What's the criteria in dignosing Complex Sleep Apnea

[Sam888]

This one's a technical one.  

What measurement (values) do the sleep labs and doctors use when titrating a patient in either establishing or eliminating Complex Sleep Apnea?  eg. X amount of Centrals on CPAP, AHI index of xx,  % of time in different stages of sleep?

[Sam888]

Thanks scarlet37 for your wishes and your post.  I don't feel so insecure anymore. I'll see what he says;  however, I looked up this psychiatrist's credentials who I am about to see and unfortunately, he has no speciality.  Previously,  I had suggested to my insurance company if I could be referred to one who specializes in neuro disorders.  I was told that we don't have any locally. This psych is being paid by my insurance company who wants me back to work asap and on [psych] meds. I'm hoping this doctor isn't  biased.

[scarlet37]

I'm sorry you're still having difficulty. Please do not knock seeing a psychiatrist- The last stop in my journey for a diagnosis was a psychiatrist. That psych and his asistant who specializes in neuro disorders is in fact the only doctors who have listened to me. They diagnosed me with Narcolepsy, had it not been for these 2 caring docs I would still be searching for an answer.

Every doc I saw treated me for anxiety and/or depression then shooed me on my way, They all sent me to another specialist who ALL said i was depressed or mentally ill. It only took the psych 25 minutes to determine my diagnosis based on all my symptoms and my home file of labs and tests. It is now clearly written on my medical file that I have no depressive or anxiety issues.

Although it's odd to say I have to see my psych- I know because of them I do not have a mental condition only a sleeping disorder that commonly presents itself as a mental disorder and is commonly misdiagnosed as epilepsy.

Hang in there Sam -  this visit just may be an answer for you or at least one step closer.

Keep posting with your progress-  Best Wishes~

[Sam888]

Unfortunately not. My sleep is fragmented and poor as before. I also have considerable muscle pain, lack of concentration, and fatigue.

At the end of the month, my disability insurance company is sending me for an independent evaluation to a psychiatrist.  You can thank public health care for that.

[Suri123]

Hi, hope you are doing better. How is your health and sleep these days. Have you got evaluated completely. Your thoughs would be of great help to some of viewers of this section so keep updating. Take care.

[Sam888]

*bump*
I assume Dr. Bhumika is no longer in this forum?  
Is Dr.  Abhijeet Deshmukh?

[Sam888]

Thanks Dr. Bhumika,

I am surprised to read that there is no parameters in defining Complex Sleep Apnea.

In my situation, the obstructive or hypopnea component isn't being sufficiently treated with xPAP therapy.  In fact, using an overnight oximetry, my O2 levels plummeted to 86%. Previously in an untitrated sleep study, confirming OSA, my O2 levels dipped to a Nadir of 89% withOUT CPAP.

With the latest sleep (titration) study in the lab though, my O2 was fine at 92% the lowest point with some mixed and central apneas. The sleep was horribly fragmented with the majority of time spent in Stages 1 and 2.  No time in Stage 3 or 4.  REM was minimal.. My   GP has read the info on Complex Sleep Apnea from the Mayo Clinic and other material on Pubmed and he feels I do have Complex Sleep Apnea; however, the two sleep doctors I have referred to don't think so. Apparently, from what my GP told me, there's still not many accredited sleep doctors that yet know much about Complex Sleep Apnea in my region.

Do you have any suggestions?

[BhumikaMD]

Hi,

Complex sleep apnea is actually a combination of both obstructive and central sleep apnea seen in some patients.

Patients with complex sleep apnea at first appear to have obstructive sleep apnea and stop breathing 20 to 30 times per hour each night. But unlike typical obstructive sleep apnea patients, their breathing problem is not completely alleviated by a CPAP (continuous airway pressure) machine.

The above parameters that you ask for have not been defined for complex sleep apnea because this is a combination of obstructive and central forms of apnea and is only diagnosed once the obstructive component is taken care of after CPAP application.

I suggest you refer to the mayo clinic site about more information on this.

Hope this helps.

Good luck.