Central Apnea

[Guest guest]

I've been reading these posts about Obstructive Sleep Apnea with interest. Does anybody have any information regarding the incidence of Central Apnea and its usual causes? This is the most recent diagnosis handed to me after a couple of sleep studies, having something close to 80 occurrences in the hour, with O2 levels dropping to 85%. There is also a suggestion that I have had a pevious diagnosis of Lupus, of which I have never been informed. Does any person know of any connection? I'm sure I will learn as much or more from the people on this site than I have so far from any where else.

Regards from Bill Pilgrim in Australia.

-- RESEARCH: Sleep apnea in multiple system atrophy

Nippon Rinsho 2000 Aug;58(8):1722-7Sleep apnea in multiple system atrophyAsahina M, Yamaguchi M, Fukutake T, Hattori T.Department of Neurology, Chiba University School of Medicine.Multiple system atrophy(MSA) characterized clinically by any combination ofautonomic, extrapyramidal or cerebellar symptoms and signs. MSA patientsfrequently manifest a variety of sleep-related respiratory disturbances,which are life threatening problems. Above all, a common and seriouscomplication is upper-airway obstructive sleep apnea associated withstridor, which is caused by vocal cord abductor paralysis(VCAP). For theearly diagnosis of VCAP, it is important to perform laryngoscopy duringsleep, because VCAP does not appear during awakefulness in the early stageof MSA. Polysomnographic study should be obtain to assess the severity ofrespiratory disturbances. Tracheostomy is reliable treatment for respiratorydisturbances due to VCAP, while nasal continuous positive pressure may be auseful treatment for some patients.If you do not wish to belong to shydrager, you may unsubscribe by sending a blank email to shydrager-unsubscribe

[Guest guest]

Greetings BIll,

I probably I don't know if anyone answered your question or not. No,

Central Apnea (awake or asleep) is not very normal. I suspect too many

people don't survive long enough for accurate diagnosis. Is it related to

MSA? Perhaps. Afterall what can be more autonomic than breathing. But the

mechanisms that govern breathing are very complex and can malfunction due to

a number of reasons.

In the course of an hour 80 central apneas is definitely troubling. Do you

use a ventilator during sleep. Not just a CPAP or BiPAP unit. If not, you

need to insist your doctor do something about this. Poor sleep due to

central (or obstructive) sleep apnea is very debilitating.

Poor oxygen saturation is not a good thing. It can lead to *massive*

headaches, as you probably already know. Oxygen can help elevate the oxygen

saturation. But it does have it's own set of very serious risks.

And there are Positive Airway Pressure devices that can recognize lack of

breathing and help give a gentle assist, which in some cases helps improve

problems with sleep. As an interesting aside, when my sleep is very bad

(over the course of weeks and months) the times I simply fail to breathe

increase. Again, that per my wife. Though sleep studies do find that as

well. (That is also unusual, but not really surprising to me, seeing how

any stress impacts my symptoms and body).

Just as an example, Respironics (at http://www.respironics.com/) produces a

machine that helps with such symptoms. Goto that site, and enter 1003986

and return. Then select the one item (that should appear) titled: BiPAP®

SynchronyT Ventilatory Support System with or without Modem. There are also

Sullivan machines, made by ResMed, if I remember correctly. Their ResMed

Enhanced VPAP II unit provides similar features (and the company is based

down under, if I remember correctly).

Do not let doctors get away with the old " There's nothing we can do about

this. " routine. Especially since with that, there is some treatment options

available. Medications can also help, though with 80 apneas per hous, they

would probably be an adjunct to such a machine.

If your doctor doesn't want to do anything, ask for a referal to a board

certified sleep specialist. If you have one and that doctor is doing

nothing, request a referral to another sleep specialist, who took his

initial work as a neurologist (most start as pulmonologists).

Pulmonologists seem to often miss the central nervous system / breathing

problem link. I had to bring my wife into a visit with me to force him to

take action. I explained that neither he nor the sleep lab machines slept

with me every night, and I would appreciate he listen to my wife who could

explain how I slept. It put a face on the impact failure to work with me

might have.

Why do doctors ignore central sleep apnea? Because it is VERY rare,

fortunately. So, you need to do your own research and decide what level of

testing and pushing you want. And also decide when you will just accept it.

But no, there is very, very little literature that discusses central sleep

apnea and MSA. I think I found some articles several years back. But

nothing very concrete. MSA is rare, CSA is perhaps rarer. As a result,

combining the two groups, there is very little overlap.

I hope this helps.

Regards,

=jbf=

B. Fisher

[Guest guest]

Thanks for the response . You are not wrong about everything you said - Headaches - Fatigue - and many others. I really think that I start to become a bit delerious sometimes because of either lack of Oxygen or Fatigue.

I'm just home from a short stay in hospital again to try to reduce the fluid retention in my body. My legs were starting to crack and weep because of the swelling, but the worst problem was I could not breath properly, so the two thiongs together are knocking me about.

I have an appointment to see an Neurologist, at my request, on 14th October. I may last that long.

I will look up the Site you advised as so far I am only on an Oxygen Generator. It is helping a little through the night, but it is becomming more difficult, as every time I sit down and relax, the Apnoea cuts in. It's a frightening feeling.

Once again thanks. I will have to turn in as it is taking a lot of concentration to do this.

Regards from Bill P.

