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Central Sleep Apnea
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zonk Offline

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Post: #1
Central Sleep Apnea
[parts of this thread were copied from our old forum]

Central Sleep Apnea
http://www.mayoclinic.com/health/central...ION=causes

Causes
Central sleep apnea occurs when your brain fails to transmit signals to your breathing muscles. Central sleep apnea can be caused by a number of conditions that affect the ability of your brainstem - which links your brain to your spinal cord and controls many functions such as heart rate and breathing - to control your breathing. The cause varies with the type of central sleep apnea you have. Types include:
Idiopathic central sleep apnea. The cause of this uncommon type of central sleep apnea isn't known. It results in repeated pauses in breathing effort and airflow.
Cheyne-Stokes breathing. This type of central sleep apnea is most commonly associated with congestive heart failure or stroke and is characterized by a periodic, rhythmic, gradual increase and then decrease in breathing effort and airflow. During the weakest breathing effort, a total lack of airflow (central sleep apnea) can occur.
Medical condition-induced central sleep apnea. In addition to congestive heart failure and stroke, several medical conditions may give rise to central sleep apnea. Any damage to the brainstem - which controls breathing - may impair the normal breathing process.
Drug-induced apnea. Taking certain medications such as opioids - for example, morphine, oxycodone or codeine - may cause your breathing to become irregular, to increase and decrease in a regular pattern, or to stop completely.
High-altitude periodic breathing. A Cheyne-Stokes breathing pattern may occur if you're acutely exposed to a high-enough altitude, such as an altitude greater than 15,000 feet (about 4,500 meters). The change in oxygen at this altitude is the reason for the alternating rapid breathing (hyperventilation) and underbreathing.
Complex sleep apnea. Some people with obstructive sleep apnea develop central sleep apnea while on treatment with continuous positive airway pressure (CPAP). This is known as complex sleep apnea because it is a combination of obstructive and central sleep apneas.

Risk factors
Certain factors put you at increased risk of central sleep apnea:
Sex. Males are more likely to develop central sleep apnea than are females.
Age. Central sleep apnea is more common among older adults, possibly because they may have coexisting medical conditions or sleep patterns that are more likely to cause central sleep apnea.
Heart disorders. People with atrial fibrillation or congestive heart failure are at greater risk of central sleep apnea. Central sleep apnea may be present in up to 40 percent of people with congestive heart failure.
Stroke or brain tumor. These conditions can impair the brain's ability to regulate breathing.
High altitude. Sleeping at an altitude higher than you're accustomed to may increase your risk of sleep apnea. High-altitude sleep apnea is no longer a problem when you return to a lower altitude.
Opioid use. Opioids, such as morphine, oxycodone and codeine, increase the risk of central sleep apnea.
CPAP. Some people with obstructive sleep apnea develop central sleep apnea while on treatment with CPAP, continuous positive airway pressure. This is known as complex sleep apnea because it is a combination of obstructive and central sleep apneas. For some people, complex sleep apnea goes away with continued use of a CPAP device. Other people may be treated with a different kind of positive airway pressure (PAP) therapy.

Complications
Central sleep apnea is a serious medical condition. Some complications include:
Fatigue. The repeated awakenings associated with sleep apnea make normal, restorative sleep impossible. People with central sleep apnea often experience severe daytime drowsiness, fatigue and irritability. You may have difficulty concentrating and find yourself falling asleep at work, while watching TV or even when driving.
Cardiovascular problems. In addition, sudden drops in blood oxygen levels that occur during central sleep apnea may adversely affect heart health. If there's underlying heart disease, these repeated multiple episodes of low blood oxygen (hypoxia or hypoxemia) worsen prognosis and increase the risk of abnormal heart rhythms.
03-09-2012 07:05 PM
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zonk Offline

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Post: #2
RE: Central Sleep Apnea
[parts of this thread were copied from our old forum]
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Yaatri wrote:

