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DiscussionCan a CPAP machine treat central apneas?
Sleep Health | Last Active: Aug 30 12:13pm | Replies (37)Comment receiving replies

I have mostly Central Sleep Apnea. 30 to 50 events per hour. I also have an O2 ring and suggest everyone get one. First time I used my O2, it showd my Oxygen dropping by 8-10 points every 40-45 seconds all night long. This cycle seems to happen even though I'm breathing as I can watch it go down as I am breathing at 15 Breaths per minute (which is every 4 sec). This would happen as i was very relaxed and almost asleep. It would cycle between 98% to 88% all night long at an almost fixed rate or every 40 seconds. I put the ring on my wife and kids and it was steady. What is going on with me. I don't wake up and gasp. I don't think I'm obstructed. I don't snore. I even had a dental appliance made to advance the jaw, which would stop obstuction from the tongue going back while sleeping. At times the O2 would go to low 80% and even below for 10-15 minutes at a time. Still after 5 complete sleep studies have I NOT received an description of what is happening. The docs just seem to want to "try this and if it doesn't work we will try something else". Central Sleep Apnea is hard to treat. From information I gathered from the net, supplamental Oxygen via a nasal cannula "makes it melt away" in some patients. I could not get any of my doctors to even try it.
I believe its an lung oxygen transfer problem that happens with very shallow breathing due to possibly some lung defects in the part of the lung involved during shallow breathing. The CO2 does not build up ( which is the usual feedback to cause a breath) because CO2 transfers much easier then O2. So with no CO2 feedback to cause a breath the O2 drops till a back up system detects the low O2. This will either open more blood flow to the lungs or deeper air flow etc, which restores the O2 but now it goes to high and the system cycles. this is what engineers would call a feed back loop over compensation. So much for my theory.
Yes, you need to download your cpap data to OSCAR and look at your flow to see if it stops or just get reduced etc. You need to expand the view so you can see the individual events. Lots of interesting data in there.
My first Tx was a BIPAP machine which did nothing but made it worse as I was now getting Chayes Stokes breathing pattern from it. After 5 complete sleep studies in a lab, my last sleep study, which was to titrate me for an ASV machine (needed to get insurance to pay) seemed to indicate the ASV machine will reduce the events. My first night with the ASV machine, the events were under 5, and almost always an hypopnea rather then apnea. This would appear to be great news. However, the machine is designed to keep the Minute Ventilation to a fixed level and will vary the mask pressure up and down as it learns what events lead to the apnea and it tries to intercept this before it happens. This results in very high pressures at times,(machine max at 24), which is difficult to prevent mask leaks.
I coordinated my O2 ring data with the ASV machine data into OSCAR. Need to put in time correction to get them both aligned for some strange reason. There is no way go correct the time stamp of machine even when traveling internationally. The O2 ring gets it time from the apple watch. They were off by just under 2 minutes and hours because of DST. Interestingly, the O2 will still go down at times to although not as low as without the ASV machine. The machine is happy keeping minute ventilation at a fixed level even though the O2 is now in mid 90s% rather than 98% or so.
I don't know why they don't make a machine whose goal is to keep the O2 up rather then just a nice flow rate. I assume there is a lung problem that the doctors tends to ignore with central sleep apnea. Their goal is to get events down. Its a very complicated system with various feedback loops, that's pretty simple to understand with Obstructive Sleep Apnea. I'm not so sure they (the doctors) really understand the problem or cause with central sleep apnea. I have my own theory but still need to get doctors to do more testing. Make sure you get a Pulmonary Function Test, which will tell you how good your lungs are doing. (obviously, a big part of the equation).
Anyway, to answer the original question: YES a machine can help with central apnea but you probably need an ASV machine not a normal CPAP or BIPAP. They are expensive and you may need a sleep study to prove it works for you to get insurance to pay. I have traditional medicare with an insurance secondary, and so far everything has been covered.
My machine as an aircurve11 ASV auto.
Hope this information helps.
I'll check in randomly to see if anyone has further questions.
Replies to "I have mostly Central Sleep Apnea. 30 to 50 events per hour. I also have an..."
An ASV is really the only effective treatment machine for central apnea, and may be needed for 'complex' apnea where the two forms are present in one body. For some reason I still get statements from qualified physicians, even experts such as electrophysiologists, who tell me that I might need a BiPAP machine if I have the odd central. I don't bother pointing out that the heavy majority of CA sufferers continue to do poorly on anything but the admittedly very costly ASV machines.
I sincerely appreciate seeing your detailed and comprehensive responses here.