Can a CPAP machine treat central apneas?

Posted by gramps @gramps, Jun 17, 2020

I was diagnosed with moderate to severe apnea 8 years ago. Twice I tried to adjust to the CPAP machine, twice I gave up after a few weeks. Then last year I decided to try it again - this time the machine was much quieter and I had a more comfortable mask, and after a few weeks of struggling I was waking up in the morning more rested and alert than I had for many years. Eureka!
But after a few months of this, my AHI shot up from 4 to anything between 6 and 12, and my sleep quality really deteriorated. This has been going on for about 3 months. (My GP thinks it may be because the Corona business disrupted my life, and that as things go back to normal so may my sleep.)
Turns out the CPAP is doing wonders with the obstructive apneas - they are close to zero - but I now have central apneas.
Today I went back to the sleep doctor to ask about other treatments. Without explaining why, he said that he treats central apneas that come after CPAP treatment the same way as obstructive apneas, took me in to the technician and told her to work with me, to raise the pressure. And to come back to him if it doesn't help.
Has anyone had experience with, or know anything about, cases where the CPAP machine resolved central apneas?

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Hi @gramps, Welcome to Mayo Clinic Connect. I use a CPAP to treat my obstructive sleep apnea but have not really looked into central sleep apnea. I do believe I've read that a CPAP is also used for treating central sleep apnea. There is another discussion on Connect that you can meet other members discussing central sleep apnea -- Central sleep apnea. Cause?: https://connect.mayoclinic.org/discussion/central-sleep-apnea-cause/

@peetiepie @tiss @thankful and @mstara may be able to share what they are using for treating central sleep apnea. You may be interested in reading the following article I found on the Mayo Clinic News Network.

Mayo Clinic Q and A: Understanding central sleep apnea: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-understanding-central-sleep-apnea/

My AHI has been around 4 or lower on a regular basis but I've had several episodes every once in awhile where it shoots up to 5 to 8 for a period of 3 or 4 days. How are the central apneas identified, everything other than the ones listed obstructive?

REPLY

Hello @gramps, and again, welcome to Mayo Clinic Connect. Great question about CPAP and central apneas. I'd like to tag some other members (I know @johnbishop also tagged a few people) who have talked about central sleep apnea or other forms of sleep apnea who may have some insights for you. Please meet @kiwi @trippangie17 @yusofa @menotpvcs @hosta @johnhans and @gailb.
Once you have a chance to use the CPAP at the new pressure recommendation, will you have a follow up with your GP?

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@johnbishop

Hi @gramps, Welcome to Mayo Clinic Connect. I use a CPAP to treat my obstructive sleep apnea but have not really looked into central sleep apnea. I do believe I've read that a CPAP is also used for treating central sleep apnea. There is another discussion on Connect that you can meet other members discussing central sleep apnea -- Central sleep apnea. Cause?: https://connect.mayoclinic.org/discussion/central-sleep-apnea-cause/

@peetiepie @tiss @thankful and @mstara may be able to share what they are using for treating central sleep apnea. You may be interested in reading the following article I found on the Mayo Clinic News Network.

Mayo Clinic Q and A: Understanding central sleep apnea: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-understanding-central-sleep-apnea/

My AHI has been around 4 or lower on a regular basis but I've had several episodes every once in awhile where it shoots up to 5 to 8 for a period of 3 or 4 days. How are the central apneas identified, everything other than the ones listed obstructive?

Jump to this post

@gramps- I am not real familiar with central sleep apneas, but I've been told by my sleep specialist that he wants to keep mine below 4. He has me on a pressure of 11 and that seems to keep me well below 4's, but recently had a 4.9 which was totally uncharacteristic for me? I seem to have issues more often with the mask leak sad face and the last time I was in to see my specialist he said he is not real concerned about that, but rather the AHI's. Since mine is often 1.5- 2.5 he said no problems here.
I could understand if your Dr. would want to 1st try increasing the pressure as a 1st step to see if your apnea's decrease.
Makes sense to me. Hopefully that will bring you back to those restful sleeps you were having before. Happy Zzzz's.....
Jim @thankful

REPLY
@johnbishop

Hi @gramps, Welcome to Mayo Clinic Connect. I use a CPAP to treat my obstructive sleep apnea but have not really looked into central sleep apnea. I do believe I've read that a CPAP is also used for treating central sleep apnea. There is another discussion on Connect that you can meet other members discussing central sleep apnea -- Central sleep apnea. Cause?: https://connect.mayoclinic.org/discussion/central-sleep-apnea-cause/

@peetiepie @tiss @thankful and @mstara may be able to share what they are using for treating central sleep apnea. You may be interested in reading the following article I found on the Mayo Clinic News Network.

Mayo Clinic Q and A: Understanding central sleep apnea: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-understanding-central-sleep-apnea/

My AHI has been around 4 or lower on a regular basis but I've had several episodes every once in awhile where it shoots up to 5 to 8 for a period of 3 or 4 days. How are the central apneas identified, everything other than the ones listed obstructive?

