OT: Central sleep apnea

[gvasale]

I may still have a machine that I can give away. Its about 7 years old but hasn't seen extensive use, less than 1 year in total. It would need to be examined and a new mask obtained.

[Evan]

What kind of machine is it? According to the Doc a regular obstructive sleep apnea machine won't work.

[TRX]

What kind of machine is it? According to the Doc a regular obstructive sleep apnea machine won't work.

I have central sleep apnea, and the regular CPAP machine *does* help. Apparently few people have all of one kind of apnea; as I understand it, most people have a mix of types. A CPAP won't be complete fix for CSA, but if it can keep you from having a heart attack, it's worth the trouble. That's how I found out I had sleep apnea...

Some medical plans replace a CPAP machine every two or three years; you can sometimes find the old ones on Craigslist or eBay. There are several types of mask; you might have to experiment to find something you can put up with.

I had a *very* hard time getting used to the CPAP machine. The mask traps a bit of CO2, and I felt like I was smothering even with enough pressure to make my ears pop. Some of the newer masks vent quite a bit of air to try to correct for that. During the time I was trying to get used to the CPAP I acquired a "pulse oximeter", which is the little finger-clip thingie that measures your blood oxygen level. I found out that I quit breathing more in the early morning than I did when I first went to bed; splitting my sleep schedule up helped a bit; I wasn't working a job that prevented it.

I had checked into oxygen assist, but it turned out to be a regulatory nightmare in the USA. I didn't trust what might be in welding bottles, but I found out about those osmotic separators tire shops use to get nitrogen to fill tires. They keep the nitrogen and throw the oxygen away; I planned to buy the filter and run an air line from the shop. But about that time I got used to the CPAP and my wake counts went down enough to not worry about extreme measures.

[elginrunner]

Evan,

You are correct in that a regular CPAP machine will not work. You do in fact need the auto SV machine. It is the only thing that will work for folks with complex central sleep apnea.

An auto SV unit is basically a non invasive ventilator. It will "push" enough air to cause ventilation, or breathing. It is very effective, and I have seen it work wonders for folks who need it.

The central sleep apnea is something that we normally see in pt's that have pretty significant heart condition (like CHF), or renal failure. The process of respiration is very complex and difficult to explain. The body has a delay in the system, and has to play "catch up", our doc refers to it as a loop - gain effect. The body over ventilates the oxygen shoots up, and then "doesn't breathe" untill the oxygen goes way low, then it tries to catch up again, and over ventilates......

I've been wearing a cpap for about ten years. I'm also a pain in the arse sleep study tech that applies all those darn wires that everyone loves. I've been doing it about ten years as well. The auto sv is something that fairly new. It does work, given that two things happen. One, you wear it. and two, that you make sure that the mask has no large leaks. The machine's logarithm is based on tidal volume. If you leak large amounts of air, the machine can't adjust itself properly.

I look at cpap therapy, and auto sv as taking a medicine for our medical condition. Some people take their meds, and some don't . Everyone has to make the conscious decision to take it or not. It's only your health at stake, nobody else's.

I hope some of this rambling helped.

Brock in Ar (RPSGT,RST)

[Evan]

Lots of good information guys. Thanks for responding. How will the mask work with my full beard? I can't shave as it tears up my face regardless of what I use to shave. That is the main reason I have had a full beard since I got out of the army. Also, my beard grows incredibly fast which was always a huge problem in the army.

Incidentally, I do have mild atrial fibrillation which is probably a result of minor damage from low oxygen at various times over the years. It isn't bad enough to warrant treatment at this time but I don't want it to become worse.

Brock,

How common is it for people to have normal (above 90) O2 with a high number of events like I have? What difference will it make to what I need?

[elginrunner]

Trim the beard down for best results.

[maweis]

I am addicted to my cpac machine, I cannot sleep without it.
Had a hard time finding a mask that worked, always was trying the full face one and they would never keep a seal. Finally got a nasal pillow one and
it is used every night and nap times. The nasal one should work
even with the beard.

Mark

[gvasale]

Its likely just a regular cpap. Can't find out more tonight, but soon after, I'll give details.

[elginrunner]

Not common to see that. Although i did see it last week in a young man (30's). Treatment will probably be the same. The one thing that is constant is that every person is unique. Based on blood chemistry an phsycal characteristics of each individual, each persons treatment will be specialized for them.

What im dancing around is that breathing is a very fine balancing act with chemicals in the blood stream. Lots of thing affects that ballance. Even body position can affect a change.

[dp]

I also have central apnea but with a twist. If I lay on my back, awake or asleep, I will stop breathing. It happens with such predictable regularity I can demonstrate it to skeptical doctors in their office. I have a fixed-rate cpap because my doctor did not believe me, and the insurance company would not spring for a variable-rate machine. I was willing to buy my own but could not get a prescription. My cpap machine does me no good at all when I'm on my back, and actually works best by keeping me awake longer than normal.

When I took my sleep study they did not allow me to sleep on my side or stomach, and I warned them the numbers would be alarming. I did not complete a full minute without an apnea event all night long. They would not re-run the test with me in my normal sleep position.

I never stop breathing while laying on my stomach or either side so long as I am rolled forward slightly. I'm concerned about this because next week I'm having a hip replaced and will be required to lay on my back a lot and that's just not going to work.

When I stop breathing while asleep I'm aware of it and will roll over automatically. Years ago before I knew what was going on I'd sleep on my back all night long.

In my investigations I've also learned that too much cpap pressure will increase the likelihood of apnea becoming central apnea. Home shop types are warned not to fiddle with the program!!