Some questions about sleep apnea and what's worked for others..

[richb]

[quote='Rob S' pid='149801' dateline='1455066002']
[quote='Dreidels' pid='149772' dateline='1455043310']

Does an "asv" work with mixed as well?

Also curious to anyone else with central... Do you catch yourself breathing shallowly or not at all during the day?? It's very weird to suddenly think about the fact you're not breathing (sometimes not at all), and sometimes very shallow. Sometimes it even seems like it's been a while, like periodic times of holding your breath..

ASV machines can be set with a pressure that is effective for treating Obstructive Apneas and the ASV mode can also kick in for the Central events. ASV is not prescribed if Centrals are only a small portion of total apneas.

I have found that when totally relaxed with mind wandering I sometimes realize that I am not breathing. I think my respiration shifts from conscious breathing to the in between mode that occurs when falling asleep. I am not holding my breath. My airway is open but I am not inhaling. I don't know if this is related to my Central Apnea/Periodic Breathing. I do know that my ASV machine is working very hard for most of the night. The end result is that my AHI has gone from over 40 to under 0.5. I also feel more rested.

RichB

[green wings]

Hi Dreidels. I am a new CPAP user and am going through the psychological adjustment to the idea that I need all thus gadgetry to breathe when I'm sleeping. I took the past two nights off from using the CPAP and it was so nice until I woke up with a bad headache this morning and my blood pressure was 161/101.

I have also been trying to discover a way to cure my sleep apnea. Until and if I am able to do that, though, I have reluctantly made the decision to use CPAP therapy.

If you have measurable stats that go into bad ranges when you don't use CPAP, like blood pressure and oxygen saturation, I think it's good to have home devices to check these.

Since I have started checking my blood pressure regularly, I find that it does provide positive reinforcement when I see much closer to normal readings after 3-4 nights of CPAP use.

I also like Dr. Steven Parks newsletters about sleep apnea. They are really informative, plus they scare me a little bit, which I need.

You might also want to check out the NIH study about the effect of didgeridoo playing on sleep apnea. I got a beginner-quality didge (resin, not wood) for $55 but have only been playing it a little.

If I hadn't started gaining weight about three years ago and if my blood pressure had not become first high then treatment-resistant, I don't think I would be able to talk myself into using CPAP equipment.

Oh - there is also some interesting work being done on hoseless CPAP technology - basically little "smart" devices that fit into your nostrils that are in development now.

I have also read some interesting info on Dr. Parks' site about exercises to improve the tone of the soft palate and structures in the back of the throat.

I don't know if any of these alternatives to CPAP will be viable, but it helps me to accept the idea of using CPAP for now while I continue to look for something that won't involve a bedside gadget with a giant hose attached to it.

That doesn't mean that I'm not grateful that CPAP technology exists. My father had a stroke when he was in his mid-50s even though he wasn't overweight and didn't have severe hypertension. Looking back now, it seems like he very likely had sleep apnea. (He had afib.)

Best of luck to you.

I do agree with that. He seems to recommend surgery rather quick, or maybe cause I had a very strong no for cpap, but I guess in the end I'll have to give it another go. It just seems like there has to be another way, sleep apnea isn't normal, so seems like something we are doing is probably causing it, I don't know

---

Though there are some cases where surgery has cured sleep apnea and the need for a cpap wasn't needed, but there are a lot of surgeries to have to test :/

[wolson]

This is a very interesting thread. Almost all of the posts are very inciteful in a very positive way.

I will speak of maintaining the body below: what I mean this is that ASV as it is used is a palliative treatment which the does not cure the disease but rather prevents the disease from doing further harm to the body. Some may wish to call this adjuvant therapy rather than palliative therapy and I have no problem with this semantic. Sleep apnea is implicated as a factor in over 80 diseases and is a known safety risk. By maintaining the body, much of this risk is removed as long as the treatment continues.

Central sleep apneas are caused by a complex process, almost all of which, interfere with the CO2 in the blood stream. CO2 is thought to be the major compound in controlling breathing processes. If it is caused by congestive heart failure, the only real treatments are valve surgeries and bypass surgeries. ASV helps to maintain the body but really doesn't cure the apneas. To cure sleep apneas due to congrstive problems, there needs to be more blood flow between the heart and the lungs.

But congestive heart failure is not the only causes of central apneas. As mention before they have been noted in High Altitude Sickness. But this is really a misleading term as high altitude sickness in the medical liteature refers to processes that occur at 12000 feet (3500 meters) and higher. Central sleep apneas have been shown to occur in altitudes of 4000 feet (1000 meters), hardly an altitude that one would be concerned with HAPE or other high altitude sicknesses! What actually happens to the body when altitude is increased is very poorly understood. However it does not seem that acclimatization affects central apneas. In this case, the only known cure is to reduce the altitude. ASV is effective though in maintaining the body.

Then there are central apneas of unknown causes, the so called ideopathic central apneas. The cause is unknown and so is the cure. Thus ASV is the only known treatment to maintain the body.

[richb]

Then there are central apneas of unknown causes, the so called ideopathic central apneas. The cause is unknown and so is the cure. Thus ASV is the only known treatment to maintain the body.

As you note ASV is a treatment (for idiopathic central apnea) but not a cure. There are other treatments as well. Various sleep inducing medications have some success because some Central Apneas disappear during deeper levels of sleep. Sleep inducing medications can also be used in conjunction with ASV therapy. Acetazolamide (Diamox) is a medication fro treating high altitude sickness. It has shown some ability to treat Central Apneas. Acetazolamide is a carbonic anhydrase inhibitor. It acts to lower blood pH thereby stimulating breathing. Regarding Theophylline: "It could be hypothesized that theophylline works, at least in part, by inhibiting the ventilatory depressant effect of adenosine, which has been found to be elevated in the peripheral blood of patients with OSA (22). In addition, theophylline may stimulate ventilation by other mechanisms:" Theophylline seems to be use primarily in cases where Congestive Heart failure is a factor. You can use Google Scholar and key words if you want to read the studies. ASV therapy is capable of reducing AHI numbers very significantly. This should have an effect that reduces desaturation events. I don't have data to show that sleep levels are significantly improved. Patients have reported improved sleep quality in some studies. Respiratory Event Related Arousals were not improved in one study that I read using ASV alone. To me it seems that ASV has improved my sleep quality but returned me to what I would hope is normal. I have more consultations scheduled with my sleep Doc. One problem is there are downsides to all of the medications that might be used in addition to ASV.

RichB


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