[Guest]

If I am diagnosed mixed apnea ( a combination of Obstructive apnea Central apnea ) would I see a Pulmonologist or a neurologist b/c cetral part of Apnea deals brain.

Please let me know
Jessica Kenjerski
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[Guest]

I think either one of these two specialties as long as they emphasize in their practice sleep medicine are fine. Mixed apneas are generally thought to be obstructive in nature but appear to have a central component. They are usually treated the same as obstructive events. What an obstructive apnea is is an apnea that is caused by airway obstruction, usually at the level of the uvula and or the base of the tongue. The event is terminated when the patient aroses and opens up the airway. Central apneas are caused by the brain not triggering a breath, so there is no effort to breath, obstructive apneas there is an effort to breath against the closed airway, with a resulting absence of airflow. The airway is left open in cental apneas. A mixed apnea is felt to occur when the airway closesa and this closure of the airway triggers a breath hold reflex, if you would, in the brain which causes a cessation of respiratory effort. The brain then gets a stimulation to breath and starts to try to breath against a closed airway. So a mixed apnea looks like a central obstruction initially but it is caused by a closed airway and then the last part of the apnea appears obstructive (as it is) as the patient starts to try to breath again and finally the patient wakes up and opens up the airway again. So for pratical reasons a mixed apnea is usually felt to be obstructive. Again many neurologists do an excellent job of treating sleep apnea and some pulmonologists don't have a great background. I am a pulmonologist so I think I can get away with saying that. I think whoever treats sleep apnea in your community, probably whoever read your sleep study, could do a fine job.