call this "wake apnea" even though doctors would never use that term.

"Wake apnea" if it exists, is so different than "sleep apnea" that the treatment for or knowledge about sleep apnea probably won't be of much help.

You might get some useful information here, but you're sort of asking in the wrong place.

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.
08-06-2015 10:29 AM
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OpineCone Offline

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Post: #7
RE: Central Apnea While Awake
(08-06-2015 10:29 AM)archangle Wrote:  "Wake apnea" if it exists, is so different than "sleep apnea" that the treatment for or knowledge about sleep apnea probably won't be of much help.

You might get some useful information here, but you're sort of asking in the wrong place.

Are you kidding? This is an apnea board, not specifically a sleep apnea board, and in my opinion this board is the ideal place to discuss all forms of apnea. Personally I believe the possible connections between sleep apnea and the other kind (variously called daytime apnea, awake apnea, waking apnea, etc.) are in urgent need of discussion, especially in light of of my recent experiences, about which I will post soon.
08-06-2015 02:16 PM
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Marc615 Offline

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Post: #8
RE: Central Apnea While Awake
I didn't know there was such a thing as wake apnea, but I do find myself occasional not breathing while wide awake. I will sometimes be sitting at my computer at work or with my wife somewhere and notice it. My wife notices sometimes and asks if im holding my breath.
08-06-2015 02:21 PM
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AlanE Offline

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Post: #9
RE: Central Apnea While Awake
I seem to recall reading here that breathing is controlled by a different part of the brain when you are awake. Could be wrong. I don't have the time to do a search since I'm heading out the door in a few.



Using FlashAir W-03 SD card in machine. Access through wifi with FlashPAP or Sleep Master utilities.

I wanted to learn Binary so I enrolled in Binary 101. I seemed to have missed the first four courses. Big Grinnie
08-06-2015 02:58 PM
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Rob S Offline

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Post: #10
RE: Central Apnea While Awake
(08-06-2015 09:58 AM)vsheline Wrote:  
(08-06-2015 06:39 AM)Rob S Wrote:  after first reading this i started thinking back to when i first started noticing problems with my sleep and breathing.
i came up with.... shortly after i had a major electrical shock at work...18,000 volts, 60 amps. it actually burned holes in my shoes and my legs burned from the knees down.

To calculate the heating power (wattage) one multiplies the electric pressure (voltage) times the electric current (amperage).

18,000 Volts times 60 Amps would have been 1,080,000 Watts. You are extremely lucky you survived that, even for a fraction of a second.

i know how lucky i am, lucky i leaned into the machine with my knee's making contact first. i also now believe it could have damaged my brain stem causing my central apnea problems.
08-06-2015 05:53 PM
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