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Have you had Central Apnea?
#1
I suffer from central apnea, the ability of the brain to sense the decrease in CO2 levels in the blood resulting from the CPAP device opening up the airway and giving me better breathing. The result is  that my brain causes me to stop breathing as I fall asleep, many many times. I wake up feeling like I am suffocating, and I need to remove the mask to catch my breath. I really need the CPAP to work as I suffer from atrial fib when I have apnea. Has anyone had a similar problem with central apnea, and were you able to overcome it? If so, how? Did your brain get used to it and stop shutting down your breathing, or did the Doctor reprogram the CPAP to deal with the central apnea? Thank-you for any advice you can provide.
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#2
Welcome to the forum.

We have many users here with Central Apnea.  They are being successfully treated for it.

Treating Central Apnea typically calls for a special machine (ASV) which is more expensive that your typical CPAP machine.

Please post what machine is and what settings you are using.  Also post any sleep studies you have and download SleepyHead and post your detailed charts.  See my sig for how.

It is thru data that we will best be able to help you.
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#3
Hi victorytree,
WELCOME! to the forum.!
Hang in there for more suggestions and answers to your question and good luck to you with your CPAP therapy.
trish6hundred
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#4
Hi victorytree, welcome to the forum.  You have come to the right place.  There are a lot of friendly and helpful people here.

I also have central apnea, and atrial fibrillation.  It has been almost a year since my original diagnosis, and things are a lot better for me now.  I was in a huge hurry to get my machine and get everything going when I was first diagnosed, but it took some time to get the settings right.  But even in the early days, my AHI was a lot lower than it was during my sleep study.  My original AHI was 63.8, but even during my first week on bipap it never got above 11.  In a couple of weeks, it was below 5 most nights.  But there were still nights when it was right back up above 8.  It takes time to adjust, and if you make changes it can take a few days to find out if it is an improvement.  I have become a lot more patient.  But now my AHI is almost always below 1 and I have actually started dreaming again.

My memory is terrible - I am sure oxygen deprivation due to apnea has not helped.  But I've been using Sleephead to look at the data from my bipap machine, so I can go back now and look at statistics for my whole year, so far, or even any given day.  You should take a look at this page: http://www.apneaboard.com/adjust-cpap-pr...r-computer
and consider getting this free software so you can look at your own data.  You can post questions on the forum when you need help interpreting the graphs.  It has helped me a lot to be able to do this.
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#5
G'day victorytree. Welcome to Apnea Board.

Central apnea is said to affect about 2% of the population, though I suspect it's somewhat higher than that. So it's uncommon but not rare. Many people with CA also have obstructive apnea (myself included).

Obstructive apnea occurs when your tongue, soft palate and other tissues in the throat collapse during sleep, blocking (obstructing) your airway. This is the most common type.

Central apnea is a totally different animal. Central apneas occur when the signal from your brain to your lungs to "breathe now" doesn't go through. It may not be generated by the brain, or it may be interrupted and not received / acted on by the lungs. Central apnea may be idiopathic (ie it's an existing condition) or it may be caused as a reaction to the CPAP treatment (pressure induced).

If the central apneas showed up in the original test then they are idiopathic and the appropriate machine is an adaptive servo ventilator (ASV). These are wonderfully effective in most cases but will cost several times as much as a standard auto machine. On the other hand, if the centrals are pressure-induced it may be possible to eliminate them by careful attention to the pressure and EPR/flex settings on your machine.

From your description of your symptoms I believe you have pressure-induced central apnea - is that right? Did central apnea show up on your original sleep test?

As the others have said, get hold of the excellent SleepyHead software which will allow you (and us, if you share) a far more detailed analysis of what's happening.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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#6
I to have centrals and afib  was on bipap 12 but went for a test to update my machine which was 15 years old. I had a hard time sleeping and only got two hours of sleep. Went to dr. and he put me on a auto machine.  Going to get a copy of my test and see if any centrals are on it. 

Now I get about 75% centrals and the rest obstructions.

Would like to get rid of my afib so I guess I have to have a new test to get a new machine.
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#7
Hi victorytree,
I am also new to this site. I was given a CPAP machine at first. Interesting that you indicate that you feel like it is hard to breath at times, I was like that also, They had me buy a bipap, thinking that would solve it. I am now diagnosed with central apnea, and on a ASV machine. Still tired, but this machine is alot better, I dont have that hard to breath issue any more. 
Good luck.
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#8
If you have problems before you are asleep, make sure you ramp and/or min pressure is 6. this is normally the reason for the stuffy suffocation feeling. Then if you are still gasping, that may be a central and need further medical advice on.
new http://www.apneaboard.com/wiki/index.php...re_success
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
From machine or charts for auto-cpap, set the min 1cm below median pressure, or 2cm below 90/95%. max at 20cm for now. Forum will help you fine tune settings
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#9
Hi and welcome to the forum - you have found the right place for help with many friendly and knowledgeable people.

Before getting help here I was having nights with some 60+ central events in one hour and almost every night 75%+ of the events were central. 
 
I also have a form of A-Fib called SVT (Supra-Venticular-Tachycardia over 200 beats/min.) which furthers my desire to get the sleep and apnea under control. 

I'm still in the "fine-tuning" stage but have the centrals now down to under 25% of the events with AHI under 5 most of the time.  With the mixture of both OA and CA for me turning off EPR and reducing the max. pressure (to minimize the CA) and getting the Min. Pressure high enough to handle the Obstructive events (for me I found 8.6 to 11.4 working best so far with EPR turned off).  I would also be sure to get the mask leaks under control as that for me can create false data.  Look at the CSR/PB (Cheyne-Stokes Respiration/Periodic Breathing) as you need to minimize that as well (I was logging as much as 20% of the night in CSR before getting help from this forum). 

Good luck in your quest for a better night's sleep and keep posting here so we can see the progress.
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#10
From what I've noticed by looking at posters' charts, most everyone has central apnea events. My understanding is that these often occur as your body is getting used to CPAP treatment; these become less frequent after you adapt. They are also fairly common in the "getting to sleep" stage.

You may also get "central apneas" when you take off your mask with SmartStart on (or similar). The machine thinks you're not breathing, but in reality, your mask isn't on.

Having predominantly central apneas is a whole 'nother story, as I understand it. This generally has a different treatment regimen than a CPAP, as other posters have mentioned.

The smartest thing for you to do is to download SleepyHead and upload data from your APAP. Take screenshots per the instructions on this forum. Post them. You will get help sorting it all out.

When you have done that, take a bit of time to look at SleepyHead charts that other folks have posted. You will soon get a feel for when they are simply a normal feature in starting out, or when they are something to worry about and get specific treatment for.
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