What's a "clear airway" and why does it show up ?
What's a "clear airway" and why does it show up ?
I've never seen 'clear airway' show up in SleepyHead, but suddenly, I'm finding quite a few.
Can anyone explain?
Thanks
Can anyone explain?
Thanks
_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier |
Mask: DreamWear Nasal CPAP Mask with Headgear |
Humidifier: XT Heated Humidifier |
Additional Comments: My headgear varies (STILL!) |
Resmed S9 with humidifier and in need of the right mask.
Re: What's a "clear airway" and why does it show up ?
You stop breathing for 10+ seconds but there is no blockage as there is in an apnea event.
_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier |
Mask: Fisher & Paykel Vitera Full Face Mask with Headgear (S, M, or L Cushion) |
Additional Comments: Back up is S9 Autoset...... |
- Wulfman...
- Posts: 6688
- Joined: Mon Sep 01, 2014 6:41 pm
- Location: Nearest fishing spot
Re: What's a "clear airway" and why does it show up ?
Please feel free to search the archives of the forum:DeeCPAP wrote:I've never seen 'clear airway' show up in SleepyHead, but suddenly, I'm finding quite a few.
Can anyone explain?
Thanks
viewtopic/t158231/search.php?keywords=% ... +airway%22
Den
.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
Re: What's a "clear airway" and why does it show up ?
Excellent. Thanks. How could I have forgotten? Much appreciated.Wulfman... wrote:Please feel free to search the archives of the forum:DeeCPAP wrote:I've never seen 'clear airway' show up in SleepyHead, but suddenly, I'm finding quite a few.
Can anyone explain?
Thanks
viewtopic/t158231/search.php?keywords=% ... +airway%22
Den
.
_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier |
Mask: DreamWear Nasal CPAP Mask with Headgear |
Humidifier: XT Heated Humidifier |
Additional Comments: My headgear varies (STILL!) |
Resmed S9 with humidifier and in need of the right mask.
Re: What's a "clear airway" and why does it show up ?
"clear airway" is a term made up by respironics... the rest of the respiratory industry uses the term "central".
Get OSCAR
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.
Re: What's a "clear airway" and why does it show up ?
Thanks. Now it makes more sense.palerider wrote:"clear airway" is a term made up by respironics... the rest of the respiratory industry uses the term "central".
I'm curious as to why would they suddenly appear after never having seen them before. I suspect it's because I reset my max and minimum pressure a couple of months ago, so maybe the maximum pressure is too high (the minimum pressure seems okay). In the graph (I posted it in the first message of this thread) there were about ten clear airways in the last hour (and *only* the last hour).
I've also noticed puffs of air push through my lips when I'm going to sleep.
Thanks
_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier |
Mask: DreamWear Nasal CPAP Mask with Headgear |
Humidifier: XT Heated Humidifier |
Additional Comments: My headgear varies (STILL!) |
Resmed S9 with humidifier and in need of the right mask.
Re: What's a "clear airway" and why does it show up ?
Sometimes just as the transition between being awake and being asleep occurs, you get one of these. They can also show up when the pressure is high (for you). Noticing one just as you are going to sleep is an indication of the first cause and is nothing to worry about (neither is the second for that matter but reducing the max pressure might be required to control them.)
_________________
Mask: Oracle HC452 Oral CPAP Mask |
Humidifier: DreamStation Heated Humidifier |
Additional Comments: EverFlo Q 3.0 Liters O2 PR DSX900 ASV |
Oracle 452 Lessons Learned Updated
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
Sleepyhead and Encore Pro 2.21.
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
Sleepyhead and Encore Pro 2.21.
Re: What's a "clear airway" and why does it show up ?
