Central Sleep Apnea and BiPAP Therapy

by Harry
(Mumbai)

I was diagnosed with OSA and have been on CPAP since 2004.In 2006,I underwent a triple-vessel CABG,but,apparently there was no damage to the heart muscles.

Recently, I bought a new CPAP with a card-reader (Respironics REMstar, A flex). It was comfortable. Some days ago, whilst asleep with the CPAP, I awoke, startled and 'choked', after a mere 2 hrs sleep at night.

The memory card was sent to the dealer for interpretation, and, he replied that I had a Central Apnea problem and needed a BIPAP. My AHI was also high, averaging 12. I'm skeptical of using a BIPAP un-necessarily as it may weaken/strain my lungs.

Am I correct in assuming that pre-mature use of a BIPAP can be counter-productive to one's health?Can I forward the recent CPAP readings for expert evaluation,please?

Answer


BiPAP or bilevel positive airway pressure is usually only prescribed for the following cases:

  • for patients with obstructive sleep apnea, who also have other respiratory or cardiac conditions, such as Chronic Obstructive Pulmonary Disease (COPD), or Congestive Heart Failure (CHF), as these patients would normally have problems dealing with the continuous air pressure from CPAP.

  • for those requiring a pressure in excess of 20 cms H2O.

  • for patients who need a lower exhalation pressure.

  • for patients with central sleep apnea.

I personally have never heard of anyone suffocating on BiPAP. The bilevel PAP machine builds to a higher pressure when you inhale and decreases to a lower pressure when you exhale. The goal of this treatment is to boost the weak breathing pattern of central sleep apnea.

Some bilevel PAP devices can be set to automatically deliver a breath if the device detects you haven't taken a breath after a certain number of seconds. The ResMed S9 VPAP Adapt adapts to the patient’s ventilation needs and is specifically designed to treat central sleep apnea.

Here is a video about Resmed S9 VPAP series:



However, I can recommend a better sleep apnea machine for central and complex apnea. Have you heard about adaptive servo-ventilation (ASV)?

This new device monitors your normal breathing pattern and stores the information in a built-in computer. After you fall asleep, the machine uses pressure to regulate your breathing pattern and prevent pauses in your breathing.

Click here to learn more about Resmed ASV device.

I hope it helps. Don't be afraid to comment back.

Remy Thierry
Founder of Sleep Apnea Guide

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May 27, 2011
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by: Harry

Dear Remy,
Thanks for the reply.There are 2 issues which I need to clarify:(1).The odd 'choking' incident was experienced whilst on the CPAP & NOT Bipap.(2).My apprehension was in switching-over to a Bipap pre-maturely-ie without any pulmonary obstruction or a congestive heart failure,etc.This needs to be clarified.Thanks.

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