Central Apnea - Treatment Emergent vs Altitude

[ausername]

Hi,

I just started CPAP again after a 5 year break. Sleep is not restful, tiredness, brain fog, memory issues, and I can never get a full 8 hours like I need to (I always wake up 2 hours early).

I live at 7500 ft. I had a take home sleep study (nightowl) at altitude. Dr said it was 15 AHI (but unsure of OA vs CA). I previously had mild sleep obstructive apnea.

I did a full night CAPA titration @ 1000 ft (there are no study places where I live). Sleep report says no central.

I was hoping for help on:
1) Is it possible to tell if this is Treatment Emergent vs Altitude with OSCAR data?
2) I notice that the central seem to start right after the pressure ramps up. Or many that is just when I happen to be falling asleep.
3) Could this amount of centrals cause the symptoms I'm having?

Thanks!

[Crimson Nape]

Hi ausername! -
I would say it is both altitude and treatment emergent. At 7500 feet you have approximately a 20% oxygen saturation reduction. EPR is not helping you out in this case. Combined with the altitude, it is probably acerbating the CO₂ washout.

- Red

[SarcasticDave94]

I would consider getting an in lab sleep study that's close to the same elevation as your home. In lab would monitor the Central Apnea component better than a home study.

Pending the results from the lab study, you may need to get a Titration with ASV mode being in the mix of those tested. The reason these both are likely useful, to prove the CA are the hindrance, they need identified in the sleep study, then shown what ASV does to reduce them in the Titration.

Also please request those detailed results. You need them for your personal health file, and you can post it here redacted of your personal info.

[ausername]

Thanks @Crimson Nape and @SarcasticDave94,

Ill see if there is a place to do a study around here at elevation, and try to grab the actual sleep reports.

[Deborah K.]

As Dave said, be sure to ask that an ASV be available if you need a titration study.  Otherwise, they might prescribe you a machine that may or may not work.  Also, make sure they prescribe a ResMed AirCurve 10 ASV machine, not a different model or another brand if you need an ASV.