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central apnea problem?

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Herbertolivera +1 point · over 2 years ago Original Poster

I just got a cpap machine but it seems I've developed a new problem, every time I start to doze off, I stop breathing and wake myself up. I haven't had a good night's rest in 3 days. My cpap is for obstructive sleep apnea, but now I have what seems like central sleep apnea. Is there anyone that can point me in the right direction. Of course I'm going to see my doctor, but this isn't something that can wait, obviously sleeping and breathing are pretty much 2 things that can't wait. Any help would be greatly appreciated. Thank you.

Edit: I forgot to mention, this problem started happening a few days before I got my cpap, and it also happens even when I'm not using the cpap.

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SusanR +2 points · over 2 years ago Researcher

Hello- sorry to hear about your problems. One possibility is that the pressures are not optimized (especially as pressure ramps up) and you are still having obstructive apneas. However, your intuition is correct to ask about central apneas--some people have central apneas that are "unmasked" once the obstructive apneas are treated with CPAP. Sometimes this problems settles out as your body adjusts to the pressure and new breathing pattern. So, it is possible this will get better soon. Other times, the appearance of central apneas may indicate a condition known as "complex sleep apnea". You may want to read about a patient and physician's experiences with this at: https://myapnea.org/blog/complex-sleep-apnea, noting that until you are re-evaluated it is hard to know which problem you are dealing with. Many PAP machines transmit your breathing patterns to "cloud" that allows your doctor to get real time information on how well your CPAP is working. You can check with your doctor in case she or he can remotely check that information and make an initial estimation of what is happening. So, please talk to your sleep provider. I hope things get better quickly!

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wiredgeorge +0 points · over 2 years ago Sleep Enthusiast

Interesting that you mention some machines transmit to "cloud" and a doctor can access this information. I have a ResMed machine and it shoots my night's stats to the cloud; I had assumed for compliance as I am sure neither my sleep doctor or PCP looks at these stats. Perhaps the DME to ensure compliance (4 hrs a night useage). Is ResMed one of the machines that a doc can access sleep reports and since it doesn't seem to know the difference between central and obstructive sleep apneas (at least from a patients view), can a doc see more? This is just a question as I am not having any issues as my therapy is going great and has since day one (other than a bunch of mask related trial and error to get a leak-less fit).

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SleepyChief +0 points · over 2 years ago

The SD card in the ResMed machine has a great deal of nightly data written to it. If you view the data with software like Sleepyhead you can indeed see the various different events, such as obstructive apnea, or "clear airway" apnea (otherwise known as Central Apnea, as the airway remains open, but the person stops breathing for 10 seconds or more). On my results I was about 50/50 between the two, but once the obstructive apnea was dealt with, my total events dropped to an acceptable level. If the Central Apnea frequency gets worse, however, I will be checking back with my specialist. It's a good reason to review your own data if your are so inclined. Otherwise, just keep aware of how rested you feel on the whole. I'm not sure if the transmitted cell data is as comprehensive as the SD card records.

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wiredgeorge +0 points · over 2 years ago Sleep Enthusiast

I am fully aware of the info on the SD card. My question was with regard to the info that is sent to the "cloud" which I doubt has ever been seen by a medical professional in my case. I am sure the DME monitors the usage stats for the year of machine rental by the insurance company and likely reports only non-compliance to them.

Since my therapy has been pretty much on the mark since day one and my AHI has been under 1 consistently, I feel no need to study in-depth the full stats that an 3rd party software program like Sleepyhead offers. Others may find this useful. One of my main concerns was my SPO2 level which tanked pretty badly prior to therapy and I now monitor from time to time with a Pulse Oxymeter device. Prior to therapy I woke numerous times during the night thinking I needed to get up and go to the bathroom but since starting therapy I have not gotten up a single time for this reason and sleep soundly through the night. I think this implies more REM sleep and bouts of daytime dropping off have ceased. Good luck

If anyone knows what data is "sent to the cloud" and available to medical professionals, would appreciate hearing this.

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Herbertolivera +0 points · over 2 years ago Original Poster

Thank too so much, it's a relief to be able to talk to someone about this, is it possible that this is all in my head? The reason I say that is because I have suffered anxiety attacks in the past, and right now, with what is going on i constantly feel an attack coming on and i have to focus hard to keep it at bay. I should also mention that in my desperation i drank an entire bottle of red wine last night, the calming effect allowed me to sleep for what i think is a good 5 hours, but once it wore off (around 2 a.m.) it was the same old story again. So as much as i would hate the idea, do you think its possible that i am doing this to myself? I don't see how that is possible but I feel I need to ask. I am going to see my dr today and I hope he has a solution for me because I feel like I am losing my mind, I've missed work for 4 days and I am at my wits end. Thank you for your help.

Edit: if I do have central sleep apnea, is the treatment easy, is their light at the end of the tunnel for me?

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SusanR +1 point · over 2 years ago Researcher

Agree with SleepyChief! Also to add-- many sleep centers either arrange to have access to these reports, so they can directly view the reports generated by the machine, and/or arrange to receive reports on the effectiveness of treatment and adherence from the DMEs. It can be very rewarding to take a pro-active role in discussing the CPAP machine feedback with your doctor--make sure you are both satisfied with what the numbers say as well as how you are sleeping/feeling.

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sleeptech +1 point · over 2 years ago Sleep Enthusiast

The reps always tell me that if a doctor or (as in my case) a technician wants to review the data they can get all of the same data they would get from downloading your SD card. I have never actually put this to the test because we don't have the appropriate software where I work, so I can't verify this. All recent machines that I know of will report obstructive and central apnoeas separately, but I don't have great faith in their ability to differentiate based studies I have performed compared with downloads.

Herbertoliviera, what you are describing sounds a lot like you are having central onset events. A series of central events that occur just when you are falling asleep and disappear quickly once you get to sleep properly. They are not unusual, and often CPAP will make the more pronounced. Also, if you had a sleep study with CPAP on they would have seen if you had central events that extended beyond sleep onset and done something about it, so it seems very likely that they are just onset events. If your overall AHI is OK then they should not be a source of great concern. The main issue is that they stop you falling asleep, and the best way to overcome that is with a bit of practice. It may be worth a call to your Dr or CPAP supplier to see if they can check the data and tell you if your AHI is significantly elevated, mainly for your piece of mind. As I said, if you had a sleep study with your CPAP on, you can rest assured that you were breathing OK with it.

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