Unfortunately I belong to the minority of about 10% of the APAP patients that find high numbers of central Apneas in their sleep report. I am useing SleppyHead for two weeks now and was very surprised, to find constantly more CAs than OAs and HAs together.
I have used a ResMed S9 Autoset for more than two years with the inital setting that was set after my first sleep study. In April my insurance company forced me to return the S9 and take a DeVilbiss machine instead. In all this years I always felt, as if I had no treatment at all. Because it became even worse with the DeVilbiss machine I surfed the net and found this forum and SleepyHead software.
After a little fight with my insurance company I could return the DeVilbiss machine and got the next ResMed S9 Autoset, this time with looking at the SlepyHead reports. After finding the high CA numbers it became clear why the therapy was no success. My OAs were treated nicely but were replaced by CAs.
In this forum I have found a post from dgossman who treated his CAs with high doses of vitamin C. That has inspired me to give it a try et voila it worked for me too. Before going to sleep I take 500mg vitamin C plus 500mg vitamin C in a time released C supplement. Up to now that has reduced my CAs by half and no visit to the bathroom. Without vitamin C I had a lot of double CAs that I now only find shortly before wake up time. The positive effect of vitamin C doesn't last very long, but that is fine by me, beause I usually only sleep 6 hours plus 45 minutes siesta.
I'm very glad that I have found this Apnea Bord Forum with all the insights from other sufferers.
Waiting for AHI below 1.0
06-26-2015, 05:09 AM
(This post was last modified: 06-26-2015, 05:11 AM by DocWils.)
There is a debate in the medical community whether or not CAs measured really are Central Apnoeas or just a cessation of breathing without an indicative flow limitation, which indicates an OA - in short, a skipped breath or held breath or rhythm change or a swallow would all read as a CA in that case - all CPAP manufacturers saw no, their devices measure real Centrals, but all medic types say - how can that be without an EEG to confirm? So, the increases in CA events may not be actual Central Anpoea events at all. If they are, and you were not diagnosed with Central Apnoea, it is likely caused by the pressure increase, which can trigger the mind to cease breathing for a beat or two to compensate. EPR often solves this.
There is no hard medical evidence to suggest that high doses of vit C does anything in the way of reducing CA events, but it is certainly worth looking into and I will pass it on to any of my students looking for a thesis. A word of caution - vit C, even in time release form, is toxic over time, and can cause bowel distress and other problems, such as kidney stones, and under no circumstance ever should be taken if you have hemochromatosis, as it would worsen any iron overload in your body and cause permanent tissue damage. Be sure, with your physician, that your iron levels are not too high ever before starting on a regime of high dose C.
Also, don't don't obsess about your AHI numbers - anything below 5 is brilliant, and getting below 1 is illusory - in the real world, people with NO apnoea whatsoever don't normally score below 2 to 3 consistently - an AHI of 0 does not exist in nature. Your body does not work that way.
Doc, to be counted as an apnea, the breathing pause has to exceed 10 seconds. That's too long for a skipped breath or held breath or rhythm change or a swallow, don't you think?
Apnea Board Moderator
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.
06-26-2015, 05:30 AM
(This post was last modified: 06-26-2015, 05:34 AM by DocWils.)
(06-26-2015, 05:17 AM)DeepBreathing Wrote: Doc, to be counted as an apnea, the breathing pause has to exceed 10 seconds. That's too long for a skipped breath or held breath or rhythm change or a swallow, don't you think?
Nope. Not when sleeping. When awake, yes. But the entire breathing rhythm is heavily slowed at night, and swallows combined with a skip breath are not uncommon, nor cessations for near ten seconds due to carious causes, including changes of sleep state. The point is rather the debate as to what the CA count may really mean on a CPAP - I know neurologists who are p***ing furious at the big manufacturers for their claims that they are indeed measuring ONLY Central Events with their algorithms, instead of saying that they are calculated guesses - possibly good guesses, but calculated, and not a real measure. The debate rages on. Especially in the canteen (what you call a cafeteria). In fact, and by coincidence, I had a discussion with a another doc about this the other day over lunch, and she was pretty adamant about her standpoint. I miss the days when we discussed the symphony or any non medical thing over lunch - we don't discuss the ballet any more, because for years we have had rotten ballet directors and never go any more, and I never discuss sports, and politics only begets fist fights.
