Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Central apnea events not associated with O2 drop?
#11
RE: Central apnea events not associated with O2 drop?
Shalafer, it's clear based on the results posted above, that we would first reduce the EPR to control centrals. Your doctor is saying as long as your oxygen needs are met that you are well-treated and it's no problem. This illustrates a fundamental misunderstanding of the respiratory drive. The respiratory drive or respiration rate is far more controlled by the presence of CO2 in the blood stream than oxygen. You can have an oxygen deficit, but you won't have a "need" to breath more rapidly or deeply unless CO2 is also high. You can search the terms hypercapnea and hypocapnea, as well as respiratory drive, and you won't find oxygen is even mentioned. Oxygen (SpO2) is dependent on oxygen being present in the air being breathed, and with ventilation devices the Positive End Expiratory Pressure (PEEP) determines oxygenation, by improving transfer across the alveolar membrane. Pressure support (PS /EPR) promotes ventilation, which reduces CO2 (hypocapnea), which may cause central apnea if CO2 drops enough to affect respiratory drive. .

So with CPAP and especially BiPAP, pressure support (the difference between IPAP and EPAP pressure) can affect ventilation o r reduction of carbon dioxide, and the higher the PS, the lower the CO2 tends to go. PEEP or minimum EPAP will increase oxygenation with higher pressure. You can have excessive PS which results in a lot of CA events, and still have relatively low SpO2. This is getting pretty deep in the weeds in ventilation theory, but the point is, your doctor is wrong, or at least looking too simplistically at your therapy which is in fact a bilevel therapy with EPR (PS) at 3. Without oximeter data, we really can't say if your oxygen saturation is remaining at normal levels in spite of central apnea; however in many cases CA can occur without significant desaturation. Whether you have an oxygen problem or not, or your doctor is right or wrong, we want to resolve the CA events, and there is an easy tool to potentially affect that, by minimizing EPR or PS, and maintaining your normal CO2 level.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply






Donate to Apnea Board  
#12
RE: Central apnea events not associated with O2 drop?
(11-12-2019, 07:02 PM)bonjour Wrote: Whatever the type of apnea, we strive for an AHI of 2 - 2.5 not being fussy about deviation from these values.  Centrals are the hardest to handle.    Point me to your other thread please.  20-40 is way too high.

How to make the best of it?

Thanks,
S
Post Reply Post Reply
#13
RE: Central apnea events not associated with O2 drop?
(11-12-2019, 07:30 PM)Schlafer Wrote:
(11-12-2019, 07:02 PM)bonjour Wrote: Whatever the type of apnea, we strive for an AHI of 2 - 2.5 not being fussy about deviation from these values.  Centrals are the hardest to handle.    Point me to your other thread please.  20-40 is way too high.

How to make the best of it?

Thanks,
S

Have you tried reducing EPR as suggested in this or the other thread, as things won’t change as they are, all that your dr is concerned with is are you using the machine an AHI of 22 is clearly not treated
Post Reply Post Reply
#14
RE: Central apnea events not associated with O2 drop?
(11-13-2019, 01:33 AM)jaswilliams Wrote:
(11-12-2019, 07:30 PM)Schlafer Wrote:
(11-12-2019, 07:02 PM)bonjour Wrote: Whatever the type of apnea, we strive for an AHI of 2 - 2.5 not being fussy about deviation from these values.  Centrals are the hardest to handle.    Point me to your other thread please.  20-40 is way too high.

How to make the best of it?

Thanks,
S

Have you tried reducing EPR as suggested in this or the other thread, as things won’t change as they are, all that your dr is concerned with is are you using the machine an AHI of 22 is clearly not treated

Hi yes! I was able to get my provider to set the EPR to zero, without a prescription change, and I've been running that way for almost 2 weeks. Since then I've still been seeing some CA event clusters - so the question about how "unhealthy" CA events are is still concerning me (10 to 22 seconds long, at 20-40 time per hour). Based on responses so far on this topic, I still have a hard time understanding my Dr's position on CAs. I suspect clusters of CA events should be classified as more of a risk or concern, and "override" averages. An average of 10 CA events per hour over the night, allows for huge clusters at much higher frequencies.

Thanks!
-S-
Post Reply Post Reply






Donate to Apnea Board  
#15
RE: Central apnea events not associated with O2 drop?
Doctor is incorrect. Based on your sleep study results, you had complex apnea with a significant central component before CPAP, so this is not simply a treatment emergent condition.  Some doctors have difficulty seeing anything but obstructive sleep apnea, and yours may be one of them.  Given your doctor's dismissive response to your concerns, and the obvious complex apnea in your sleep study, I recommend you consider seeing a different specialist or your primary doctor.  Discuss the diagnostic sleep study, and request a new bilevel titration study, with an ASV endpoint.  These central apnea and hypopnea are not going to spontaneously disappear because they were present along with obstructive apnea before therapy.

Please read the Justifying Advanced PAP Machines wiki
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  Please help with dealing with central apnoeas due to CPAP chen30 38 893 11-30-2020, 02:48 PM
Last Post: chen30
  [Diagnosis] All central -- should I be concerned? boss 4 215 11-29-2020, 11:08 PM
Last Post: Sleeprider
  Central Apnea Onset Kazman 8 308 11-16-2020, 09:19 PM
Last Post: Sleeprider
  Why the increase before events? Nero 1 118 11-13-2020, 03:18 PM
Last Post: SarcasticDave94
  Treatment Resistant Central Sleep Apnea? asdz123 50 1,193 11-11-2020, 01:21 PM
Last Post: SarcasticDave94
  Interpreting OSCAR, Clusters of Central Apnea letsrun100 61 2,975 11-11-2020, 06:21 AM
Last Post: jaswilliams
  About 2 weeks in... a lot of central apneas. sleepy331 5 197 11-10-2020, 06:18 PM
Last Post: SarcasticDave94


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.