Possible treatment for central sleep apnea

[cruzer43]

If you have Central Sleep Apnea (CSA) or know of someone who has it, then this thread may be of help.

A brief internet search on the causes of CSA will return things like; drug induced breathing problems, high altitude breathing problems, congestive heart failure, medically induced problems, complications from CPAP therapy, and another group of “still unknown” causes.

Unfortunately, that same research will show that there are precious few treatments currently available for CSA patients, such as; drugs, CPAP/APAP/Bi-level breathing machines, oxygen therapy, and other medical devices. One web site even stated that CSA sometimes goes away spontaneously.

I am neither a doctor nor a clinician. I am just curious.
This thread is intended to shed some new light on part of the group of “still unknown” causes and propose a possible (easy) treatment for it.

I have been using CPAP/APAP breathing machines for several years. I am 69 years old and a bit over my goal weight. I am not drug user, a smoker, or a diabetic. I haven’t had a stroke or a heart attack (that I know of). The only condition that I am aware of that is threatening my health is my age.

In early 2012, I realized that I have Central Sleep Apnea. I graphed the number of my CSA episodes using my Excel worksheet and found that there were significant variations from one day to the next. Over the graphed period, my apnea episodes ranged from a high of 33 to a low of 0. I wondered why they varied so much, and why some nights were better than others.

I don’t believe that medical conditions such as CSA simply go away for no reason. So, I started to record what I was doing just before I went to bed. Was I too tired, not tired enough? Did I eat too much, not enough? And so on.

Nothing seemed to make any sense until I was about 2 months into my study. That’s when I noticed that whenever I had fats for supper, my CSA episodes decreased significantly, often to zero. I had been using virgin coconut oil for breakfast because of an article that I had read about how it might help support brain functions, i.e., memory! So, I decided to see what would happen if I also used it before bedtime.

Since I started consuming that same virgin coconut oil before bedtime, my CSA episodes have decreased significantly. There isn’t a perfect correlation between my consumption of coconut oil and the absence of my CSA episodes, but the correlation is strong enough to indicate that I’m on the right track.

In short, it looks like whenever I eat certain fats (coconut oil, cheese pizza, …) before I go to bed, my recorded CSA episodes are reduced significantly.

Brief note on virgin coconut oil:
There is too much information on the benefits of coconut oil to detail them here. If you browse the internet for the benefits of virgin coconut oil, you will find a number of medical and health web sites that promote its use.

My findings are not as specific as they could be because my database is still too small. It needs to be expanded to better answer questions like:
1. How much coconut oil (or other fats) do I need to consume before bedtime?
2. Is there a minimum amount of fats that I need to consume?
3. How long does it take for the fats to get to, and sufficiently feed, my brain?
4. How long do the fats keep my brain from “forgetting” to tell my body to breathe?
5. When a CSA occurs, how many hours was it after I had the fats?
6. How close to bedtime do I have to eat these fats?
7. How much of a role does my weight play in the dosage of fats?
8. Are there better “fats” for me to consume?
(What else do I need to have in my database?)

A quick summary of my findings is that consuming protein and sugar will not reduce my CSA episodes, while consuming certain “fats” will. While it is only anecdotal evidence that my consumption of virgin coconut oil has helped my memory during the day, there is actual data that shows that it has reduced my CSA episodes at night. An unexpected finding from the project is that I feel more refreshed in the morning when my CSA episodes are few and far between.

I’m sure that there are CSA causes where it doesn’t make any sense to prescribe a special diet of fat. However, I’m also convinced that there are CSA causes where the brain simply needs to be fed in order for it to tell the body to breathe.

Hopefully, this finding will help someone who has significant CSA episodes.
If you try this approach and it helps, please let me know.

[trish6hundred]

Hi cruzer43, Thanks for posting this information, very interesting.
I look forward to reading more findings as you go through your study.

[zonk]

there is no study would support such claim about treatment for central sleep apnea

its claimed to help with tooth decay and now they claim the saturated fat in coconut is good for you and nutritional goldmine

the only real goldmine is for those who selling the product

I do like Thai curry and coconut macaroons with

[cruzer43]

ZONK
I'm disappointed that you've so quickly dismissed my finding simply because you've never heard of it before. Your comment that I'm foolish for falling for advertisements from vendors of coconut oil (or other elixirs) is demeaning and simply misses the point of my findings.

My reference to coconut oil was simply that it's a good source of fats for the body (the brain in particular) - doctors say that, it's not just me. The point of the finding is that one of the "still unknown" causes for CSA may very well be that the brain is simply not being fed enough and that fats in the diet (especially for the evening meal) may actually help some reduce the CSA episodes in patients.

Granted that adding fats to one's evening meal may not help all CSA patients, however, it has helped at least one. This study is repeatable. If other CSA patients respond with similar comments, perhaps the medical profession will study it under better controlled conditions and offer it to other CSA patients as an optional treatment.

I intend to post a follow up study in about six months. At that time, I should have better answers to the questions I outlined in the posting.

[zonk]

let me point out that you,re using S9 apap set at 7-15

not sure if you have been diagnosed at sleep lab with central sleep apnea
(cpap/apap do not treat central sleep apnea)
if you have been than you would using different type of machine to treat central sleep apnea

maybe if you post some charts from your ResScan would give some idea

last point would make on this subject, there is no way for the machine to tell if you,re awake or asleep when events are flagged

[Sleepster]

In early 2012, I realized that I have Central Sleep Apnea.

How did you reach that conclusion?

