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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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Mentor
John, Volunteer Mentor | @johnbishop | Jul 19, 2020
In reply to @gramps "Thanks Gene. What's the difference between the two machines?" + (show)
@gramps

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

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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

REPLY
hindsight | @hindsight | Jan 2, 2022

Hmm…I've read that CPap use can actually exacerbate central apnea. Is your sleep doc up on the research?

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hindsight | @hindsight | Jan 2, 2022
In reply to @gramps "Thanks for the links. They say that CPAP may not be effective in treating central apneas...." + (show)
@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….😣

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Whatever it takes, change doctors. Find a neurologist who specializes in sleep apnea. Ask him/her about the Remede system.

REPLY
cyrusmanz | @cyrusmanz | Jan 6, 2022

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.

REPLY
kudzu | @kudzu | Aug 21, 2022
In reply to @gramps "Thanks for the links. They say that CPAP may not be effective in treating central apneas...." + (show)
@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….😣

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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🙏

REPLY
raye | @raye | Aug 22, 2022

Agreeing 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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