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airsense13
Unread post  Post subject: Central Apnea Real or Not  |  Posted: Thu Jul 08, 2021 1:10 am

Joined: Thu Jul 08, 2021 12:37 am
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PAP Mask: ResMed N30
PAP Machine: ResMed AirSense 10 AutoSet
Humidifier: Electrostatic filter + HME
Pressure Setting: APAP 4-20, no ramp, no EPR

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Hi,

I've been using an APAP for just over a month now. My take-home sleep study (WatchPAT) showed AHI of 13, RDI of 18, and ODI of 4.

My AHI has always been under 5 ever since I started using the AirSense 10 AutoSet. Typically, the OA is under 1, and the CA is between 2 and 3. I tried increasing the minimum pressure to 6, 8, 10, etc. but that did not change either the OA or the CA. Increasing pressure only increased large leaks.

Is the CA real? And is it serious enough that I should worry about lowering it? I can't seem to get my AHI below 2.

Attached are OSCAR screenshots of a typical night and of a typical CA event. My CA events are generally shaped like that.

Thanks!


Attachments:
CAShape.png
CAShape.png [ 70.77 KiB | Viewed 1048 times ]
OSCAR20210706.png
OSCAR20210706.png [ 148.63 KiB | Viewed 1048 times ]
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Pugsy
Unread post  Post subject: Re: Central Apnea Real or Not  |  Posted: Thu Jul 08, 2021 2:48 am
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Joined: Wed Aug 02, 2017 8:01 pm
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PAP Mask: Bleep/DreamPort nasal mask
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You look at the flow rate or breaths immediately prior to the flagged event to see if it looks like you were asleep or not.
http://freecpapadvice.com/sleepyhead-free-software
With the CA/central flagged above....some very irregular breaths happened just before you see the flat line that ends up with a CA flag.
To me that means..not asleep because we don't breathe like that when asleep. If that was my report I would rank it at most likely an arousal breath....probably a turn over in bed and hold my breath while turning thing. We often will pause our breathing a little while turning over in bed.

At 04:18:50 the irregularities start....and it does look like you went right back to regular asleep breathing after the flag.

BTW...we can have this happen with other flagged events as well. It's not limited to Centrals.

But even if every single one of those flagged centrals was the real deal asleep centrals you aren't having enough of them for most docs to even bat an eye at. You would need at least 5 per hour average for most of the night before anyone would even take a second look at them.

If we aren't asleep....they aren't real and they don't count.

Asleep breathing circled in red

Image

Same thing zoomed out a little further.
Everything that happens after the red circled part...not asleep so it doesn't count.

Image

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SleepingTight
Unread post  Post subject: Re: Central Apnea Real or Not  |  Posted: Thu Jul 08, 2021 11:50 am

Joined: Sun Jun 20, 2021 1:00 pm
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PAP Mask: Resmed AirFit N20
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Thanks Pugsy - this is helpful to me too!


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airsense13
Unread post  Post subject: Re: Central Apnea Real or Not  |  Posted: Thu Jul 08, 2021 11:30 pm

Joined: Thu Jul 08, 2021 12:37 am
Posts: 2
PAP Mask: ResMed N30
PAP Machine: ResMed AirSense 10 AutoSet
Humidifier: Electrostatic filter + HME
Pressure Setting: APAP 4-20, no ramp, no EPR

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Pugsy wrote:
To me that means..not asleep because we don't breathe like that when asleep. If that was my report I would rank it at most likely an arousal breath....probably a turn over in bed and hold my breath while turning thing. We often will pause our breathing a little while turning over in bed.

At 04:18:50 the irregularities start....and it does look like you went right back to regular asleep breathing after the flag.


Is it normal to have so many arousals? Should I be concerned that I wake up repeatedly at night?


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Pugsy
Unread post  Post subject: Re: Central Apnea Real or Not  |  Posted: Fri Jul 09, 2021 3:42 am
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How many is "so many"?
It's normal to wake after completion of a REM cycle for one thing.
Google sleep stages and look at the normal hypnograms...there is always a wake time (hopefully very brief) after a REM cycle.

Not all arousals/awakenings are remember and yes...we can have several as seen based on the breathing but we might not always remember each one.
So it's normal....up to a point...it's like apneas...it's normal to have a few and not a problem. The problem is when we have a truckload of them.

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braheem24
Unread post  Post subject: Re: Central Apnea Real or Not  |  Posted: Mon Jul 12, 2021 9:09 am

Joined: Thu Jul 01, 2021 10:42 pm
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Thank you Pugsy, your reply helped me too.


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Joe Shmoe
Unread post  Post subject: Re: Central Apnea Real or Not  |  Posted: Thu Jul 22, 2021 6:51 pm

Joined: Fri Aug 25, 2017 2:05 pm
Posts: 14

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5 arousal per hour? Is that considered sleep? Like someone blowing a whistle in your bedroom every 12 minutes.
I had a terrible night sleep, at my sleep study. Felt unrefreshed in the morning. Was sent home as being normal. It's a wonder this society functions at all.


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