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Central Apnea - Treatment Emergent vs Altitude
#1
Question 
Central Apnea - Treatment Emergent vs Altitude
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!


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#2
RE: Central Apnea - Treatment Emergent vs Altitude
Hi ausername! - Welcome
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
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
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Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Central Apnea - Treatment Emergent vs Altitude
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.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Central Apnea - Treatment Emergent vs Altitude
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.
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