Good timing for me. I had been wondering if I had central apnea too, in addition to OSA, as my sleep had become less restful. My compliance had gone down too as due to tiredness, I often fell asleep without the VPAP. One night my VPAP started acting strange. I use a bi-level machine which has a marked difference between inhaling pressure and exhaling pressure. It was running constantly at one pressure. The next morning I called my provider. They did not have another one of the type I had, ResMed S8 series, VPAP Auto25 SO they replaced with a new S9 series VPAP AUto25. The S9 series is decidedly superior to the S8 series. I especially love the fact that it stores on an SD card, unlike the proprietary interface and card used by S8 series. I love the sleep report feature too. I am happy to report, that as far as my machine is concerned, I have no central apnea. My AHI has been under too and AI has been zero for 10 days now. I am thinking of playing around with the pressure settings. I
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weeble wrote:
This is interesting because before my cpap I was told I had "moderate to severe" OSA.....I have been regularly downloading my stats and noticed that I am now getting CSA, and they are becoming more and more each day. I really don't think my pressure is high enough, so much so that I am having a follow up sleep study tomorrow, which I will tell them of my concerns. Is it normal to suddenly have CSA on cpap?? I'm still snoring but not as bad. Spoke to the retailer and they agreed the pressure needs to be changed.
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Yaatri wrote:
There is an opinion out there that in some people use of CPAP may just about eliminate OSA, as measured by AHI and AI, but prolonged use of CPAP can lead to CSA as you become "dependent" on CPAP.

The normal muscular activity is accompanied and directed by chemical exchanges controlled by electrical impulses from your brain. In some cases successful PAP therapy sort of make your nervous system dependent on external stimulus of CPAP that uses excess positive pressure to open your air passage.
If CPAP therapy is "too" successful", the carbon dioxide levels in your body do not build up. If CO2 levels are to low over prolonged period of time, your brain sort of forgets to impliment the chemistry triggered by CO2 levels.

There is some validity to it. You can train your body to do lots of things, good, as well as bad.
As an example starving yourself will not necessarily make you loose weight, in fact it cam do quite the opposite, as your body learns to make do with less food by going into starvation mood. Your body hoards any calories that you do take in as fat, much as a squirrel or a hamster hoards nuts.

I have heard of claims that Yoga breathing exercises called "Praanaayaam" can "cure" apnea without use of CPAP. There are a handful of breathing exercises. Unfortunately, I do not know their English equivalent names. My sister claims to have vastly superior health using these exercises, including losing weight.

Anulom Vilom (Anu-Lome, Vilome)--You block one nostril with your finger, from the outside that is, (LOL--I can imagine some of you going "Yuck! I ain't going to stick my finger in my nose". Big Grin)
and inhale through the open nostril. Then block the one through which you breathed in, and exhale through the other one. Reverse and repeat. I do not recall, how many repetitions.

Kapal Bhati (Kapaahl Bhaati) Inhale normally, and then exhale forcefully while pulling up your abdominal muscles to pull your abdomen up (not in).

These are done after you wake up, but before you eat anything.

There are others I don't recall. If you are interested, I can help you look. The names given above are Sanskrit names. I happen to know some Sanskrit, having studied it for a few years to the point of being able to write letters extemporaneously.

Praan refers to the the vital element of life itself, i.e. breathing. Praanaayaam means breathing exercises.

Anulom vilom literally means alternating nostrils.

Kapaal Bhaati approximately means energising brain.You cycle out more CO2 and take in more oxygen than normal breathing. Normal breathing requires little physical effort for most people, but pulling your abdomen requires more effort, which burns more calories, which produces more CO2.

