.

These are the best websites that I have found that explain Central Sleep Apnea:

Central Sleep Apnea
By Mayo Clinic Staff
June 15, 2007
http://www.mayoclinic.com/health/central-sleep-apnea/DS00995/DSECTION=1

Central Sleep Apnea
MedlinePlus (a service of the National Library of Medicine and NIH)
Update Date: 11/13/2006
http://www.nlm.nih.gov/medlineplus/ency/article/003997.htm

Please note that I think that the treatment section at the MedlinePlus link is not updated. The newer more advanced bi-PAP and ASV-PAP treatments may be more effective than CPAP for treatment of Central apnea.

Please note that most people on the ASAA forum have Obstructive sleep apnea, and therefore most posts contain tips or suggestions to help with Obstructive. This type of general advice may not appropriate for people with Central. So please keep that in mind and always note that you have Central apneas whenever you post.



Last edited by Guest MJ on Sat Feb 09, 2008 8:15 pm; edited 5 times in total

The following info is quoted from the Mayo Clinic website referenced above:

Treatments for central sleep apnea may include:

Treatment for associated medical problems. Possible causes of central sleep apnea include heart or neuromuscular disorders, and treating those conditions may help your sleep apnea. For example, appropriate therapy for heart failure may eliminate central sleep apnea.

Reduction of opioid medications. If opioid medications are causing your sleep apnea, your doctor may gradually reduce your dose of those medications.

Supplemental oxygen. Using supplemental oxygen while you sleep may help if you have central sleep apnea. Various forms of oxygen are available as well as different devices to deliver oxygen to your lungs. This treatment isn't recommended for those with heart failure.

Medications. Certain medications have been used to stimulate breathing in people with central sleep apnea. For example, some doctors prescribe acetazolamide to prevent central sleep apnea in high altitude.

Continuous positive airway pressure (CPAP). This method, also used to treat obstructive sleep apnea, involves wearing a mask over your nose while you sleep. The mask is attached to a small pump that supplies pressurized air which holds open your upper airway. CPAP may eliminate snoring and prevent central sleep apnea. As with obstructive sleep apnea, it's important that you use the device only as directed. If your mask is uncomfortable or the pressure feels too strong, talk with your doctor so that adjustments can be made.

Bilevel positive airway pressure (bilevel PAP). Unlike CPAP, which supplies steady, constant pressure to your upper airway as you breathe in and out, bilevel PAP 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.

Adaptive servo-ventilation (ASV). This newer airflow device is designed to treat central sleep apnea and complex sleep apnea. The 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.



Last edited by Guest MJ on Sat Feb 09, 2008 8:15 pm; edited 5 times in total

.
It may be that the ASV PAP treatment is so new, that docs/labs may not be up-to-date about its existence. Following are links & quotes regarding the ASV devices (offered by the two major PAP device manufacturers) specifically for treatment of central apneas.

ResMed
ResMEd VPAP Adapt SV™ is an adaptive servo-ventilator designed specifically to treat central sleep apnea (CSA) in all its forms, including complex and mixed sleep apnea. [... ]
Link: http://www.resmed.com/en-us/products/flow_generators/vpap_adapt_sv/vpap-adapt-sv.html?menu=products

The VPAP Adapt SV™ is the first device cleared for the treatment of central sleep apnea (CSA), mixed sleep apnea and periodic breathing such as Cheyne-Stokes respiration (CSR). It is my understanding that ResMed may introduce an upgraded/newer version of above device sometime in early 2008).



Respironics
BiPAP® Auto SV™ Sleep Therapy System [...] "it's clinically proven to treat obstructive, central and complex apneas and hypopneas, as well as periodic breathing."
 
Link: http://bipapautosv.respironics.eu/

(I am not sure when the Respironics device will be available in the US market. It was FDA approved March 2007.)



Last edited by Guest MJ on Sat Feb 09, 2008 8:10 pm; edited 3 times in total

.
Again, it may be that the ASV PAP treatment is so new, that docs/labs may not be up-to-date about its existence. Therefore it may be helpful for patients to read and show these articles to their physicians:

Title: New Sleep Apnea Technology Helps Patients Rest Easier
University of Cinncinnati Health News
By Katie Pence
Published August 2007
http://healthnews.uc.edu/publications/findings/?/5282/5338/


Editorial: Adapto-Servo Ventilation using the ResMed VPAP Adapt SV
Sleep Diagnosis and Therapy 2007;2(4):20-22.
Brown S., MD
Medical Director, Memorial Care
Sleep Disorders Center, Long Beach, CA
Associate Clinical Professor of Medicine, University of California, Irvine, CA
http://www.resmed.com/en-us/dealers/medical_research/documents/Brown_SleepDT_AdaptiveServo-VentilationUsingResMedVPAPAdaptSV.pdf


Title: Treating the "Untreatable"
Sleep Review The Journal for Sleep Specialists
by Stephen E. Brown, MD, DABSM
Issue: June 2007
http://www.sleepreviewmag.com/issues/articles/2007-06_03.asp

Here's another posted topic with other links to discussions and info about Central Apnea:

Click here for link to another topic on Central Apnea posted in Interesting Links

Central Sleep Apnea
Pathophysiology and Treatment
(Chest. 2007; 131:595-607)
© 2007 American College of Chest Physicians
Danny J. Eckert, PhD; Amy S. Jordan, PhD; Pankaj Merchia, MD and Atul Malhotra, MD, FCCP

* From the Division of Sleep Medicine, Sleep Disorders Program and Harvard Medical School (Drs. Eckert, Jordan, and Merchia), and Division of Pulmonary/Critical Care Medicine (Dr. Malhotra), Brigham and Women’s Hospital Boston, MA.

Abstract
Central sleep apnea (CSA) is characterized by a lack of drive to breathe during sleep, resulting in repetitive periods of insufficient ventilation and compromised gas exchange. These nighttime breathing disturbances can lead to important comorbidity and increased risk of adverse cardiovascular outcomes. There are several manifestations of CSA, including high altitude-induced periodic breathing, idiopathic CSA, narcotic-induced central apnea, obesity hypoventilation syndrome, and Cheyne-Stokes breathing. While unstable ventilatory control during sleep is the hallmark of CSA, the pathophysiology and the prevalence of the various forms of CSA vary greatly. This brief review summarizes the underlying physiology and modulating components influencing ventilatory control in CSA, describes the etiology of each of the various forms of CSA, and examines the key factors that may exacerbate apnea severity. The clinical implications of improved CSA pathophysiology knowledge and the potential for novel therapeutic treatment approaches are also discussed.

The link to the full free article is http://www.chestjournal.org/cgi/content/full/131/2/595