Forum · Central sleep apnea and Heart Failure

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[-] VersatilePurpleEchidna1016 +0 points · about 1 month ago

Sleep study qualified me for VPAP, but Ejection fraction of 30 (Heart Failure) disqualifies me. The only "treatment" for waking up 40 times a night due to central sleep apnea seems to be losing weight, which is harder since energy is so low in the day. Has anyone out there improved their central sleep apnea through weight loss? I know--weight loss is a dandy thing, but not easy, and if I had clearer evidence that it helps, my motivation would go up. Also, anyone out there with experience with treatment of Heart Failure + Central Sleep Apnea at Stanford medical clinics? Any tips for getting second opinion referrals?

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[-] Ruby +0 points · about 1 month ago

I recently lost 20 lbs but my CPAP setting is still the same. I do know that weight loss can greatly help with sleep apnea but have not heard of this before--however, I am not a doctor. Can you get a referral for a second opinion from your current doctor or from one at Stanford?

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[-] BrightSpringbudSandpiper5105 +0 points · 25 days ago

If you can, buy yourself a machine even a cheap one. That's what we have to do here in Australia, health cover doesn't cover much of machines (only 25% or so).

When I lost 20 kg it made not a jot of difference to my apnea but the machine has over time. I am finding the better the machine the better my apnea is becoming. I am about half way between my best and worst weight and my apnea has never been better.

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[-] ShiftWorker +0 points · 24 days ago

VersitilePurpleEchidna1016 I am almost in the same boat as you but had an echocardio and my LVEF is above the 45%. I am now in the "Holding Pattern" between sleep study and Dr. prescribing an ASV machine. Before starting treatment on your own I would have a talk with the doctor about using xpap therapy. For me the regular cpap pressures caused central apneas to occur, and if my ejection fraction was less then the 45% then i had to deal with the 33% mortality rate of this group of people. I am not sure which direction I would have needed to go in but would definitely had medical advise before just doing something i read on a forum. Good luck in getting a solution and keep us posted. Shift Worker.

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[-] sleeptech +0 points · 17 days ago

Sometimes, but not often, central apnoea can respond to oxygen therapy, either partially or completely. It does require a proper study with full monitoring (including transcutaneous carbon dioxide monitoring) to make sure the oxygen is not causing any ill effects. Also, in some of our patients central apnoea has reduced one their heart function has improved, and they only need CPAP. Also, the increased mortality for people with low ejection fraction only applies to ASV, not standard BiPAP. Standard BiPAP may very well be effective in treating central apnoea without needing ASV and, indeed, it should be the dsefault choice. ASV was designed specifically for treating Cheynne-Stokes respiration in the setting of hypocapnea, not just as a BiLevel Swiss Army Knife. Although ASV has auto in the name, IT IS NOT and automatic BiPAP and was never designed to be one (I have spoken with the team who first deigned it).

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