Some Praanaayaam exercises are rather extreme, and I wouldn't try them without a teacher. One involves taking water through your nostrils, letting it flow into your mouth and spitting it out.
Another involves taking water through one nostril and letting it exit through the other. Another involves using a string to take the same path as water. I have never tried them nor am I inclined to, but I have seen people do that. It requires a lot of training and I am worried that you are setting yourself up for sinus infection. I suppose if your immune system is good and you use reasonable clean water, some people might get away with it.
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zimlich wrote:
Yaatri, can you quote some studies to support your idea that the body can become dependent on CPAP. Yes, those of us with OSA need CPAP, but our bodies are not dependent on the machine. CPAP only splints open the airway- one exhales normally so CO2 should not build up. It sounds like you are referring to hypoxic drive in people who have COPD where the buildup of CO2 is the drive to breathe. That is why peoople with COPD have to be careful about how high they turn up their O2. CPAP does not involve the nervous system it only splints open the airway with air pressure. Central Apnea is a different animal in which the brain does not tell the body to take a breath, the airway is open( see zonk's article). There is also mixed apnea which is a combination of OSA and CSA. I suspect part of the problem here is one of compliance. CPAP (or AUTO, BiLevel) must be used all night every night and during naps. Rather than trying these esoteric exercises I believe total compliance with therapy is a must. If you do not use the machine any complaints you have are moot until you use it 100% of the time. If there are issues of comfort which prevent you from using the machine, hash them out here or with your doctor.
zonk started this thread with a wonderful article about CSA and the mechanisms behind centrals.
The only way to be sure you are having predominantly CA is a sleep study in the lab looking for centrals.
If your AI and AHI are 0 why in the world would you change your pressure settings? And if your machine is not reporting any centrals why do you believe you have them? You are tired because you are not using your machine. Until you make that commitment to yourself you will continue to have symptoms of untreated OSA.

Weeble, you are doing the right thing by having a sleep study where they can check for centrals and prescribe the best machine to treat you. Good Luck.
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weeble wrote:
Will post my results in a few weeks when I get them back, was just curious as to why I'm suddenly reading more centrals on my data - apart from that, personally, I've used machine every night since I've had it, I've not taken the mask off once, am feeling better than I did b4, certainly not sleepy during the day any more. AHI readings are terriffic at between 0.3 and 1.0 (although last night 2.2) So everything is going great except for the snoring and the centrals. I believe I can talk to the sleep specialist after the study, so I will do that too. Was just curious to know if developing CSA was common for cpap users - according to Zonks original post and virtually the same post on wikipedia it says it can develop in people.
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Taken from zonks link: Complex sleep apnea. Some people with obstructive sleep apnea develop central sleep apnea while on treatment with continuous positive airway pressure (CPAP). This is known as complex sleep apnea because it is a combination of obstructive and central sleep apneas.
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03-09-2012 07:13 PM
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zonk Offline

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Post: #3
RE: Central Sleep Apnea
[parts of this thread were copied from our old forum]
................................................................................​.................

archangle wrote:
I'm worried that we may be overdiagnosing central apnea and complex sleep apena because we put too much faith in our machines.

In the old days, it wasn't an "apnea" at all unless it was 10 seconds long, AND had an EEG indicated arousal, or a SPO2 drop.

Most home CPAP machines can't see EEG or SPO2, so they guess based on airflow and pressure. While this is useful info to a competent expert looking at the data, we need to remember that an "apnea" indicated by a home CPAP machine is not the same as an apnea from an in-lab PSG.

I see several ways home CPAP machines can score false centrals (or other events as well.)

1) Short apneas. If you stop breathing for 40 seconds in your sleep, you probably have something wrong. If you stop breathing for 11 seconds in your sleep, there may not be anything wrong. Without EEG or SPO2 readings, you don't really know.

If you look at an events per hour number, an 11 second "apnea" counts just as much as a 120 second apnea. Your body doesn't see it the same way.

2) CPAP pressure causes "central apneas." CPAP pressure can cause the alveoli in your lungs to inflate more fully. When your lungs come to rest and stop breathing, you have more air left in your lungs. O2/CO2 can cross from the blood to the air in your lungs. Even though you're not inhaling or exhaling, your blood O2/CO2 is still good until you use up the air in your lungs. You may not NEED to breathe for a while and may stop for a few seconds.

As long as your blood O2/CO2 levels are good, and you don't get an EEG arousal, there's nothing wrong with this. Your body doesn't care. An in lab PSG will not score this as an apnea. A CPAP machine will score this as a central apnea.

3) We may be hooked up to CPAP while awake. We may take a while to fall asleep. We may wake up during the night and take a while to get back to sleep. We may wake up in the morning and lie there before getting up. Some of us may put on the CPAP if we're watching TV and getting drowsy just in case we fall asleep.

Normal awake breathing may look like an apnea to a home CPAP machine. It will score apneas for this time. An in lab sleep test will not score any apneas when the EEG indicates you're awake.

