Can central sleep apnea go away for a period of time and then return?

[joseph421]

I posted this on the Redditt sleep apnea board, but was hoping I could get some additional insight here. About 7-8 years ago I began having episodes at night where I would start to drift off to sleep but my brain would immediately wake me up. My heart would feel like it was about to beat out of my chest. This would go on all night until my body just gave out and I would fall asleep. But it would also happen during the day if I tried to nap or even if I nodded off. On several occasions I also woke up gasping for air. The best way to describe it is it felt like my brain just stopped working and I was forgetting to breathe. 

Tons of specialists, three sleep studies, a CPAP, BiPAP, MRI, and endoscopy and I was told I had some central sleep apnea and mild OSA. But those tests were inconclusive IMO based on how long I slept. My sleep doctor ended up putting me on low dose Ambien and I slept without any issues for about six months and one night I stopped taking the Ambien and haven’t had issues since. Now years later, and I’m back to square one. Same symptoms (minus gasping for now). It sounds like I have central sleep apnea. I’m just so confused and frustrated because I don’t understand how I could be fine for almost a decade and now I’m starting to have these problems all over again. So has anyone heard of CSA returning like this or has this happened to anyone else? 

[Bluesv6]

Sorry your having a rough go with everything ! 
I had similar episodes like you walking up ,heart racing what not.  Except no gasping 

I would also be dreaming I was falling and I'd wake up and like a jolt . After falling and hit the ground. 

My heart would race during the day as well 

They told me it was heart palpitations and to cut out all caffeine and monitor blood pressure.  

I did that and blood pressure was at a cut off and they didn't want to treat me for BP at that time .

Years went by and got treated for high blood pressure and added in medication for anxiety .

Things got better but would wake up  and let's tired . Then daytime exhaustion really hit me . Started snoring , so got tested for apnea this jan . 

Now have a machine and made a big difference. I have my machine dialed in to the best right now. 

I do have a small number of CA how ever they seem to be random now.  One day will be higher and another day lower. 

I wish you get some help, there is alot of knowledgeable patient people here to give you help. 

I'm sorry I couldn't advise on how too proceed but wanted to share my experience with this long response

[Nightynite]

Your sleep test identified the problem. You have sleep apnea. You don’t need drugs, drugs just mask the problem. You just need to follow the diagnosis and move to the standard treatment. Apap/Cpap

[joseph421]

But to ask my question again, is it normal for CA to just one day disappear and then re-emerge nearly a decade later? I've had zero symptoms over the past 8 years and now suddenly they're back. I met with my sleep doctor on Thursday and he wants to start all over since my initial sleep studies were so short. He also noted that my oxygen levels were really good. The one thing he said that bothered me was that they typically don't look for a cause for CA if it isn't serious or there isn't a serious condition attached to it. That's truly hard to accept since whatever was causing it last time is most likely causing it this time. And if it can be prevented from happening in the future, then I'd like to have that answer.

[snoozingswede]

About 7-8 years ago I began having episodes at night where I would start to drift off to sleep but my brain would immediately wake me up. My heart would feel like it was about to beat out of my chest.

I am not a doctor disclaimer. To me, it sounds a lot like a hypnic jerk. I have those sometimes too. In regards to your sleep apnea, if you had an inconclusive sleep study 7-8 years ago, maybe you can have another sleep study so you can get some conclusive results?

[PeaceLoveAndPizza]

I have similar things happen. Going away happy as Larry for months, then *poof*, the central apnea fairy arrives. I go from a typical < 1 AHI to 2-5 AHI. In the past I’ve tried changing some settings to get better rest, but it seemed that no matter what I changed things would get better, then quickly worse.

What I did the past few times is not change anything. I kept my typical settings and within a few days to a few weeks or so, things went back to normal. Sometimes overnight, other times over a few weeks.

The tweaking of things is in my case is not helpful. It only caused frustration. YMMV.

[joseph421]

I am not a doctor disclaimer. To me, it sounds a lot like a hypnic jerk. I have those sometimes too. In regards to your sleep apnea, if you had an inconclusive sleep study 7-8 years ago, maybe you can have another sleep study so you can get some conclusive results?

I don't think I'm experiencing hypnic jerks, since I'm just opening my eyes when it happens. I slowly drift off to sleep and then my brain essentially says, "NOPE" and I open my eyes and it continues like that. I've had hypnic jerks where I kick my legs and it bring me out of sleep. My doctor scheduled a home test since insurance probably wouldn't pay for the same lab test again.   Regardless, I'm scheduled to pick it up on May 8, so until then I'll do my best to get some sleep. Thanks for your reply!

[joseph421]

I have similar things happen. Going away happy as Larry for months, then *poof*, the central apnea fairy arrives. I go from a typical < 1 AHI to 2-5 AHI. In the past I’ve tried changing some settings to get better rest, but it seemed that no matter what I changed things would get better, then quickly worse.

What I did the past few times is not change anything. I kept my typical settings and within a few days to a few weeks or so, things went back to normal. Sometimes overnight, other times over a few weeks.

The tweaking of things is in my case is not helpful. It only caused frustration. YMMV.

Do you also have moments where your brain basically doesn't let you drift off to sleep? And does the machine help with that at all? My doctor initially had me on CPAP, but I still couldn't drift off to sleep and I woke up gasping for air (just like I was before the machine). Then he tried me on BiPAP and I had the same exact symptoms.

[Bluesv6]

Hypnic jerk thought this was turning into a catty thread . Then read the second comment about hypnic jerk and was like ooooh

[PeaceLoveAndPizza]

Do you also have moments where your brain basically doesn't let you drift off to sleep? And does the machine help with that at all? My doctor initially had me on CPAP, but I still couldn't drift off to sleep and I woke up gasping for air (just like I was before the machine). Then he tried me on BiPAP and I had the same exact symptoms.

Definitely sometimes have an active brain when trying to sleep. For me the machine does nothing to help, but good sleep hygiene has made a big difference. Turning down the lights about an hour before bed, no screens, some nice relaxing music (I prefer smooth jazz, but whatever works), reading a good book, etc. Anything to make the transition from active to relaxed.

To me using a CPAP took a while to make the mental shift as my body adjusted to it. Like many I tried different masks and finally settled on using the Resmed P10 along with a soft cervical collar, unless I have a bad night of allergies or a cold when I move to using a full-face mask like the Resmed P30 for a few days. The Bi-level made all the difference in pressure for me as I needed some extra "EPR" (PS on the bi-level) to deal with the flow limitations and allowed me to use much lower pressure. This stopped me waking up from the somewhat dramatic pressure increases to overcome the flow limits. I still get some centrals, some nights more than others, but I don't dwell on it if it is a one-off and don't overanalyze things any longer. 

It was years ago when I started CPAP so I don't remember specific instances of feeling starved for air, but can imagine it happening. A lot of my early problems with CPAP were from over-thinking things. Once I found something that worked I stopped experimenting, which was the hardest for me as I was tinkering almost nightly.

CPAP was not a magic fix, but given time and patience it has made a big difference.