Jump to this post

Not sure what you mean by "how are they identified". They show up in the data from the CPAP machine.

REPLY
@kellyhahn1

Hello @gramps, and again, welcome to Mayo Clinic Connect. Great question about CPAP and central apneas. I'd like to tag some other members (I know @johnbishop also tagged a few people) who have talked about central sleep apnea or other forms of sleep apnea who may have some insights for you. Please meet @kiwi @trippangie17 @yusofa @menotpvcs @hosta @johnhans and @gailb.
Once you have a chance to use the CPAP at the new pressure recommendation, will you have a follow up with your GP?

Jump to this post

I tried the higher pressure last night (maximum 10). So far it hasn't done much for me (ahi 8.4). I guess I'll have to do it for a few nights to get any conclusive data

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@thankful

@gramps- I am not real familiar with central sleep apneas, but I've been told by my sleep specialist that he wants to keep mine below 4. He has me on a pressure of 11 and that seems to keep me well below 4's, but recently had a 4.9 which was totally uncharacteristic for me? I seem to have issues more often with the mask leak sad face and the last time I was in to see my specialist he said he is not real concerned about that, but rather the AHI's. Since mine is often 1.5- 2.5 he said no problems here.
I could understand if your Dr. would want to 1st try increasing the pressure as a 1st step to see if your apnea's decrease.
Makes sense to me. Hopefully that will bring you back to those restful sleeps you were having before. Happy Zzzz's.....
Jim @thankful

Jump to this post

Thanks Jim

REPLY
@johnbishop

Hi @gramps, Welcome to Mayo Clinic Connect. I use a CPAP to treat my obstructive sleep apnea but have not really looked into central sleep apnea. I do believe I've read that a CPAP is also used for treating central sleep apnea. There is another discussion on Connect that you can meet other members discussing central sleep apnea -- Central sleep apnea. Cause?: https://connect.mayoclinic.org/discussion/central-sleep-apnea-cause/

@peetiepie @tiss @thankful and @mstara may be able to share what they are using for treating central sleep apnea. You may be interested in reading the following article I found on the Mayo Clinic News Network.

Mayo Clinic Q and A: Understanding central sleep apnea: https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-understanding-central-sleep-apnea/

My AHI has been around 4 or lower on a regular basis but I've had several episodes every once in awhile where it shoots up to 5 to 8 for a period of 3 or 4 days. How are the central apneas identified, everything other than the ones listed obstructive?

Jump to this post

Thanks for the links. They say that CPAP may not be effective in treating central apneas. I hope that's not the case with mine. To go through adjusting to CPAP, only to find out that it doesn't work for me....
The sleep doctor doesn't believe in explaining why the CPAP should help with the centrals. Basically he told me to either work with the technician or leave. If that doesn't help he'll tell me what else to do.
As he's the only sleep doctor available from my insurance I don't have much of a choice right now. The way I see it, he's going to see how high he can raise the pressure before concluding that the CPAP doesn't do the job. Which can take weeks or more.
I'm not even sure he has anything else i(besides CPAP) in his tool box. But he still thinks he's G-d....
Sorry for venting all this. It's just bloody frustrating....😣

REPLY
@gramps

Thanks for the links. They say that CPAP may not be effective in treating central apneas. I hope that's not the case with mine. To go through adjusting to CPAP, only to find out that it doesn't work for me....
The sleep doctor doesn't believe in explaining why the CPAP should help with the centrals. Basically he told me to either work with the technician or leave. If that doesn't help he'll tell me what else to do.
As he's the only sleep doctor available from my insurance I don't have much of a choice right now. The way I see it, he's going to see how high he can raise the pressure before concluding that the CPAP doesn't do the job. Which can take weeks or more.
I'm not even sure he has anything else i(besides CPAP) in his tool box. But he still thinks he's G-d....
Sorry for venting all this. It's just bloody frustrating....😣

Jump to this post

@gramps, Sorry for the confusion. I was asking if there was something in the CPAP machine that says "central apnea". I'm guessing they have to download all of the data from the CPAP machine to see the time periods where a central apnea occurred. I was thinking about the way the CPAP machine shows my AHI.

From the link below -- "Central sleep apnea occurs because your brain doesn't send proper signals to the muscles that control your breathing. This condition is different from obstructive sleep apnea, in which you can't breathe normally because of upper airway obstruction. Central sleep apnea is less common than obstructive sleep apnea."
-- Mayo Clinic - Central sleep apnea - Symptoms & Causes: https://www.mayoclinic.org/diseases-conditions/central-sleep-apnea/symptoms-causes/syc-20352109

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my sleep apnea was diagnosed originally as obstructive SA then was rediagnosed as Central Sleep Apnea and my sleep doctor changed me from CPAP to BiPap breathing machine and it seemed to work fine for me

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Thanks Gene. What's the difference between the two machines?

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