I'm worried that some of us "internet amateurs" may be looking at our CPAP machine event scores and panicking about "Central Apneas" CA or "Complex Sleep Apnea" CSA when there's really nothing bad going on. We may be turning down our pressure and getting more "real" apneas when we're trying to avoid "false" apneas.

I'm even more worried that some sleep techs or doctors who know less than some of us amateurs do simply say "Central Apnea, cut the pressure." Or even worse, "Complex Sleep Apnea," get an ASV. Even sleep specialists who should know better may do the same out of laziness, overcaution, insurance considerations, or (dare I say it?) profit motive.

For goodness sake, at least look at the flow waveforms and see if it looks like a real event. How long was the event? Did he take a deep breath beforehand and just didn't need to breathe as deeply? Did he really stop breathing or did the machine think something happened because he is breathing a little shallower than he was before because he changed position or something? Did he gasp for air after the event?

The other events like hyponeas, flow limitations, and RERAs are even more suspect. If you look at the airflow graphs, a lot of these events don't look convincing to me. Yes, it's a good thing for the machine to flag them so that a competent person can check the waveforms or do further study. However, if you look at the graphs, they don't all look like a real problem.

As far as I'm concerned, CPAP machine events should only be categorized as "Maybe Events." You need to look at them as indications that further study is needed. Some of them are "real." If you look at the waveform and the patient had a 120 second central apnea 10 times and hour, you have problems. If he had 20 11 second long apneas, he may not have anything.

Now, if your machine is indicating a small number of events, I think you can mostly believe that. My concern is false positives.

Yes, the manufacturers are doing the best they can. They tweak their algorithms to make the machines better. Are they being over cautious? Don't forget that the more apnea and other events they see, the more machines they sell. Even an honest person tends to see the things that put money in their wallet.

Remember, a CPAP event numbers does not equal PSG event numbers.

If someone wants to put you an an ASV make some other drastic changes due to your numbers, make sure they've really looked at your data.
Click here for information on the most common alternative to CPAP treatment.
Get the free SleepyHead software here.
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weeble wrote:

Archangle, thank you for your indepth informative reply. I had another sleep study done last night, mainly because they wanted me back for a repeat cpap study. As luck would have it, the technician on last night was the tech manager and he knew what he was doing, I told him of my concerns and he said basically what you said that the reports generated aren't really indicative of what's really going on. And not to worry too much regarding the CSA, however, the snoring he agreed with me, shouldn't be happening. He tested my machine and says it is running just under what it should be. During the night he adjusted the pressure and about an hour ago when he woke me, said the snoring happened on the lower pressure that I am on (9) but disappeared on the higher setting, so I will take my machine back to be tested. So I won't start jumping up and down in a cold sweat over the CSA just yet....as previously stated, my AHI's are great 0.3 being the lowest and 2.2 the highest, and I am not sleepy during the day, so I know it's working, my only concern is the snoring....but I can deal with it, however, upon saying that, I'm still not going to discount the CSA entirely....will just monitor it - hopfully in a couple of weeks time I get my report back and they up the pressure slightly, and we shall see where we go from there. Cheers
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zonk wrote;

Central Sleep Apnea Detection and the Enhanced AutoSet Algorithm
Abstract
The ability to detect central apneas is a useful addition to an automatic algorithm for the treatment of OSA. The ResMed AutoSet algorithm has recently been enhanced to include a Central Sleep Apnea Detector (CSAD). This paper describes the CSAD as part of the enhanced AutoSet algorithm on the S9 flow generator and documents the process of validation which included early human testing, bench testing and clinical trial results. The enhanced AutoSet algorithm and CSAD showed that it identified and appropriately treated the different types of apneas with a very high degree of accuracy leading to better overall therapy.
http://www.resmed.com/au/assets/document...-paper.pdf

