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Can a CPAP machine treat central apneas?
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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@gramps - The main difference between BiPAP and CPAP devices is that BiPAP machines have two pressure settings: one pressure for inhalation (IPAP), and a lower pressure for exhalation (EPAP). ... BiPAP may also be used for patients who require some breathing assistance.Jul 1, 2015 ... excerpt from the following article.
What's the difference between BiPAP therapy and CPAP therapy?: https://www.aastweb.org/blog/bipap-biphasic-positive-airway-pressure-vs.-cpap-therapy
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1 ReactionHmm...I've read that CPap use can actually exacerbate central apnea. Is your sleep doc up on the research?
Whatever it takes, change doctors. Find a neurologist who specializes in sleep apnea. Ask him/her about the Remede system.
Studies suggest that some OAS patients develop CAS after using a CPAP machine for a while, however that is simply an observation which is subject to further scientific studies. So I don't know why your doctor just threw that out as "fact".
This being said, if you have Central Sleep Apnea (CSA) , then a normal CPAP machine will do very little for you.
I was correctly diagnosed with CSA and I was prescribed a BiPap ASV machine which monitors EVERY BREATH while I am asleep and then provides breaths as needed and upon detection of my breathing cessation.
ASV machines are a form of VENTILATORS and quite different in the way that they operate, in comparison to normal CPAP machines.
If your insurance pays for your treatment, you need to talk to your doctor about a prescription for an ASV machine.
ASV machine titration is also very simple in that they require almost no setting. There are 4 or 5 parameters in regards to Pressure Support, EPAP and IPAP which are left open to the max and the machine algo simply self adjusts these parameters whiting their full range, as needed.
Good luck.
Sounds like my new sleep dr. and one I had in the past.
I just saw this post; I realize I’m two years late. Hopefully you or someone will see it and find it useful.
I don’t care how bright someone is, or how many diplomas hang on his/her wall, there is no excuse for the way he talked to you.
If he can’t take a few minutes to answer your questions/ concerns maybe he’s better suited to research where he doesn’t have to deal with human beings who have feelings.
I understand about the insurance and sympathize with you. Can you find a sleep doctor or facility who will work with you financially? Will MAYO?
Most of the progress I made with my Cpap was on my own, reading patient forums (cpaptalk.com is a good one, plus this one) and Dr. Google. I just let the technician do what he was ordered to do, then I took it from there.
I know some people will disagree, but it really is how I did it. Not telling anyone not to see a doctor, just relating my own experience FWIW.
BTW, I have read that higher Cpap pressures can encourage centrals in some people.
Best of luck to us all🙏
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1 ReactionAgreeing with KUDZU’s last sentence. I’ve heard or read somewhere that excessive air pressure in a PAP can cause central sleep apnea.
I have OSAS and feel very grateful that my DME supplier Diana Guth in Westwood, CA appropriately adjusted my CPAP, and subsequent APAPs. I never adjusted them myself.
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1 ReactionCentral Apnea Elevated and Machine Problems
I have been using a ResMed Air Sense 10 CPAP bec diagnosed with obstructive and central apnea. I used CPAP for years but never ckd my oxygen levels. I thought the machine tracked on the provider level. Lo and behold I found out during COVID the machine doesn’t track it either. I have levels below 90 with a oxygen meter and then found out my Apple Watch tracked my oxygen hot years. My hypopneas were averaging 5-9 before COVID and my oxygen from my Apple Watch was going down to the low 80’s. My pulmonologist then said I needed a new sleep study to ck oxygen levels. After the study they said I needed oxygen bec my levels were too low for a prolonged period during sleep. They chngd my machine to a Bipap. They said I am having central apnea episodes which the CPAP didn’t pick up and my pressure level was changed from 14 on CPAP to 22 on ResMed Air Curve Bipap. My episodes now are averaging between 56-87 per hour w this machine. They say it’s not working for me snd now I need another study to get a ST machine. Does anyone else have this problem? My dtr sd my breathing is worse than someone twice my size. I am now tired every afternoon and have to take naps. I fall asleep using my computer. They can’t do another sleep study until May 11. My oxygen levels are good on the machine with oxygen but the issue is the apnea episodes and tiredness. Any input would be helpful.
Welcome @eliza419. I moved your question about CPAP issues with elevated central apnea to this existing discussion:
- Can a CPAP machine treat central apneas? https://connect.mayoclinic.org/discussion/can-a-cpap-machine-treat-central-apneas/
I did this so you can read previous posts and connect easily with fellow central apnea members like @hindsight @cyrusmanz @kudzu @gramps @roxiesmom13 @renu18 @leefuller1 and others.
You might also be interested in this related discussion:
- Diagnosed with Central Sleep Apnea (CSA)? How's therapy going? https://connect.mayoclinic.org/discussion/central-sleep-apnea-csa-suitable-therapy/
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1 ReactionIf you have a nightly AHI (Apnea-Hypopnea Index) of more than 5 events of any kind per hour, you are considered at risk and need refinement of existing treatment or to start treatment.
If you have persistent CSAs (central sleep apnea), which the RESMED clan call 'open airway', then a BiPAP will not serve you well. You need what is called an ASV (adaptive-servo-ventilator). They cost an arm and a couple of your legs, but you can look on the open market, or even get a good used one, for a lot less than the DMEs will sell you one (Durable Medical Equipment suppliers). It is a shame that so many sleep experts and DME sellers will suggest that BiPAP machines will help someone with CSA. They do not. A BiPAP will help to stent the airway when pressures are insufficient to those set as the main settings by adjusting flow to suit the need. That is not how to treat CSAs.
I had only one episode of central with my nasal cpap. My neurologist has a doctorate in sleep study and the more medication you are on that affects your central nervous system, the more apt you are to have them. Xanax, valium, cyclobenzaprines, anti convulsants......any of those that deal with nervous system.
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