Thanks. You may be right. Here's a recent chart showing the most clear airways:JDS74 wrote:Sometimes just as the transition between being awake and being asleep occurs, you get one of these. They can also show up when the pressure is high (for you). Noticing one just as you are going to sleep is an indication of the first cause and is nothing to worry about (neither is the second for that matter but reducing the max pressure might be required to control them.)
https://imgur.com/gallery/VbcoWqK
_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier |
Mask: DreamWear Nasal CPAP Mask with Headgear |
Humidifier: XT Heated Humidifier |
Additional Comments: My headgear varies (STILL!) |
Resmed S9 with humidifier and in need of the right mask.
- Jas_williams
- Posts: 1120
- Joined: Tue Dec 19, 2017 2:12 pm
- Location: Somerset UK
Re: What's a "clear airway" and why does it show up ?
I would not be concerned with the CA’s at the moment kind of look like you holding four breath whils rolling over (the one in the middle of the night) I would be more concerned with the amount of leaks going on that needs resolving as it will be reducing the effectiveness of your therapy
_________________
Mask: Bleep DreamPort CPAP Mask Solution |
Additional Comments: Using sleepyhead and a pressure of 6 - 21 Resmed S9 Adapt SV with a Bleep Sleep Mask |
Re: What's a "clear airway" and why does it show up ?
Thanks for the reassurance on the CA's. I really am worried about the leaks. Sometimes it's a percentage, but at other times it's high. I have no idea why that is, but I've been using the CPAP for years and haven't been able to resolve the leak problem once and for all.Jas_williams wrote:I would not be concerned with the CA’s at the moment kind of look like you holding four breath whils rolling over (the one in the middle of the night) I would be more concerned with the amount of leaks going on that needs resolving as it will be reducing the effectiveness of your therapy
Someone suggested the leaks are caused when I open my mouth during REM sleep, so that's pretty bad because it negates the treatment -- it's like not using the CPAP. Everyone here knows how important it is to use! I do know that once I solve the leak problem once and for all, it'll be the first time I'll be getting both REM sleep AND treatment for the apneas. I've been working at this for a VERY long time! <sigh>
Again, thanks for your help!
_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier |
Mask: DreamWear Nasal CPAP Mask with Headgear |
Humidifier: XT Heated Humidifier |
Additional Comments: My headgear varies (STILL!) |
Resmed S9 with humidifier and in need of the right mask.
Re: What's a "clear airway" and why does it show up ?
try a mask that covers the mouth as well, you will see if it fixes stuff.
_________________
Mask: ResMed AirFit™ F20 Full Face CPAP Mask with Headgear |
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control |
Additional Comments: S9 ST-A iVAPS and adapt ASV |
Re: What's a "clear airway" and why does it show up ?
Personally, I appreciate their honesty with the terminology they use. My preference is to reserve the word "central" for apneas that have manually been scored such based on PSG.What is Clear Airway Apnea?
An apnea is detected when there is an 80% reduction in airflow from a baseline for at least 10 seconds if there is no airflow detected for 10 seconds. During the apnea, one or more pressure test pulses are delivered by the device. The device evaluates the response of the patient to the test pulse(s) and assesses whether the apnea has occurred while the patient has a clear airway or an obstructed airway. The airway is determined to be clear if the pressure test pulse generates a significant amount of flow; otherwise the airway is determined to be obstructed. When the airway is clear then a Clear Airway Apnea event is recorded.