Have you noticed a correlation between your CA index and the APAP pressure?

I have no doubt that the effect you've noticed is real. Lot's a things can affect your AHI. Have you noticed, though, that the effect weakens with time?

[Shastzi]

Hi cruzer43,
I am open minded but I am also from Missouri.
I am sure you are logging a positive effect on your sleep state with the fats, coconut or otherwise.
(I do like pizza!)
However...
The Central Apnea is a bit more slippery to nail down In order to be able to point to the data with any real confidence,
you must be able to show at least a 10% drop in oxygen saturation during a true central apnea event.
You need to be running a simultaneous oximeter log at the same time during these events and see if you are desaturating.
Since CPAP/APAP cannot prevent a real central event (being a brain based issue) from happening it will happen anyway regardless of the pressure administered.
So you need the pressure log showing the time you stopped breathing with an accompanying drop of at least 10% in the oximeter logging. Then you can truly say "Gotcha!"
Other than that, If the coconut oil helps you sleep better, I can't argue with success!

Keep up the good work!

=^.^=

[cruzer43]

Sleepster,

You've asked important questions.

I have the S9 and a copy of the RESMED reporting program.
My sleep doctor only told me that I have sleep apnea. He did not explain that I had two kinds (obstructive and central). I thought there was only one kind and had no reason to ask.

After a got a copy of the reporting program, I primarily looked at only three charts, the pressure index, the number of apnea episodes, and the leakage.
I did the best I could with the leakage, and then stopped looking at it.
The number of apneas was concerning, but at that time it was just more data than information.
The pressure index was interesting because of its cycle. It normally peaked four times a night at 15.

When I found out what central sleep apnea is, I began to look a lot closer at the number of apneas being reported.
The "average" number of central sleep apneas (up until recently) has been around 10 every night. Sometimes it has been higher, sometimes it ha been lower.

For the last 4 months, I have found that when I have fats in my evening meal, the average number of CSA's has been less than 4 episodes, many times it's been zero. Unfortunately, that average (of 4) includes nights when I didn't have any fats with my evening meal so it's slightly inflated. It's too hard for me to separate them.

I need to better control the amount of fats in my evening meal. Some of my records indicate that I had some, but they don't indicate how much. On those nights the number of CSA episodes exceeded four. Those records are included in my average of four episodes.

As far as the pressure goes, I've noticed the same cycle as before with the exception of last week. I don't know why but for some reason the pressure has not peaked at 15 (like it normally does). This is particularly interesting because at the same time I've had a terrible head cold. I don't understand what the lowering of the reported pressure means and will watch it.

The reason I believe that I'm on the right track is because of the significant variance in the current number CSA episodes from the prior average.

Finally, I don't think that the effect of the fats in the evening meal has weakened my body's response.
That is, I don't think that my body now needs a greater amount of fats to get the same result.
The study has been in force for only four full months, so we'll see what happens later this year.

If you have any suggestions on what I should be watching for, or add to my study, I would appreciate hearing about them.

[cruzer43]

Shastzi,

I wouldn't know a central sleep apnea from an obstructive sleep apnea even if it hit me in the face.

My reporting program tells me that I used to have around 10 CSA episodes a night.
Since I've started the study, it tells me that the number of episodes has decreased significantly.

I have no idea what my blood oxygen level is and I probably won't buy the attachment to find out.
I think that the important point is that my new diet (fats in my evening meal) has somehow lowered the number of my total apnea episodes.
I'm sure that you're right about the true definition of central sleep apneas, however, for now, I'm willing to accept the reporting programs definition of what I have. Even if it's wrong, the effect is still there. It's true, I could be lowering a different kind of apnea. I don't know.

I don't understand the importance of a drop in pressure.

[PaulaO2]

Easy to tell the difference.

Obstructive apnea is when the throat collapses and you cannot take in air. The body and brain get more and more frantic to wake you up so you take a breath.

Central apnea is where the brain, for a wide variety of reasons, doesn't think it needs to breathe. There is no struggle.

Ten CA events a night is not anything to worry about.

There are three things to look for in the data:

The AHI - you want this lower than 5. In case you didn't know, the AHI is the number of apnea (both CA and OA) events plus the number of hypopnea events divided by the number of hours slept. So if you have an AHI of 5 and slept 8 hrs, that means that you had 5 or less events average per hour that night or a total of 40 events total. So ten total CA events (and nothing else) in 8 hrs of sleep would be an AHI of 1.25 which is pretty dang good.

The length of the events. In ResScan, the number of each marker for an event represents the length in seconds. An event is not counted unless it is 10 seconds or longer.

And the flow rate. I don't understand this part of it enough to comment other than the wider the band, the better. That means you're taking good deep breaths and releasing good deep breaths.

As for your study, in order to make sure the food intake is the culprit, you'd have to ensure each day is exactly the same. Same stress level, same relaxation level, same activity level. Since each day is as different as each night, this will be difficult to do. For example, you'd have to also note not just what you ate, but your mood as you ate it. Does your high fat meals mean you went out to eat with friends or you were depressed and ate ice cream while crying during Old Yeller? Was the meal with friends to celebrate a promotion or to mourn the loss of a friend? How much alcohol did you consume? How much caffeine? There's just far too many variables that go into getting a good night's sleep.

I just don't see how a single fatty meal would interfere with the lung/heart O2/CO2 exchange for the same night. I can see how perhaps it would make you sleep deeper since you are fuller. Or it would perhaps make you sleep lighter because you are fuller or indigestion. But those factors would add more obstructive events, not more central events.