[quote='pizza41466' pid='119458' dateline='1435303652']
In this forum I have found a post from dgossman who treated his CAs with high doses of vitamin C. Without vitamin C I had a lot of double CAs that I now only find shortly before wake up time. The positive effect of vitamin C doesn't last very long, but that is fine by me, beause I usually only sleep 6 hours plus 45 minutes siesta.
Hi pizza41466. I also have very high CAs on Bi-PAP that were HAs in my sleep study. Sleep Study HAs produced an AHI of 44. On Bi-Pap AHI is around 30 nearly all CAs. I think I will give the Vit C a try. It may be just what is needed to lower blood pH and return breathing to normal.
Thank you doc, for the advice on hemochromatosis. One more reasen do donate blood on a regular basis. The next check up with my general practitioner is due in a couple of weeks. I will tell him to include the iron level with the lab order.
I always added vitamin C to my nutrition (for stressed people like me, who is stressed at night), but up to now I took the dose in the morning. So what I do is changing my time table and increase the dose.
When I look at the waveform that Sleepy Head shows, I often thought that my OAs look very similar to my CAs and wondered, how the machine can precisely distinguish between the differnt types of apnea. The theory behind the software algorithm sounds plausible, but in real life it might be more complex.
It's not my goal to only improve numbers, but they indeed correlate to how I feel. It was very frustrating to be on CPAP treatment for more than two years with next to no benefit.
Thanks to fine tuning and suggestions from the community I now see light at the end of the tunnel.
[quote='pizza41466' pid='119481' dateline='1435323894']
When I look at the waveform that Sleepy Head shows, I often thought that my OAs look very similar to my CAs and wondered, how the machine can precisely distinguish between the differnt types of apnea.
My ResMed AirSense 10 trys to identify a CA by sending out tiny puffs of air to check for an open airway. Looking at my SH graph there are a lot of events that look like periodic breathing (HA) and short CAs that don't have a breathing interruption long enough to count as a CA. I am going to give the Vit C a try. I don't expect to see a big difference since the machine seems to be flushing out a lot of CO2 raising my blood pH. When I am able to lower the pressure (hopefully with Dr approval) I will get a better idea if the Vit C works.
06-26-2015, 08:38 AM
(This post was last modified: 06-26-2015, 12:09 PM by Mosquitobait.)
Have you tried just eating red bell pepper or kiwi fruit for an evening snack before bedtime? Given that the average American doesn't get enough fruit and veggies, it will also likely help your diet more than a pill. Both have more vitamin c than an orange. Just a thought of something to try.
(06-26-2015, 08:38 AM)Mosquitobait Wrote: Have you tried just eating red bell pepper or kiwi fruit for an evening snack before bedtime? Given that the average American doesn't enough fruit and veggies, it will also likely help your diet more than a pill. Both have more vitamin c than an orange. Just a thought of something to try.
The idea behind the Vitamin C is that it might produce a temporary increase in blood pH. The body's response would be to increase respiration which removes CO2 and lowers blood ph. The increased respiration might eliminate the HAs and CAs.
One of my favourite dinners is a blueberry fruit salad (blueberries, banana and apple in a bifidus yoghurt dressing) - that is a massive C boost, but there is no corresponding change in my CA count - and despite having simple OSA, I show a higher number of "CAs" than OSAs most nights. My initial testing showed no CA events. So the CA events might be something else and in response to the pressure - not necessarily a real Central Apnoea, or it may be - who knows? Since my numbers hover between 1 and 2.5 I don't concern myself too much - any time I check my sO2sat overnights, there is never a desat below 91%, with the average desat only to 93%. in the end, that is all that counts, rather than a potentially interrupted breathing pattern.