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I have a woman in my AWAKE group who says she read- and that her doctor had told her -- that CPAP or BIPAP can actually CAUSE central sleep apnea to develop.  Anyone know if there's truth to this?  She writes:

That is beyond shocking because it suggests that this treatment is potentially LETHAL. ok so it does not always work-but CAUSING a severe neurological issue????????

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I think this danger is overstated.  How many people do we know who have had significant centrals (measured in the lab, looking for centrals in particular) caused by CPAP pressures.  I don't believe this situation could be over looked by the user until he/she sought medical help.

They would feel bad with significant centrals.

I do know that too high a pressure can cause centrals, so people need to be careful if they're adjusting their own machines.

what i have heard, not sure how accurate it is, or whether scientific knowledge is far enough even to have an answer on this, is that the brain can get "lazy" over time, so accustomed to the easy intake of air with CPAP that it "forgets" to send the signal for the body to breath.   all in all, people with OSA are likely much better off using CPAP and taking this remote risk than not using it and succumbing to the good likelihood of early death due to heart disease, diabetes, etc.

Interesting theory, and would be keen to hear more about this from Rock or anyone with the knowledge!  My PR One Software used to show up centrals before I got my correct levels sorted.  Now they're very minimal - mainly none or 0.1. 

Mike said:

what i have heard, not sure how accurate it is, or whether scientific knowledge is far enough even to have an answer on this, is that the brain can get "lazy" over time, so accustomed to the easy intake of air with CPAP that it "forgets" to send the signal for the body to breath.   all in all, people with OSA are likely much better off using CPAP and taking this remote risk than not using it and succumbing to the good likelihood of early death due to heart disease, diabetes, etc.

I know that in the 15 months I've used CPAP, the apneas my machine (resmed autoset s9) reports are almost all centrals apneas.  I typically get a couple of hypopneas per night and an obstructive apnea every few days, but around 2 centrals per hour.  This is about the same number of central apneas as my sleep study reported.

When my pressure increases, the number of centrals goes up.  After a certain pressure threshold, they become significant enough to wake me up with a surge of adrenaline.  So I have to make sure that my upper pressure limit is not too high (and this is problematic, since I wake up if the pressure is too low as well).

But I've never heard about CPAP causing central sleep apnea to develop and continue even without the use of the CPAP itself.

I think she may be taking her doctor's statement out of context. Too high xPAP pressure can cause central sleep apneas. This is called complex sleep apnea.Typically, it gets better as the pressure is lowered. I'm not aware of new central apneas persisting after PAP therapy removal. It's actually normal to have a few central apneas once in a while. Newborns have much more central events that are considered normal.

After showing centrals on my ResMed9, I was told by my doctor that the centrals may show up when on CPAP because everytime you change from one stage of sleep to another that it could show up as a central. And he told me not to worry about it.

Swallowing and talking will show up as centrals also.

Mary Callahan said:

After showing centrals on my ResMed9, I was told by my doctor that the centrals may show up when on CPAP because everytime you change from one stage of sleep to another that it could show up as a central. And he told me not to worry about it.

There is typically a little more going on than high pressures in these types of pts. Complex apnea is caused by gas exchange and chemo receptor issues in the lungs. These problems are exacerbated by CPAP pressures in some pts.  On the whole we see complex apnea with cardio and pulmio problems. This disorder is almost a nightly sight here in the mountains. In a high % of these pts CSA or even CSR will eventually develop on it's own.

 

Steven Y. Park, MD said:

I think she may be taking her doctor's statement out of context. Too high xPAP pressure can cause central sleep apneas. This is called complex sleep apnea.Typically, it gets better as the pressure is lowered. I'm not aware of new central apneas persisting after PAP therapy removal. It's actually normal to have a few central apneas once in a while. Newborns have much more central events that are considered normal.

one member took me to task (see quoted text below).  of course, i didn't mean to upset anyone, but i hear what she's saying.  apologize if anything i said caused dismay/ discouraged anyone:

I know how important *pap treatment is and I use bi-pap every night, to help to stop the complications of sleep aponia, which could cause premature death. I am, also, a type 1 diabetic and the same goes. If I keep up treatment and keep my blood sugar in the correct range I will not be "succombing" to an early death anymore than anyone else. Please be careful how you write as your last discussion really upset me, and more than likely others.

Mike, I believe this had to be said.  Changing ones pressure in the begining without a doctor's guidance could result in central apneas, especially when you get to the higher pressures. 

I have been using CPAP for 5 years now with moderate OSA.  Last week, for the first time, I realized that during the day I started holding my breath until I was almost choking.  It's been happening quite a few times per day and I am worried that I have somehow developed Central Sleep Apnea.  I do suspect that I am getting too used to having a machine help me breathe and 'getting lazy'.

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