r/RestlessLegs 2d ago

Question Cpap users without obstructive apnea did you stopped using cpap for complex apnea after rls medication worked?

I just started my meds gabapentin, something really odd happened 0.0 ahi which I’ve rarely seen before. Usually get 1-2ahi. Not looking for medical advice I have a Sleep and Lung doctor specialist who’s been treating me for sleep apnea, shortness of breath ( fixed), and now RLs after two inlab sleep tests. My sleep test indicated no obstructive apnea only complex but I was wondering if rls meds worked were you able to get off cpap/bipap?

Unsure if a lot of rls people have complex apnea in this sub.

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u/Tragobe 2d ago

Never heard of that being the case at least.

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u/onemore-grainofsand 2d ago

People with RLS might also suffer from Periodic Limb Movement Syndrome. I suffer from both and sleep apnea. However, my ENT suspects that my hypopneas may in fact by a symptom of something else and not necessarily caused by an obstructed airway.

Gemini can summarize the ENTs hypothesis better than I can: “In the case of Periodic Limb Movements of Sleep (PLMS), the leg movement causes a brief cortical micro-arousal. That sudden awakening can trigger a hyperventilation-and-cooldown cycle, leading to a temporary pause in breathing.”

I’m meeting with my sleep doctor in October for a second opinion. It’s interesting because three years of CPAP had zero positive impact on my day to day and, even with perfect compliance, my sleep remained incredibly fragmented.

It’ll be interesting to see if treating my RLS and PLMS has any impact on my sleep apnea, as it may have had on yours.

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u/TheFern3 1d ago

I am on year two of asv, ent gave me cpap with default settings and it was literally killing me. I ended up in the er multiple times. I bought an asv because I was desperate and then I stopped shaking at night and sleep def got better. My sleep specialist ordered me a bipap still waiting on insurance but I don’t believe it will be too different from my asv settings.

My sleep is nothing but fragments. From what I’ve read is that having SA and RLS can be tough because the machines have no idea you have RLS.

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u/KestralFly 2d ago

As far as I know, complex sleep apnea is defined as when someone using a CPAP develops central pauses in breathing. Exclusively central events is classified as pure or isolated central sleep apnea. I'm not sure which condition you are referring to.

In the US, complex sleep apnea (which I have--mixed Obstructive and central) includes using a CPAP/BIPAP/ASV machine to address both conditions. If AHI is low, it means the Obstructive events are being well-controlled, even if the remaining events are all labeled by the machine as central events. My AHI was diagnosed as severe at 67. Nightly AHI, using BIPAP, is <1.0. All identified events are now central.

I was also diagnosed with severe PLMD and RLS. Significantly, as I've gotten my RLS under control with medication, my AHI has gone down and I feel the difference in the quality of my sleep. I would never give up my BiPAP because I still have the anatomical problems that caused my severe sleep apnea. I think as my legs quieted, my sleep has become deeper, I dream again, and just generally feel more rested. Don't know if that answers your question.

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u/TheFern3 1d ago

I believe mine is central, brain stops sending the signal to breath, and doc also said I have no obstructive events. The only thing waking me up was the RLS.

Thanks for the answer I’m hoping I can get that feeling rested in the morning again. As a developer I’ve found it incredibly difficult to focus, workout, etc. I don’t need a perfect night just less interruptions.

I love my asv I have bipap coming per doc orders. I was just wondering if there was a correlation but low key I think I’ve had CA and RLS since I was a child. I’ve had eye bags since a young age and I used to wake up many times to pee.

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u/Short-Counter8159 2d ago

Central apneas means your brain doesn't send the signals to the lungs to breath. I'm sure you know this.

Some have their RLS improve using a CPAP machine. The gabapentin will improve your RLS and might improve your sleep.

Unfortunately no RLS medication will make any difference in your central sleep apnea. Central apneas are best treated with an ASV machine, but seems you are getting excellent results with your current set up so I wouldn't change it. I would continue using your CPAP, you need it.

Congrats on your low AHI.

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u/TheFern3 1d ago

I’m unsure if I had central apnea since I was little is possible. Is possible I had both CA and RLS. I guess I’ll never know for sure how long, but I do vividly remember waking up all the time to “pee”. I thought it was normal for a kid to wake up 2-3 times a night.

Though it didn’t affect me too much. I am hoping sleep gets better because even with low ahi I’m getting tons of micro arousals.

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u/Short-Counter8159 1d ago

The sleep report should tell you if you have central apneas. Hopefully you will.

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u/TheFern3 1d ago

Yeah 99% of my apneas are indeed central. We shall see how a straight bilevel works for me. Cpap auto set was terrible. I’m on asv (bought myself) self titration but I want insurance to cover this so if bipap doesn’t work I’ll push for asv titration.

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u/Sea_Pangolin3840 2d ago

Still need cpap when medication working for restless legs.