-- Re: Central Apnea

Greetings BIll,I probably I don't know if anyone answered your question or not. No,Central Apnea (awake or asleep) is not very normal. I suspect too manypeople don't survive long enough for accurate diagnosis. Is it related toMSA? Perhaps. Afterall what can be more autonomic than breathing. But themechanisms that govern breathing are very complex and can malfunction due toa number of reasons.In the course of an hour 80 central apneas is definitely troubling. Do youuse a ventilator during sleep. Not just a CPAP or BiPAP unit. If not, youneed to insist your doctor do something about this. Poor sleep due tocentral (or obstructive) sleep apnea is very debilitating.Poor oxygen saturation is not a good thing. It can lead to *massive*headaches, as you probably already know. Oxygen can help elevate the oxygensaturation. But it does have it's own set of very serious risks.And there are Positive Airway Pressure devices that can recognize lack ofbreathing and help give a gentle assist, which in some cases helps improveproblems with sleep. As an interesting aside, when my sleep is very bad(over the course of weeks and months) the times I simply fail to breatheincrease. Again, that per my wife. Though sleep studies do find that aswell. (That is also unusual, but not really surprising to me, seeing howany stress impacts my symptoms and body).Just as an example, Respironics (at http://www.respironics.com/) produces amachine that helps with such symptoms. Goto that site, and enter 1003986and return. Then select the one item (that should appear) titled: BiPAP®SynchronyT Ventilatory Support System with or without Modem. There are alsoSullivan machines, made by ResMed, if I remember correctly. Their ResMedEnhanced VPAP II unit provides similar features (and the company is baseddown under, if I remember correctly).Do not let doctors get away with the old "There's nothing we can do aboutthis." routine. Especially since with that, there is some treatment optionsavailable. Medications can also help, though with 80 apneas per hous, theywould probably be an adjunct to such a machine.If your doctor doesn't want to do anything, ask for a referal to a boardcertified sleep specialist. If you have one and that doctor is doingnothing, request a referral to another sleep specialist, who took hisinitial work as a neurologist (most start as pulmonologists).Pulmonologists seem to often miss the central nervous system / breathingproblem link. I had to bring my wife into a visit with me to force him totake action. I explained that neither he nor the sleep lab machines sleptwith me every night, and I would appreciate he listen to my wife who couldexplain how I slept. It put a face on the impact failure to work with memight have.Why do doctors ignore central sleep apnea? Because it is VERY rare,fortunately. So, you need to do your own research and decide what level oftesting and pushing you want. And also decide when you will just accept it.But no, there is very, very little literature that discusses central sleepapnea and MSA. I think I found some articles several years back. Butnothing very concrete. MSA is rare, CSA is perhaps rarer. As a result,combining the two groups, there is very little overlap.I hope this helps.Regards,=jbf= B. FisherIf you do not wish to belong to shydrager, you may unsubscribe by sending a blank email to shydrager-unsubscribe

[Guest guest]

Greetings Bill !

You wrote:

> ... every time I sit down and relax, the Apnoea cuts in. It's a

frightening feeling.

Yes, it is. I often find myself gasping for air, even during the day. Not

all the time. But more than I ever remember before. My wife tries to

reassure me that everyone does this. Yes. But not for as long, nor

litterally gasping desperately for air. I do understand.

> ... I will have to turn in as it is taking a lot of concentration to do

this.

Again, another sign your brain is desperately trying to gather resources to

get things done. Here's hoping you can get some relief. You may need to

see a pulmonologist after the neurologist. Not fun doing the

doctor-go-round bit, is it?

Regards,

=jbf=

B. Fisher

[Guest guest]

Hi . Yes I think it's a case of "You've got to have it to understand it properly". I didn't realise that you were affected also. Perhaps I should have, but it slipped bye. I am a bit confused at the moment. My body is trying hard not to lose any fluid as well and that is affecting the ability of my lungs to work, so I am sitting here trying to type, puffing and panting. As I relax and start daydreaming, WHOOPS! I stop breathing and it is hard to catch up.

I would appeciate any info you can supply. I had never heard of the Pulmonologist. It makes sense though. I haven't got past the Respiratory chap yet. He seems lost however and for some reason I seem to be getting worse. Perhaps it is the combination of the two things.

Regards from Bill P.

-- Re: Central Apnea

Greetings Bill !You wrote:> ... every time I sit down and relax, the Apnoea cuts in. It's afrightening feeling.Yes, it is. I often find myself gasping for air, even during the day. Notall the time. But more than I ever remember before. My wife tries toreassure me that everyone does this. Yes. But not for as long, norlitterally gasping desperately for air. I do understand.> ... I will have to turn in as it is taking a lot of concentration to dothis.Again, another sign your brain is desperately trying to gather resources toget things done. Here's hoping you can get some relief. You may need tosee a pulmonologist after the neurologist. Not fun doing thedoctor-go-round bit, is it?Regards,=jbf= B. FisherIf you do not wish to belong to shydrager, you may unsubscribe by sending a blank email to shydrager-unsubscribe

[Guest guest]

Greetings Bill !

Oh, I have some of the symptoms. But no where near the problems you face.

Though I am just starting to have similar problems with water retention and

edema. It's not fun.

You may have several problems at work. Your body may no longer be able to

regulate BP, so you accumulate water around the lungs (and possibly the

heart), let alone the legs. That extra pressure on the lungs actually

supresses the breathing drive. Not good if you have breathing problems

already. If you are overweight, as I am, it only makes matters worse.

Loosing weight (easier said than done), can help. But not always. This is

from my pulmonologist. I only see him if I think my pressure needs

adjustment on my BiPAP. It's been several years at this point.

Like I say, a pulmonologist will well understand medications that can help

with the breathing drive. They can also do a wake and sleep study of your

breathing. You probably need both a neurologist and pulmonologist working

together helping you. Just a thought.

Regards,

=jbf=

B. Fisher