-- https://www.mysleepmapper.com/Help/Faq
Clinicians also need to be aware that a device-detected apnea identified by the device as having a clear airway is not always a central apnea and a device-detected apnea identified by the device as having an obstructed airway is not necessarily an obstructive apnea. . . . Airway status determined by the PAP device does not distinguish obstructive from central apneas scored by PSG. For example, an obstructed airway was detected in about a third of device-detected apneas that were scored as central apneas on PSG. Although it is not possible to use PSG signals to determine if the pharyngeal airway is clear or obstructed during a central apnea, it is well known that the airway may be closed during this event. Badr et al. used a transnasal fiberoptic scope to view the pharyngeal airway in subjects with sleep apnea during nonrapid eye movement sleep and observed pharyngeal airway collapse during central apneas that were either spontaneous or induced by mechanical hypocapnic hyperventilation. The device uses its airway status determination to decide whether to change pressure delivery. Determination of an obstructed airway, even if it might be a central apnea, warrants an increase in pressure by the device in order to open the airway and allow resumption of airflow. The device classified 13% of the obstructive apneas on PSG as having a clear airway. This may be explained by the different criteria used by the PAP device and manually scored PSG to identify an apnea. The device defines an apnea as at least an 80% reduction from baseline in pneumotach airflow, whereas 2007 AASM criteria for an apnea on PSG require at least a 90% reduction in airflow on oronasal thermistor. However, it can be hypothesized that the pharyngeal airway during an obstructive apnea may open during active expiratory efforts and collapse again on inspiration. Under this circumstance, it is possible that a pressure pulse that occurred during expiration may have resulted in airflow. The device also detected an obstructed airway in about 44.1% of manually scored hypopneas. It is possible that when the narrowed pharyngeal airway has a very high airway resistance, the relatively small pressure pulse generated by the PAP device results in very blunted airflow; a response that the device would identify as an obstructed airway. PAP downloads report the same variables obtained on PSG, including AHI, AI, HI, and RERAI. However, the methods used in PAP devices and PSG to generate these measures differs markedly. Respiratory events detected by the PAP devices are based solely on measurement of airflow. In contrast, multiple signals are used to score respiratory events on PSG, including airflow, arterial oxygen saturation, chest wall movement, and, depending on the scoring criteria, electroencephalographic (EEG)/electromyographic (EMG) arousals. -- https://academic.oup.com/sleep/article- ... .4.597.pdf
-Jeff (AS10/P30i)
Accounts to put on the foe list: Me. I often post misleading, timewasting stuff.
Accounts to put on the foe list: Me. I often post misleading, timewasting stuff.
-
- Posts: 10
- Joined: Fri Jan 12, 2018 9:12 am
Re: What's a "clear airway" and why does it show up ?
I suspect it's because I reset my max and minimum pressure a couple of months ago, so maybe the maximum pressure is too high (the minimum pressure seems okay).
=========================
I know you’re getting some comments not to worry about the “clear airways/central” apneas. I have two comments to make.
1) The higher pressure you switched to can cause central apneas. You have sensors in your throat that detect high CO2 levels which tell your brain to breathe. If you’re blowing enough air into your lungs, there is never an elevated CO2 level and so no signal to the brain to breathe. I have a huge issue with this and the higher the pressure, the lower my obstructives but the higher my centrals. As I lower the pressure, it helps the centrals put increases the obstructives.
2) A central apnea causes the same health issues as an obstructive apnea. Your blood/brain oxygen level drops and your brain can give you a shot of adrenaline to get you to breathe again. Both are bad news.
So I think you’d be wise to deal with the leaks and then get your pressure optimized to get the lowest possible AHI score.
=========================
I know you’re getting some comments not to worry about the “clear airways/central” apneas. I have two comments to make.
1) The higher pressure you switched to can cause central apneas. You have sensors in your throat that detect high CO2 levels which tell your brain to breathe. If you’re blowing enough air into your lungs, there is never an elevated CO2 level and so no signal to the brain to breathe. I have a huge issue with this and the higher the pressure, the lower my obstructives but the higher my centrals. As I lower the pressure, it helps the centrals put increases the obstructives.
2) A central apnea causes the same health issues as an obstructive apnea. Your blood/brain oxygen level drops and your brain can give you a shot of adrenaline to get you to breathe again. Both are bad news.
So I think you’d be wise to deal with the leaks and then get your pressure optimized to get the lowest possible AHI score.
_________________
Machine: AirStart™ 10 Auto CPAP with HumidAir™ Heated Humidifier |
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear |
Humidifier: HumidAire H4i™ Heated Humidifier |