Justifying Advanced PAP Machines

Justifying ASV

Central Sleep Apnea (CSA) is the cessation of respiratory effort result in a lack of respiratory movements. During sleep, your breathing is disrupted regularly because of how your brain functions, your brain simply doesn't tell your body to breathe, and therefore you don't try to breathe.

Hypopneas - Obstructive and Central

How can you tell the difference between obstructive and central hypopneas?

An obstructive hypopnea if you experience:

1. An increase in PAP flow signal
2. Snoring during the event
3. Paradoxical breathing

A central hypopnea will have none of the above.

Five types of Central Sleep Apnea

per the Mayo Clinic

1. Primary CSA, which is the same as idiopathic CSA–the patient has no known related diseases.
2. Cheyne-Stokes breathing CSA, which may be a product of heart failure, stroke, or possible kidney failure.
3. Non-CSB CSA associated with other medical conditions, including heart and kidney problems.
4. High-altitude CSA, which often appears during sleep at altitudes above 15,000 feet, and induces a form of Cheyne-Stokes breathing with noticeably shorter cycles than classical CSB.
5. CSA induced by the use of certain drugs, typically opiates.

Diagnosis of Central Apnea

1. Must have clinical symptoms or medical comorbidities to make the diagnosis

- Sleepiness, insomnia, snoring, apneas, awakening with Shortness of Breath - A‐fib, CHF, or neurological disorder (such as stroke, MS)

1. Central AHI >5
2. Central apneas and Central hypopneas >50% of total AHI
3. Not better explained by another sleep disorder

Hypopneas - Obstructive and Central

How can you tell the difference between obstructive and central hypopneas?

An obstructive hypopnea if you experience:

1. An increase in PAP flow signal
2. Snoring during the event
3. Paradoxical breathing

A central hypopnea will have none of the above.

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