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Apnea ? Central as well as obstructive
When tested I did have one Central apnea episode, as well as many obstructive. So my question is will my c pap also work for the central apnea ? I think I had one last night , and its got me wondering ? I ask because in the years before I got my machine, I felt what in my estimation may have been , Deeper more prolonged apnea events where I actually had to jump up and revive myself, because I felt I was dieing.And the other night even with my machine on I had an event. Even when awake , sometimes I find myself holding my breath unknowingly, and wondered if that might have something to do with the Central Apnea. Also at my sleep study, my sleep was nowhere near like I sleep at home.After 10 years of having so many doors slammed in my face trying to get a sleep study w/o insurance I had trained my body into not sleeping deeply, fighting off the apnea. I am so happy and feel truly Blessed to have finally found someone to accept me on a sliding scale fee,so I can now sleep without fear of dying every night. This forum is wonderful, wish I had found you sooner
Views: 46
Replies to This Discussion
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Permalink Reply by Mike on
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as the sleep techs here will tell you, sometimes a single central episode is caused by the CPAP titration, and is not clinically important. I'm not sure that's the case for you. But i just don't want you to worry unnecessarily.
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Permalink Reply by RockRpsgt on
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I would not be worried about 1 central apnea. The answer to your question is maybe. Central apneas will sometimes get fixed with CPAP. Sometimes not.
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Permalink Reply by Duane McDade on
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It was not a central apnea.
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Permalink Reply by Susan M. Nelling on
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I added to my question , please read . then I ask,Why do you say that? How could you know ?
Duane McDade said:It was not a central apnea.
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Central apnea does not work that way. For one you have to be asleep to have an apneac event. Second one Central event is not enough to diagnose you with central apnea. If you catch yourself holding your breath than you are doing just that. People whom have CSA or complex apnea will rattle them off like machine gun fire, one after another. CSA is usually tied to another medical problem like heart disease, muscular degeneration, or a central nervous disorder. A diagnosis of CSA or complex apnea in the grand scheme of things is very rare.
On another note I know that we like to say things like " I trained my body into not sleeping deeply, fighting off the apnea". The truth of the matter is that the apnea is what kept you from getting good sleep. I think it is important for you to move forward in treating your obstructive apnea. Listen and to your doc, and don't read too much into it.
Susan M. Nelling said:I added to my question , please read . then I ask,Why do you say that? How could you know ?
Duane McDade said:It was not a central apnea.
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central apneas are very rare , very rare. Machines can't see central apneas. Some humans can't. You need an EEG and Air Flow gage of some kind. It all has to do with when the effort starts and the brain wakes up. So your CPAP machine can't do that.....ergo not a central apnea. The machine does not know what your brain is doing. It only knows kind of , if you breathing or not.
Susan M. Nelling said:I added to my question , please read . then I ask,Why do you say that? How could you know ?
Duane McDade said:It was not a central apnea.
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no they are not! JNK I know you've read that, and you can link the pages, but central apneas are not common. There are central like Apneas, but a true central Apnea has nothing to do with sleep onset stuff. For frigin Gods sake ! Trust me. You're misleading these poor people looking for help!! Can't you see that ? maybe thats not the best idea in the world? Sometimes a little wrong information can be dangerous.
j n k said:Actually, occasional central apneas are very common; very, very common. (Many people have them when falling asleep and sometimes when transitioning between sleep states.) And home machines that are full-data see all apneas, central or obstructive--they just aren't usually very good at knowing whether an apnea was obstructive or central. Full-data machines ARE a flow gauge. A very, very, very reliable one, as long as leak is under control. It is true that home machines don't score like a PSG, but the data ones don't miss apneas.
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I have to agree with Duane jnk. A central event at onset, in a transitional period, or within 10 seconds after an arousal is not a true central event. No tech that I know would score it as such. Central like events may be common, but true CSA is not. At onset your gas exchange needs change almost immediately. This compounded with the loss of muscle tone brought on with the relaxation of sleep onset can make for some strange happenings. The next thing we have going on are transitional centrals. when we go from one stage of sleep to another it is an arousal. During these arousals once again you have a change in gas exchange and brain function. You also during an arousal gain some muscle tone back or flex for a fraction of a second. It is very common for a person to hold their breath when they flex. For this reason most labs/techs have a standing rule not to count central within 30 seconds of onset or 10 seconds of an arousal. You are correct in the fact that these events are common, however they are not true centrals.
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I'm not being a stick in the MUD Dude, but machines just see the lack of breathing and NO the machines can not judge mixed or central apneas. If you believe they can (without effort belts or EEG.) just by an air tube. Than power to you brother! If you wake up and take a big swallow ....the machine will note that was an apnea! It doesn't even know if you're sleeping or not, so if you hold your breath the machine will also note an apnea. Don't go there please, I do not work for a company that makes these machines. I think you do........I have no agenda, do you? We all know the answer to that.
j n k said:Yes, you are right, Duane. Wrong information can be dangerous.
Rock, ignoring a central as nonsignificant, and thus not scoring it, does not mean it didn't happen. My point is that the home machines score them all, according to their criteria. To a home machine, an apnea is an apnea and a hypopnea is a hypopnea, central or obstructive. Some home machines try to guess if an event was central or not, but it scores the change in breathing either way.
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You just hit one of the problems with auto machines on the head jnk. this is exactly what I have been trying to explain to you. Auto machines WILL score nonsignificant events such as onset events or holding ones breath while awake. This leads to overtitration and tolerance issues. Not all events are significant thus they do not need to be scored.
I am an advocant for fully data capable machines that provide good usable data to the pts.
j n k said:Yes, you are right, Duane. Wrong information can be dangerous.
Rock, ignoring a central as nonsignificant, and thus not scoring it, does not mean it didn't happen. My point is that the home machines score them all, according to their criteria. To a home machine, an apnea is an apnea and a hypopnea is a hypopnea, central or obstructive. Some home machines try to guess if an event was central or not, but it scores the change in breathing either way.
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I'm down with the equal partner thing you speak of. The fully data thing too! but lets not get carried away with what these machines are capible of. When they can do what they claim I will be the 1st to pat them on the back. I hope you understand if I didn't see this 3-4000 times than I would not have this .... my pen is mightier than their swords attitude but being a confident S.O.B. doesn't hurt , much. I love you, because I know you mean well..........Duane
j n k said:Ha! :-)
The machine manufacturers hate me, Duane. I am a thorn in their side, a bane to their existance. My position is that the DMEs, their real customers in the USA, dictate too much to the manufacturers. It is my position that the reporting technology in the home machines is behind the times and that the machines are overpriced due to ugly minimum-advertised-price gouging. I will shake a manufacturers hand, yes, but I will not pat them on the back, any of them. Why is my overpriced blower dumber than the cell phone on my belt? Why doesn't it have a color screen that shows me my daily leak and AHI in chart form? Because big business doesn't think it important for me to have that--that's why.
Still, the machines are the gold-standard treatment, and customers deserve machines that give them efficacy data. If I had my way, it would be illegal to sell a non-efficacy-data machine in the U.S. That makes me an enemy of manufacturers and DMEs. Doctors, on the other hand, just smile and wink. ;-)
The info from the machines is not as good as a PSG. But it is the best data available to a patient when it comes to getting good therapy over time every night, so I am an advocate for it as a patient.
I humbly submit that you, as a professional who cares about patients, should be an advocate for that too. Let us share the agenda of good treatment and good information for patients, even patients as contrary as I can be. :-)
I do, however, take my hat off to techs and therapists who want patients to be equal partners, at least, in their own PAP therapy.
jeff
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