Centrals: Do you have Complex CSA or other type?

[S. Manz]

Since 2006 when the US Mayo clinic researchers discovered a "new" type of Central Apnea which only results from prolonged use of CPAP machines by OSA patients and called it "Complex" CSA, the proliferation of home-use ASV machines that are designed specifically for the treatment of Complex, Idiosyncratic or Opiate related CSA (use of prescribed or illicit opiates can also lead to CSA according to studies) has increased to a muti-billion dollar industry worldwide.
Given the above, there are still no statistics regarding the size of CSA and its subgroups among large populations, anywhere in the world which makes this forum a great starting point to get an idea of the size of this disorder.


I am interested to know if you have been fully diagnosed for CSA and if so, which type?
1- Complex CSA (long term CPAP user who graduated as a CSA patient)
2-Opiate Drug use (prescribed or otherwise, doesn't really matter)
3-Idiosyncratic (Root cause unknown).

Let's hear your story.

[SarcasticDave94]

Mine would be more than complex sleep apnea. I definitely didn't have much time on the DreamStation Auto BPAP in the spring of 2017, along with joining the members here at Apnea Board, that my Apnea needs were quite complex. Stats on the diagnostic (not a titration) in '17 had me with 124 CA to 24 OA, one CA event at 90 seconds. Then I think also in 2017, my diagnosis for COPD came up as well.

I've had 2 years of good results on the ResMed AirCurve 10 ASV, but in 7-2019 I had pneumonia, then a month or so later, I had bronchitis. Since then, no recurrences of these illnesses, but ASV therapy fell off the tracks. I no longer could get in sync with my ASV's breathing rate/pattern. Note that this ASV doesn't have manual time controls for breath rate, trigger, cycle, or Ti Min and Max.

I'm now under pulmonary care at Johns Hopkins in Baltimore. I've yet to be seen, but have 2 appointments in August and October for COPD and sleep. I have been told by 2 separate RT's and a pulmonary nurse that I should be headed towards an AVAPS mode ventilation machine, in my case it's the ResMed Astral 150. My current RT suggests that sticking with ResMed is a good idea as their breath patterns are unique, and if I'm used to that, I should stay with that brand.

[S. Manz]

Mine would be more than complex sleep apnea. I definitely didn't have much time on the DreamStation Auto BPAP in the spring of 2017, along with joining the members here at Apnea Board, that my Apnea needs were quite complex. Stats on the diagnostic (not a titration) in '17 had me with 124 CA to 24 OA, one CA event at 90 seconds. Then I think also in 2017, my diagnosis for COPD came up as well.

You have had more than your fair share, clearly my friend.
I know I have had idiosyncratic CSA since childhood because I remember as a kid in summer camp, the adults used to shake me awake to make sure I'm not dead because not only that I am a very slow breather, but also because I stop breathing for average of 10 seconds at a time, at least twice every darn minute.
It was not until last January that I was finally diagnosed and even then my doctor instead on first putting me on APAP for 6 months to "observe" and then move me up to a ASV....I did not agree and moved on to a Dreamstation Auto SV and recently to a Resmed Aircurve 10 ASV, since the "recall" came up.
My pulmonary functions test results came up "mild to moderate COPD", but that's only because I am 61 and a 40 year smoker, a nasty habit that I am working on ditching.

Before joining this board and getting somewhat obsessed with the world of apnea, I never knew what a large demographics this disorder covered, which is sadly not a bad thing because I learn so much from others in the same boat.

Thanks for sharing your story which sounds like you are firmly on top of. Keep up the good work.

[SarcasticDave94]

I smoked cigarettes about a pack a day, from age 10-25, when I quit cold 7/3/94. God had to help me do that.

I've also been a tractor trailer driver for 11 years, ending that career in 2010 with major back issues.

Both of those supposedly combined to give me COPD, GOLD level 1 about 2017. Now I've got 2 maintenance inhalers Breo Ellipta and Spiriva, a rescue inhaler Ventolin, a compressor type Pari nebulizer with DuoNeb.

Well anyway, best wishes your therapy does well. And if I can help in any way on your ASV therapy, shout out.

[sheepless]

my understanding is that complex apnea is pressure induced or treatment emergent ca arising from treatment for oa. this usually abates after 30 - 90 days. mixed apnea is the combination of oa & ideopathic ca.

I was dxed with ideopathic ca in 1987, no treatment available. nearly 40 years & 40 pounds later my sleep test returned ca & oa in near equal numbers (ahi: 72.4) but i was inappropriately dxed with oa & prescribed an apap because of our inefficient system governed by insurance requirements.

i bought a used asv & self titrated with guidance from AB members, greatly improving my ahi, and to a lesser extent, how i felt. not feeling as good as i thought i should turns out to be a consequence of periodic limb movement, which was reported in the details of my sleep study, but like the ca, completely ignored by my sleep doc.

now I alternate between asv & vauto. even with higher ahi, the vauto is slightly better for me because it's more capable than asv in terms of restricting pressure fluctuations caused by my respiratory response to plm. very high trigger setting in the vauto manages my ca reasonably well.

so, in my case, ideopathic ca + oa = mixed apnea (even though the system misdiagnosed it).

[SarcasticDave94]

They typically misdiagnose Central Apnea events of any sort, is my opinion.