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Central Apneas while awake and at night
#1
One post on the board is very interesting to me. The suggestion was I start a new thread. I started with a CPAP last July 2016, with success in getting my apnea AHI to 2 very quickly and that continued until December 2016 when I started to take Lexapro for depression. The Lexapro worked very well and I felt great; however, over time, I have seen my nighttime central apneas going up to between 8 and 12 an hour at night. Before I had an average number of .5 for 6 months for Central Apneas.

I am now sleeping very badly. When awake and trying to get to sleep with my CPAP on, the Central Apneas do the same thing; let night for example it was an 8; it has been a 12 awake.

This is very distressing because I can only relate it to a change in medication, which helps my mental state significantly, but my sleep is suffering. On some nights, I am lucky to get those Central Apneas down to 2 to 4, but mostly they are over 8, even if I don't get rest.

I have a Sleep Apnea appointment scheduled in April, but will call for an earlier appointment. My recent Pulmonary tests were relatively normal, or at least unchanged and oxygen levels were within normal limits. I have had cardiac tests, cardiac risk score (142) and have been diagnosed as genetic Lip A high, although cholesterol is normal. Recent medications have lowered my LDL to 50 from 99 and HDL from 65 to 75. All good. No ischemia although I have calcium build up in my heart.

Like the other writer, I feel as though I am hyperventilating sometimes, and having to breathe but I am not out of breath even when exercising.

Thanks for the feedback; I am wondering if I should wean of Lexapro?
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#2
There are numerous other antidepressants. Some folks go through several before finding the one which works best for them. This is definitely something to discuss with the prescribing provider.

When I was initially diagnosed with a mixed apnea some 20+ years ago, I was put on the antidepressant Vivactil (protriptyline) to control it. It helped immensely - no headaches waking, no feeling hung over without drinking the night before, and being able to stay awake better during the day. It is a specific option you may wish to consider with your doc. As an older antidepressant, it is quite inexpensive compared to the newer ones.
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#3
Central apnea would be a serious side-effect you should discuss with your doctor. You may need a substitute medication, or a machine that treats central apnea could be prescribed (bilevel ASV). Can't tell you which one is better, but ASV will definitely resolve centrals provided you have a medical need for it.
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#4
As someone who struggled to find an SSRI that worked for me when I was younger (I no longer take one), I would suggest you attempt to treat the Apnea using an ASV before switching up the SSRI,  provided your heart is strong enough, and your LVEF is not < 45.  

My reasoning:  when swapping SSRIs you will need to wean of the first and ramp up the second.  It will take considerable amount of time before you are stabilized on the new SSRI and could very well find the new SSRI is not acceptable from a treatment perspective or it's given you additional side-effects.  Worst of all, you may still have SSRI induced central Apnea.

Why bother with that when you can treat it with an ASV the day you have the machine, while still effectively using the same SSRI.
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#5
Many anti-depressants affect sleep quality and can cause insomnia, especially in the first first months.

I wanted to comment on this:
Quote:When awake and trying to get to sleep with my CPAP on, the Central Apneas do the same thing; let night for example it was an 8; it has been a 12 awake.

Anything the machine measures while you are not fully asleep is garbage data must be ignored.  If these CA are happening when you are trying to get to sleep, they are not real.  Unlike a sleep lab, the machine has no way of knowing if you are asleep or not.  Our normal breathing when awake can appear (to the machine) exactly like central or obstructive apnea or hypopneas.  This is usually referred to as Sleep/Wake Junk.
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#6
(03-11-2017, 09:09 AM)And what Wrote: One post on the board is very interesting to me. The suggestion was I start a new thread. I started with a CPAP last July 2016, with success in getting my apnea AHI to 2 very quickly and that continued until December 2016 when I started to take Lexapro for depression. The Lexapro worked very well and I felt great; however, over time, I have seen my nighttime central apneas going up to between 8 and 12 an hour at night. Before I had an average number of .5 for 6 months for Central Apneas.

I am now sleeping very badly. When awake and trying to get to sleep with my CPAP on, the Central Apneas do the same thing; let night for example it was an 8; it has been a 12 awake.

This is very distressing because I can only relate it to a change in medication, which helps my mental state significantly, but my sleep is suffering. On some nights, I am lucky to get those Central Apneas down to 2 to 4, but mostly they are over 8, even if I don't get rest.

I have a Sleep Apnea appointment scheduled in April, but will call for an earlier appointment. My recent Pulmonary tests were relatively normal, or at least unchanged and oxygen levels were within normal limits. I have had cardiac tests, cardiac risk score (142) and have been diagnosed as genetic Lip A high, although cholesterol is normal. Recent medications have lowered my LDL to 50 from 99 and HDL from 65 to 75. All good. No ischemia although I have calcium build up in my heart.

Like the other writer, I feel as though I am hyperventilating sometimes, and having to breathe but I am not out of breath even when exercising.

Thanks for the feedback; I am wondering if I should wean of Lexapro?
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#7
(03-11-2017, 09:09 AM)Lkng67 Wrote: One post on the board is very interesting to me. The suggestion was I start a new thread. I started with a CPAP last July 2016, with success in getting my apnea AHI to 2 very quickly and that continued until December 2016 when I started to take Lexapro for depression. The Lexapro worked very well and I felt great; however, over time, I have seen my nighttime central apneas going up to between 8 and 12 an hour at night. Before I had an average number of .5 for 6 months for Central Apneas.

I am now sleeping very badly. When awake and trying to get to sleep with my CPAP on, the Central Apneas do the same thing; let night for example it was an 8; it has been a 12 awake.

This is very distressing because I can only relate it to a change in medication, which helps my mental state significantly, but my sleep is suffering. On some nights, I am lucky to get those Central Apneas down to 2 to 4, but mostly they are over 8, even if I don't get rest.

I have a Sleep Apnea appointment scheduled in April, but will call for an earlier appointment. My recent Pulmonary tests were relatively normal, or at least unchanged and oxygen levels were within normal limits. I have had cardiac tests, cardiac risk score (142) and have been diagnosed as genetic Lip A high, although cholesterol is normal. Recent medications have lowered my LDL to 50 from 99 and HDL from 65 to 75. All good. No ischemia although I have calcium build up in my heart.

Like the other writer, I feel as though I am hyperventilating sometimes, and having to breathe but I am not out of breath even when exercising.

Thanks for the feedback; I am wondering if I should wean of Lexapro?
no real problem before
add lexapro and there is a problem
i would certainly wean off it and see if it doesnt get better
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#8
(05-10-2017, 07:09 PM)xxyzx Wrote: no real problem before
add lexapro and there is a problem
i would certainly wean off it and see if it doesnt get better

This response ignores the reason you started the Lexapro in the first place. I understand from your post there was a real problem before, it just wasn't your apnea. ASV may be the answer for your centrals as suggested by Sleeprider but that and need for and choice of medications should be discussed with your doctor.

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#9
(05-10-2017, 11:54 PM)Melman Wrote:
(05-10-2017, 07:09 PM)xxyzx Wrote: no real problem before
add lexapro and there is a problem
i would certainly wean off it and see if it doesnt get better

This response ignores the reason you started the Lexapro in the first place. I understand from your post there was a real problem before, it just wasn't your apnea. ASV may be the answer for your centrals as suggested by Sleeprider but that and need for and choice of medications should be discussed with your doctor.

the question was whether lexapro caused the apnea changes

natually a total system fix needs to consider all problems or else compromise and fix the worst one while not making others worse
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