Sleep Apnea -Central (CSA)
About 10% of patients with sleep disordered breathing have central sleep apnea (CSA). An apnea is a temporary cessation of breathing. When measured in a complex sleep study (polysomnography) there are rules by which abnormal breathing events are classified. These use airflow and breathing effort as measured by movement of the chest and abdomen. When there is no airflow but there is effort to breathe, the apnea is called "Obstructive". When there is no airflow but no respiratory effort the apnea is called "Central". Mixed apneas start with no chest/abdominal effort but effort develops during the course of the apnea. When the majority of the abnormal breathing events are of the central pattern, the patient is said to have central sleep apnea. As with obstructive sleep apnea (OSA) there are repeated interruptions to breathing during sleep with daytime sleepiness. Insomnia or difficulty sleeping may also be reported. Loud snoring is not such a common feature as in OSA.
http://www.sleepoz.org.au/images/FactShe..._Apnea.pdf
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03-09-2012 07:17 PM
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Post: #4
RE: Central Sleep Apnea
[parts of this thread were copied from our old forum]
................................................................................​.................
[Quote archangle: I'm worried that we may be overdiagnosing central apnea and complex sleep apena because we put too much faith in our machines.

In the old days, it wasn't an "apnea" at all unless it was 10 seconds long, AND had an EEG indicated arousal, or a SPO2 drop.]

HeadGear wrote:
I think you are on track, Archangel! Although I do have far more CA than OA scored on my S9, and some are long 40-60 seconds but also usually 10-20 seconds, I have decided not to worry. This has been going on for a long time! Possibly, the CA might not happen if I was not on CPAP, but the consequences of not using CPAP would be dire! The relatively small bit of CA as a result of using CPAP would not hurt me!

Prior, in using the S8 and the Remstar Pro, my AI would have been much the same, though not differentiating between OSA and CA. What's changed is only that the S9 scores most of my apnea as CA! If that CA is "real," undoubtedly most of it is, the only impact would be some fragmentation of my sleep architecture. I can live with that!

However, being in charge of my treatment, I will try to reduce the AHI whenever possible. Because I'm talking about AHI less than 5, sleep medicine professional would not really care about my efforts! So, there's no use talking to them. Some months ago, I suspected that EPR was triggering CA, and so it was. But now, I have appeared to become used to it and CAI has stabilized at under 1.

I have noticed other patterns to CA, one being early morning reverie, where one is in and out of sleep, the breathing is often more likely to halt for a moment and CA is scored. Sometimes, when travelling afar, to a different air shed, my AHI drops to 0 and pretty well stays down for the duration! Go figure! This is all for curiosity and nothing to worry about!
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[Quote zonk:
Central Sleep Apnea Detection and the Enhanced AutoSet Algorithm
Abstract
The ability to detect central apneas is a useful addition to an automatic algorithm for the treatment of OSA. The ResMed AutoSet algorithm has recently been enhanced to include a Central Sleep Apnea Detector (CSAD). This paper describes the CSAD as part of the enhanced AutoSet algorithm on the S9 flow generator and documents the process of validation which included early human testing, bench testing and clinical trial results. The enhanced AutoSet algorithm and CSAD showed that it identified and appropriately treated the different types of apneas with a very high degree of accuracy leading to better overall therapy.
http://www.resmed.com/au/assets/document...paper.pdf]

archangle wrote:
None of that addresses the question of whether there is an SPO2 drop or EEG arousal. Yes, your lungs stopped trying to breathe for more than 10 seconds. There's no indication whether or not this is having any negative health effects.

Yes, a CPAP machine scored event IS useful diagnostic information. It CANNOT ever be considered "accurate" scoring in the classical sense without SPO2 or EEG readings. It may be "accurate" in terms of determining that you aren't breathing, or that your airway isn't closed.

A lot of people want to change the definition of "apnea" to include events scored based on flow waveforms and pressure. There is a lot of money riding on this change of definition. If you are classified as having "Complex Sleep Apnea (CSA)," you will need a much more expensive device to replace your CPAP machine. A lot of money will be made by many people if they change the definition.

This does not mean anyone is being deliberately dishonest. However, you tend to see the things that make you money. As someone said, "if the only tool you have is a hammer, everything looks like a nail."

I do believe that it IS dishonest to change the definition. CPAP scored events should not be called "apneas." You are elevating an event that suggests a problem to use a term that indicates an event that has been verified to indicate there is a problem. They should be called some new term such as "breathing events."

I think it's important to realize that if you stop breathing for 11 seconds out of every minute and your SPO2 doesn't drop and you don't get an arousal, there's no indication that there will be any harm to your body at all. You will get 60 CPAP scored "centrals," however.

