[Diagnosis] Anxious newbie - Central apnea ?

[S2892]

Hey there,

First of all, I must say I'm really grateful to have found a board just like this one. 

I am quite new to this, altough I've read a lot about sleep apnea over the last two weeks, following my first sleep study. 

I am now waiting to see a pneumologist but I already received the (i guess raw) reports of the two sleep studies I have made (one with an ApneaLink device and one with a NoxT3 device). And those reports make me really anxious and concerned. 

First report shows an AHI of 18 (A3/H15) and ODI of 26 and important snoring. Second report shows an AHI of 29.6 (A3/H26.6) and ODI of 30.4. 

Second report included RIP belts reading as well as position recording, and it seems like most of my apneas are central and strongly positional (2.9 central apneas per hour on my side, 11.7 on my back, 0.4 obstructive apneas per hour on my side, 2 on my back). Hypopneas are more on the obstructive side (even though most of the 26.6 apneas are unclassified, the reading only shows 3.6 obstructive and 1 central hypopnea per hour. Reading the report I guess the rest is just RERAs ) 

I am a 29 yo male, with severe obesity (BMI 40, going down :-)), septal deviation, probable retrognathy and probable enlarged adenoids (got to get a more thorough examination on those). I thought I was the perfect candidate for obstructive apnea and I was able to wrap my head around a temporary CPAP therapy for a few years, until I get the root causes fixed. Now the perspective of having central apneas is terrifying me as it seems to be definitive in the current state of science. 

As I won't be able to see a pneumologist immediately, I'm struggling with these questions. Hope someone will be able to help me :-) : 

1. As the reports were probably the result of an automated scoring, can I trust the central apnea classification ? I have read that RIP belts are less accurate in obese subjects. 
2. I have read about a few cases of positional central apnea but those seem quite rare. Again, is the central apnea scoring accurate or have I drawn a "lucky number". Or maybe are positional central apnea common after all ? 
3. Is it normal to have such different AHIs between two studies made within two weeks, in the same bed ? 

Thank you in advance

[SarcasticDave94]

Welcome,

First, yes the numbers can be accurate despite different amounts of Apnea. It's the nature of Central Apnea. Consistently inconsistent.

Second, CA should not warrant any more concern than Obstructive Apnea. It's Apnea, it needs a correctly chosen machine to treat it. Both will be treatable with a correct device.

You may need a ResMed AirCurve 10 ASV if your CA need to be treated. If possible, we'd like to see your sleep study data, redacted of personal info. Here in the US, CPAP like the ResMed AutoSet are first choice. You might need to start there to treat any Obstructive you may have, and see if it'll avoid CA by appropriate settings. Failing that to have low enough CA, then ASV is the best bet to treat CA. CPAP treats by avoiding CA, ASV actively treats CA.

[S2892]

Thanks for your explanation. 

While CA should not warrant more concern than OA, the thing I'm worried about is that central apneas can't be really cured at the root cause level. And I'm clearly not ready to take a central apnea diagnosis that would put me under CPAP/ASV/whatever breathing support machine for the rest of my life. 

Based on what you are saying I guess I should try to wrap my head around it anyway...

I'll try to post the full study details when I can get them. So far I have only received a poor quality scan of the Noxturnal report.

We'll see, I guess

[staceyburke]

Welcome! Your numbers are not as high as many on this site and are treatable! Don’t get to worked up you will be ok. You have stated on a journey that for almost all of us is NOT a couple years and you can get off Cpap. Most of us have been on Cpap for years ( for me almost 30 years).

Again, you will get treated and your health will improve with the therapy.

[SarcasticDave94]

IMO Obstructive treatment via CPAP would be a life thing too. In most cases, surgeries to change airway issues and similar don't have a great success rate, for some it can help but mostly the results can disappoint.