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Persistent Central Apnea
Okay I have a very similar situation to you and I was wondering what your next step turned out to be. I have onset centrals and have been on autobipap for two months. When I am a little bit awake my centrals can go high and in clumps. besides that they make up half my event s on a good night. I too am learning to side sleep and got a good buckwheat hull pillow to help my neck And I put a body pillow behind my back tightly. Anyway any updates would Be awesome.
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How did ASV go I am in similar situation
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(06-03-2017, 10:12 PM)ronstar77 Wrote: Okay I have a very similar situation to you and I was wondering what your next step turned out to be. I have onset centrals and have been on autobipap for two months. When I am a little bit awake my centrals can go high and in clumps. besides that they make up half my event s on a good night. I too am learning to side sleep and got a good buckwheat hull pillow to help my neck And I put a body pillow behind my back tightly. Anyway any updates would Be awesome.
Yes, its the light sleep where the centrals occur and REM sleep where the OAs occur. 

Happy to let you know what's going on. I stopped using my APAP in late February after a followup sleep study showed that APAP, CPAP nor BiPAP relieved my centrals. To be clear, this is complex apnea I'm dealing with (as yours seems to be); it started when PAP treatment began, not before. I decided not to go to ASV right away - but rather try some "alternative" treatments. 

My sleep doc agreed wholeheartedly that trying a belt to keep me on my side during sleep was a worthwhile idea. (He had just come back from a Sleep Disorder Symposium where it was a popular topic.) All my OAs and most of my HAs occured while sleeping supine, so that seemed like a very worthwhile purchase. (Never tried a body pillow, but it should do the same thing if it works for you.) It turns out that the belt has been very successful for me. The one I have is not at all uncomfortable or hard to get used to. It works well. The only thing I don't love about it is that it has a plastic odor, which has diminished with time, but still lingers a bit.

I also started doing exercises to firm tongue, soft palette and back of the throat muscles. (There are many sources on youtube for these; I prefer one put out by South Dakota University: https://www.youtube.com/watch?v=VdRmsJYb8_Y&app=desktop

Additionally, I cut out dairy (due to the bit of congestion it caused). I also have been getting acupuncture treatments to lower stress and support my blown out adrenals (from long term sleep apnea). There is a strong connection for me between stress levels and central apneas; I have even more CAs in times of stress.

I think all these things are working in combination, but the belt is probably the thing that makes it possible. Since I no longer have a machine to keep count of my apneas, I occasionally use a pulse ox to look at my Oxygen Desaturation Index (ODi) - altho it's been a while now since I've done that because I wake up much earlier than I used to and feel much better. That is informing me about how well things are going.

One more thing. The major reason I hesitated to move on to ASV is that my drive to breath is thwarted with pressurized air. Event though ASV is not constant pressurized air, I felt it might well have a similar affect, and if I could find another answer, I'd be better off. If these other things hadn't worked, I'd likely be seeking ASV treatment. 

Hope this is helpful.
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Dear tiredDogs

My understanding is that you are still on the AirSense machine.  That is a constant pressure machine with a mild form of exhale pressure relief.  Your test was, I guess, for a bilevel machine, i.e. an AirCurve.  The bilevel machine is much easier breathing that the constant pressure AirSense.  It increases pressure on the inhale so that inhale breathing is assisted.  In doing that, it fools the brain and makes the exhale breath easier-because there is a differential pressure between the inhale and the exhale. If this is your next machine, I think you are going to be pleasantly surprised at the ease of breathing improvement over the constant pressure machine.

That having been said, it is nor going to take care of your CA's.  I to, started out with an AirSense10, then moved to an AirCurveVAuto,  then finally to an ASV.  It was one of those things of having to jump through hoops to satisfy Medicare requirements for the ASV machine-which is very expensive.  I can fully understand Medicare not wanting to easily hand out that type of machine, especially since a lot of CPAP machines wind up as doorstops.

If an ASV machine is what you want, stick to your guns!  It is a great machine and very easy to get used to.  I thought there might be some adjustment period in getting used to the forced breathing  aspect of the machine associated with CA's, but there was none.  I sleep much better, don't take afternoon naps, and have my AHI's down in the less that 2 per hour range.
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Tireddogs says she is not using any machine. Using a position controlling belt, eliminated dairy and monitors with a ODi.
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I see there is no one answer for this thing we struggle with I like the idea of being all natural first and seeing how that pans out my goals for those things are realistic in that I expect without expensive MMA (jaw advancement) surgery I will probably have some form of PAP device for the rest of my life(just turned 40). I am hoping that implementing side sleeping, losing some weight, bmi is 29, and maybe a dental device in conjunction with the pap I can get the settings low enough to not have to worry about the onset centrals and other issues that come with higher pressures. My doctor is sure my jaw is part of the problem so jaw advancement is one of my major causes.
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Dear Tasmart

The last sleep study did, indeed, demonstrate neither CPAP or BiPap worked for me. Centrals persisted, so it has been established that I need ASV as far as insurance is concerned. 
However, I decided to try the belt (and a few other things) because if it worked, it should get rid of my centrals since they are a product of the PAP. So, I experimented. Seems to be working really well, but if at some point I feel that I really do need ASV, I will pursue it.

Thanks for you thoughts about this. Appreciate your concern.
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I spent a lot of time analyzing my sleep study. There is a lot of info in it, but somethings really stood out for me, particularly that ALL my OAs happened while supine. I was unable to stay on my sides while sleeping, and when I asked my sleep doc about something that could help to keep me from turning onto my back, he mentioned the belt and agreed it made sense to try it. So I went from there. It all made sense to try these things given my situation. 

Perhaps there are somethings in your sleep study that can point to things to try to improve your situation. It's been a long exploration on my end to figure things out - lots of support from others on this, and similar forums. Lots of looking at my sleep study, checking my SleepyHead data everyday, and asking lots of questions when visiting my sleep doc. 

One of the things that pushed me is that the centrals kept increasing with time. They typically were 65-80% of my AHI, but toward the end of my tenure with my APAP, it was often over 90% and my AHI was climbing. I didn't feel well at all. That was a strong motivation to find another way to stop sleep apnea.

I really wish you luck with this.
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Yeah almost all my OA HAPPENED while "supine" sounds like we have similar scenarios I am also looking at a couple used asv machines and just do the titration myself let's face it our give a Dam is worth 10 times the clinics "experience" at least what you get for only thousands of dollars. like we will see maybe I will find peace without.
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