This is not necessarily bad news. If someone has a bunch of machine scored central apneas, a competent medical professional should review the results.

If you're having a bunch of 40 second events, you probably have a problem, no matter what the theoretical SPO2 or EEG results might be. If they're 11 second events, and the patient sleeping and feeling well, it may not matter, or more investigation may be needed. I presume there are other indications as problems such as heavy breathing on the flow waveform after the event. An in lab PSG may be needed.

Machine scored numerical events are useful data. We should all realize that CPAP machine scored events don't equate to real PSG scoring by a competent evaluator.
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Ltmedic66 wrote:
archangle,

I agree with you, and have made essentially the same point many times over. I see a lot of people mistakenly interpret the results of the machines as being equal with a PSG, or equal with other machines. One of the most common errors I see involves people talking about their "miraculous" reduction in AHI when they switch to an S9 from another machine.

There really is no way to make such a comparision, because the S9 captures and interprets data differently than other machines. I suspect that this drop in AHI is nothing more than a result of "measuring with a different ruler".

I also agree that it is difficult to evaluate the importance of respiratory data without the additional measurements that are scored in a PSG. Based on one's PSG results, it is probably possible to infer some things, but it is really hard to determine the significance of the events without the additional PSG readings.
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[Quote Ltmedic66 wrote:
One of the most common errors I see involves people talking about their "miraculous" reduction in AHI when they switch to an S9 from another machine.]

HeadGear wrote:
Ltmedic and archangle, I fully agree with you about interpretation of results and the lack of standardization! But, Ltmedic, maligning the micraculous performance of the S9 is another matter! Neither of you has experience with one?! Oh-jeez
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Ltmedic66 wrote:
Correct, I do not have an S9. And don't get me wrong, I am not bashing the machine at all. It looks like a great machine, and I envy the data collection. I am only saying that we need to be cautious about placing too much emphasis on the data in comparison to what was recorded on other machines or in the lab. I think it is probably good for measuring trends over time,, but I do not think the AHI as reported by an S9 has much relevance to the AHI reported by any other device. Heck, you get different readings between techs in the same lab.
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03-09-2012 07:30 PM
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zonk Offline

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Post: #5
RE: Central Sleep Apnea
[parts of this thread were copied from our old forum]
................................................................................​........
archangle wrote:
The bit about the S9 is funny.

I can just hear a "sleep doctor" talking. "No, no, I never let any of my patients have ResMed S9 machines. They give people CSA. I insist on Respironics M series machines. They never give anyone central apneas."


Bug-eyed Bug-eyed Bug-eyed

To explain the joke: The newer machines indicate "central apneas" in their results, which can be a sign of complex sleep apnea. The older machines didn't have the smarts to differentiate a "central apnea" from a regular apnea. The older machine might be giving you central apneas, it just doesn't know it

This is another case of a dumb medical professional interpreting a difference in data collection as a difference in therapeutic benefits.

You know, maybe I've got something here. Maybe doctors and DME love to give people the S9 Escape machines instead of the S9 Elite because they've had patients who got CSA with Elite machines and that never happens to the patients with Escape machines.
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Misguided wrote:
What's weird is that my breathing stops when I'm awake. It has for over 20 years. Imagine if you frequently discovered you were holding your breath without intending to. That is more or less what it feels like. Clearly, I'm brain damaged, which explains an awful lot.
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HeadGear wrote:
Yes, I notice that, too. There are moments of concentration or thoughtfulness where one stops breathing. Target shooters do this deliberately! Perhaps it is a natural reflex for most of us, but rarely noticed. Perhaps when sleeping, the brain can be so focused on a dream that breathing stops?

A certain amount of CA may be quite normal for some of us, but we never noticed before the CA aware machines came along! BTW, I get just as much CA registered on the S9 as on the PRS1. I suppose that does make it more "real?" I do agree that, for it to matter, the CA has to have consequences like arousal and desat.
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archangle wrote:
Machine scored event counts are useful data. I think they are not definitive. You need to understand what they're telling you and react appropriately with further evaluation and perhaps with treatment.

