[Diagnosis] Do you have central sleep apnea?

[SarcasticDave94]

I scored 124 central to 24 obstructive on the sleep study to qualify for BPAP. One of those central events was about 90 seconds. Guess the tech didn't want to disturb me. BPAP use was short lived as the ASV was needed, demanded by me. My ResMed ASV stops most all events; AHI 4 or less now.

[DeepBreathing]

Bump

[Toushiro303]

I feel like I have CSA. Would medication possibly mask it?

[SarcasticDave94]

I feel like I have CSA. Would medication possibly mask it?

I'm not sure a med would help nor which if it could. The only way I know to help that is via a machine like my ASV or an ST, and that's after having a PSG/sleep study indicate medical necessity.

[Kyteflyer]

Little to none, according to Sleepyhead/Oscar. I seem to have my events pretty much controlled now, only 1-2 or less, and mostly hypopnea. All good.

[bemused]

My first PSG showed an OA index of 0.7, CA index 5.6, mixed 0.9 and hypopnea index 8.2.  Therapy with APAP and bilevel brought out significantly more centrals. So that would make it pre-existing central with more emergent. I probably should have been diagnosed with mixed apnea and put on ASV at the outset, but that took several more years of sleepiness and frustration. I don't think most sleep docs have any clue about central or mixed apnea, and OSA is the default diagnosis.

[DeepBreathing]

I don't think most sleep docs have any clue about central or mixed apnea, and OSA is the default diagnosis.

You're absolutely right! There seems to be a perception that central apnea is so rare that it doesn't even enter the mindset. What we've seen on this forum indicates to me that it's not nearly as rare as the docs think it is (those who think about it at all). Admittedly we are a biased sample and this is by no means a scientific analysis but there is enough central apnea happening that the docs really should pay it heed.

[OpalRose]

[70sSanO]

I voted treatment emergent, although I could have voted pre-existing.

My first sleep study in 2001 indicated the following:

Obstructive Index: 54.0
Central Index: 4.5
Mixed Index: 19.0
Hypopnea Index: 2.0

Apnea Index: 77.5

The mixed is probably up for debate as to whether it was chicken or egg between Obstructive and Central.

John

Edit Added: Mine is kind of a curious case. In September 2018, my central apneas just went crazy. They have always been around 60% of my AHI, (since I started cololecting data in 2011), but they jumped to 90%. My AHI had been humming along at 2.5 but it suddenly was at 5, then 8, then over 10; primarily all centrals. I was scrambling to change settings on my autoset, used all sorts of pillow setups, (1, 2, or 3), but nothing worked. I swapped out my cervical collar for a new one and the centrals subsided. The collar change was probably a placebo of sorts as the central numbers started rising after a month, although not as bad, but they never got back to where I was for years. In September 2019, I did an ASV titration and since the end of October I have knocked them out, as well as obstructives and I am left with less than a 1.0HI.

[Osiris357]

In my sleep study 25 of my apneas got scored as centrals. I was unaware of that up until recently when I decided to take a look at it to compare it to where I am now. That said, when I first started CPAP I was having quite a few a night. Anywhere from 10 to 20 or so some nights but not being aware of my studies results and not exhaling properly I needed EPR to exhale easier so I turned it on set at EPR 3 and they became even more frequent and longer in duration. So I went back to EPR OFF and slowly made it back to EPR 3. 

I still get them but most of the time they are barely able to be scored at around 11 secs with some around 18 and a few others I've noticed around 26 secs. Whether they are actually centrals that should be scored is up for debate apparently. As I've been learning more and more about sleep apnea and learning how to read the flow rate I've been going back over my charts and I've noticed that about 60%, maybe even slightly more, are being scored after an arousal and/or after a deep breath or 2. In which case they aren't actually true Central Apneas. The other 40% do occur right in the middle of a constant flow rate with the flow rate continuing on as normal after the central apnea.

To answer the polls question, I think I do have central apnea, albeit minor. If your brain not telling your lungs to breathe out of nowhere can be considered minor that is lol.