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+--- Thread: Does CPAP also treat central sleep apnea (csa)? (/Thread-Does-CPAP-also-treat-central-sleep-apnea-csa)
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RE: Does CPAP also treat central sleep apnea (csa)? - Gideon - 03-05-2022
Help me understand how this applies to the OP right now.
RE: Does CPAP also treat central sleep apnea (csa)? - Geer1 - 03-05-2022
He is trying to understand how his central apnea improved from 8 pre CPAP to 3 post CPAP. The answer to his question is yes, the CPAP is treating his central apnea.
RE: Does CPAP also treat central sleep apnea (csa)? - Gideon - 03-05-2022
And without seeing any charts I'm not attributing the difference to anything.
It is IMHO that the difference is much more likely to be the expected decrease in CA that comes with time as the body adjusts to the improved ventilation that occurs with CPAP..
RE: Does CPAP also treat central sleep apnea (csa)? - LetMezz - 03-06-2022
Hi all,
Thankyou for welcoming me and all the feedback.
My view:
1] I agree with the posts that say I would need to know the variability of CA events to say anything about the influence of CPAP. I only have one measurment from the sleep test. I would also want to be sure the sleep test and CPAP device is measuring CA events in the same way. With the sleep test I remember oxygen levels being measured in the finger and having a band around the waist. Could this be more sensitive to picking up central hypnopea/apnea events?
2] I am aware of a "big data" study that concluded there were 3 types of CA progression groups during CPAP use: persistent (majority of people), emergent, and declining. I think the CA was measured by the CPAP device itself, so says nothing about the impact of using CPAP itself on CA .
I can find very little (none
)research articles on the initial impact of CPAP use on CA. These articles must exist...
RE: Does CPAP also treat central sleep apnea (csa)? - Gideon - 03-06-2022
During a diagnostic sleep test chest and stomach bands are used to measure breathing effort. No breathing effort, no expansion is a sign of central apnea. Obviously CPAP devices do not have this. Instead CPAPS use various techniques to send pressure pulses as a kind of "sonar" to see if an obstruction/restriction is present, lack of this indicates a Central event vs an obstructive event. Additionally a sleep test uses either, there are 2 standards, a 3% or a 4% reduction in O2 SATs as needed to classify an event as an Apnea. The CPAP devices evaluation of being central is considered acceptable indication of a Central Apnea. Another significant difference is that sleep tests monitor your sleep state and CPAPS do not. It is not considered Sleep apnea unless you are asleep.
On the 3 forms, persistent,Emergent, and declining, nearly everyone has a few, I'll say based on my observations here, insignificant number of central Apneas. The majority of those with significant persistent Apnea are on ASV and as such do not exhibit any significant persistent central apnea. By far the most significant central apnea we see is Emergent. Over time this form often declines so I am quite confused about the difference you describe as Emergent and declining, Treatment Emergent Central Apneas are often managed by avoidance techniques vs treatment techniques. Avoidance techniques include minimizing pressure differentials and higher pressures. Note that these avoidance techniques also tend to increase obstructive events.
I hope this helps.
RE: Does CPAP also treat central sleep apnea (csa)? - sfr79 - 03-06-2022
(03-05-2022, 12:23 PM)Crimson Nape Wrote: Hi LetMezz! -
The CAs you are experiencing could be treatment induced. CAs can occur by having CO2 washout. If they are less than 20 seconds per event, then I would see if they diminish as your treatment continues over time.
- Red
I'm still fairly new to therapy myself (2 months in), but I wanted to note that my treatment-induced CA's routinely lasted longer than 20 seconds, and have greatly subsided over the last two months on APAP therapy (CAI > 10 some days during the first 2-3 weeks of treatment, w/ occurrences lasting 5-40 seconds. During the last month my CAI is below 2.5, and their duration is consistently 10 seconds or less).
Stick with it OP, those CAs will hopefully subside over the coming months.
RE: Does CPAP also treat central sleep apnea (csa)? - sheepless - 03-06-2022
I hope they do subside but unless I'm mistaken the OP had ca in the sleep study; i.e., without cpap. that suggests they aren't treatment emergent or pressure induced. just not enough to worry about.
apparently I got mixed up with the event numbers. it was 13oa, 8ca not 3 and 8 as I mistakenly said above.
RE: Does CPAP also treat central sleep apnea (csa)? - Geer1 - 03-06-2022
A lot of the studies are related to heart failure patients but many of the same basics still apply.
Here is a literature review and meta analysis on the subject.
https://pubmed.ncbi.nlm.nih.gov/22215916/
Here is an abstract for the pharyngeal narrowing, no free link to article though.
https://pubmed.ncbi.nlm.nih.gov/7649916/