The modern machines record a lot more data than just a count of apneas and other events. If the number of events is bad, you should look deeper into the data. If the number of events increases from what you had before, you should look deeper into the data. If the number of events doesn't change, that's a pretty good indication your therapy is still working like it was before.

The event counts are like an early warning system.

Look at it like snoring. If someone snores badly, they should probably be investigated for apnea. It's probably not a good idea to give someone a CPAP simply because they snore.

By the way, I DO believe in the flow waveforms. I think a competent sleep professional can tell a lot from flow waveforms in many cases. It's entirely possible he could make a pretty good diagnosis of CSA or other problems from machine based scoring plus flow waveforms. I might even agree with a diagnosis based on increasing CA counts with increasing pressure IF the duration of the machine scored CA events is recorded and is long enough.

I'd really hate to see someone get put on an ASV just because their CA count was high if they did
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tombarelybreathing wrote:
Since checking out my stats on the resmed software I've noticed that I have about 2/3rds of my apnea's as centrals. I usually have only a couple of obstructives and about 15 central apneas and they are usually clustered in the second hour of sleep and then a few sporatically throughout the rest of the night. My sleep specialist never commented on the different apneas so I've never been too concerned about it.

tombarelybreathing
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ooblick wrote:
I've read through this thread with great interest. My cpap titration study showed central apneas of enough duration to be concerning, increasing as pressure to stop the obstructive apneas increased. I guess that's the classic symptom of complex apnea. I started on the VPAP auto last week with discomfort and sleeplessness, and thanked the board profusely for the software I could use to investigate. The waveform and duration corresponded pretty much to the ramping up of the VPAP, showing a pretty interesting pattern complete with huge increases in tidal volume on the next inhalation gasp, etc. The RT looked at it and said I might need an ASV. She also told me that my doc is one of the few she thought had a clue re: this stuff, and said I was lucky to have him. Reading the nonsense so many of you went through re: therapy I believe her wholeheartedly.

I think I'm lucky to have this RT too because when she saw the print outs she said "great, you're smart enough to have the software. That makes my job easier. I'd suggest trying to lower the pressure just a tad at a time and see if that waveform straightens itself out. If you have problems, call me." That was VERY refreshing given it takes 45 minutes to get to her, and I'd much rather have control of my therapy anyway.

So I'm rather nervous about the whole thing, do NOT want to go for another study, but I feel so much less sleepy these days... Only problem is this horrendous gas that's really screwed me up.
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03-09-2012 07:37 PM
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mudgee167 Offline

Members

Posts: 2
Joined: Feb 2012

Machine: ResMed S9 Elite
Mask Type: Nasal pillows
Mask Make & Model:
Humidifier: Si5
CPAP Pressure: 8
CPAP Software: ResScan SleepyHead

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Sex: Male
Location:

Post: #6
RE: Central Sleep Apnea
I agree with those on this thread who question the validity of Central Apnea readings from their S9. I've been following my data now for about 6 weeks and I've noticed the vast majority of events are Centrals lasting around 10-12 seconds. I've also noticed many of them are being recorded when I have just woken up and laying there trying to go back to sleep. Consequently I've decided not to worry about them, as there was no mention of central Apneas in my sleep study results. What I have noticed is a drastic reduction in hypopneas, which has to be a good thing - now if I could just stay asleep for longer than two hours with the machine on.....
03-11-2012 11:24 PM
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JudgeMental Offline

Advisory Members

Posts: 324
Joined: Feb 2012

Machine: Respironics DreamStation Auto-CPAP
Mask Type: Full face mask
Mask Make & Model: Respironics Amara View
Humidifier: Respironics
CPAP Pressure: 11-14
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Florida USA

Post: #7
RE: Central Sleep Apnea
Mudgee/ I share your thoughts on the centrals. I get an awful lot of them ( CSRor periodic breathing also) most especially around an arousal time, such as P breaks and or awaking for the day.

Good luck on trying to sleep longer. Maybe when you wake up in the middle of the night you might take a small amount of melatonin. It might help you get back to some zzzzzzzzs.

Yesterday is history; Tomorrow is a mystery; Today is a gift; Thats why its called "The Present".
03-12-2012 09:50 AM
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