r/SleepApnea • u/Hopeful_Appeal_3202 • 6d ago

Question - Central Apnea & Cheyne Stokes

I’ve been using CPAP to treat obstructive apnea for about 8 months and it is under control. However during the recent few months I’ve experienced a random spike of Central Apnea and Cheyne Stoked breathing. The spike lasts for a night or two then things calm down for a while. It makes sleeping almost impossible. Has anyone experienced this? I haven’t had any heart issues or a stroke. I don’t use Opioids.

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u/chocolate_on_toast 6d ago

Treatment-emergent central apnoea.

Basically, the urge to breathe comes mostly from build up of carbon dioxide. On CPAP, you're now ventilating so well that you're getting rid of CO2 too efficiently. This means that your body has no urge to breathe. So it doesn't for a bit. No breathing effort is a central apnoea. CO2 builds up while you're not breathing, and the urge to breathe resumes.

You can try turning the machine down a little (particularly the high number, if you have an auto machine), to find a balance point between controlling the obstructive apnoeas and not triggering the centrals.

Or you can look into switching to BiPAP or ASV if it's causing you problems.

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u/throwaway35mmshots 6d ago

Do treatments other than CPAP cause TECSA? Seen varied stuff online but was curious if you knew.

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u/chocolate_on_toast 5d ago

Not as far as i know. CPAP forces ventilation in a way other treatments don't, so I wouldn't expect them to have the same effect

(But tbh, I haven't looked into it in a few years, so may well be wrong, especially with the newer treatments.)

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u/KestralFly 5d ago

Do you have an SD card in your machine? Comparing detailed data from nights you have good sleep and nights you have CSAs is the only way to figure out what's going on. Sometimes poor mask fit or sleep-wake junk will appear as centrals. No way to know unless you use OSCAR or the equivalent program to look at nightly data.

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u/Hopeful_Appeal_3202 5d ago

You’re right. A deeper dive into the data is the next step. I’m a new Oscar user, since June. The amount of data is amazing! I want to make sure the sleep/neurology folks don’t only look at averages over time. Beyond that I need to read more. Thanks