It seems to me this is an important question since a lot of people like me will inevitably have more central apnea if they increase the pressure of their CPAP to eliminate more obstructive apneas. I've always assumed obstructive apnea is worse, especially in my case since it always mostly occurs during my REM sleep, but I've never actually looked into it.
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What's worse? A central or an obstructive apnea
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05-28-2020, 12:55 AM
What's worse? A central or an obstructive apnea
Are central apneas as bad as obstructive apneas? Does anyone know if you have as strong a physiological flight or fight response to central apneas as you do to obstructive apneas? I'd be curious as to whether there is any research into whether desaturations and heart rate increases are as great during central apneas as they are during obstructive apneas. Or peoples personal experience.
It seems to me this is an important question since a lot of people like me will inevitably have more central apnea if they increase the pressure of their CPAP to eliminate more obstructive apneas. I've always assumed obstructive apnea is worse, especially in my case since it always mostly occurs during my REM sleep, but I've never actually looked into it.
05-28-2020, 02:32 AM
RE: What's worse? A central or an obstructive apnea
Each depends on the duration and what your level of O2 saturation was at the time of onset.
Generally, an OA of 30 seconds is going to be worse than a CA of the same duration. The rationale is that a CA is often due to hyper-flushing of CO2 from the blood stream going to the lungs, and this happens because so much air is being pushed through the lungs by the PAP machine. That is, many CA's are caused by the PAP therapy itself. We inhale due to a stimulus caused by rising CO2 in the blood. Some ventilators get us acidotic if they're too aggressive, and we find that we develop therapy-onset CA's. CA's that are caused by other matters could potentially be more problematic in the long run. But if we assume that a person getting CAs is not suffering from a lack of O2, but a lack of CO2, this is not the same as, or as deleterious as, a person who is hypoxic and running consecutive events of OA.
05-28-2020, 10:43 AM
RE: What's worse? A central or an obstructive apnea
I don't know which is worse, but as I recall, most of my obstructive apneas were just over 10 seconds while some of my central apnea events were longer. One CA on a BPAP sleep study was at 90 seconds. Me personally, I grade both as bad, but since I get more CA I'll say they are worse. I will say mesenteria has a point to consider on the CA in that a lowered level of CO2 is the typical cause of them.
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05-28-2020, 06:08 PM
RE: What's worse? A central or an obstructive apnea
"Generally, an OA of 30 seconds is going to be worse than a CA of the same duration."
I don't buy this. "generally" speaking, not breathing is not breathing. otoh, I do agree that some ca is pressure induced or wakeful breath holding or otherwise what many have called false ca & those can be discounted. I've yet to read anything that suggests a true ca is less damaging than oa. |
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