Detecting central apneas w/o sleep lab?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
sawinglogz
Posts: 400
Joined: Mon Aug 27, 2012 12:53 pm

Detecting central apneas w/o sleep lab?

Post by sawinglogz » Wed Aug 27, 2014 2:57 pm

If someone (not me) was titrated at home with an Auto machine, how can you tell whether there are central apneas under treatment? I know Respironics will flag "clear airway" events, but what about Fisher & Paykel?

_________________
Mask: Mirage Liberty™ Full Face CPAP Mask with Nasal Pillows With Headgear
Additional Comments: EEP=5-15, PSmin=4, PSmax=19, Max=25 cm H2O, SleepyHead software

User avatar
palerider
Posts: 32300
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Detecting central apneas w/o sleep lab?

Post by palerider » Wed Aug 27, 2014 3:17 pm

sawinglogz wrote:If someone (not me) was titrated at home with an Auto machine, how can you tell whether there are central apneas under treatment? I know Respironics will flag "clear airway" events, but what about Fisher & Paykel?
that depends on which machine it is...

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
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.

JDS74
Posts: 3397
Joined: Sun Jan 23, 2011 2:57 pm
Location: South Carolina

Re: Detecting central apneas w/o sleep lab?

Post by JDS74 » Wed Aug 27, 2014 3:31 pm

My reading of the InfoSmart software is that apneas, hypopneas and flow limitation events are reported depending on the exact model.
I couldn't find any reference to central or clear airway apneas being reported separately.
Here is a documentation link.

infoSmart

_________________
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.

sawinglogz
Posts: 400
Joined: Mon Aug 27, 2012 12:53 pm

Re: Detecting central apneas w/o sleep lab?

Post by sawinglogz » Wed Aug 27, 2014 7:17 pm

palerider wrote:that depends on which machine it is...
Icon+ Auto

I don't see a row for CA in SleepyHead, so I'm guessing the machine doesn't flag CA events itself?

Is there any other way to see them in the data that is there? (Flow waveform, pressure adjustments, etc.)

_________________
Mask: Mirage Liberty™ Full Face CPAP Mask with Nasal Pillows With Headgear
Additional Comments: EEP=5-15, PSmin=4, PSmax=19, Max=25 cm H2O, SleepyHead software

User avatar
palerider
Posts: 32300
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Detecting central apneas w/o sleep lab?

Post by palerider » Wed Aug 27, 2014 8:08 pm

sawinglogz wrote:
palerider wrote:that depends on which machine it is...
Icon+ Auto

I don't see a row for CA in SleepyHead, so I'm guessing the machine doesn't flag CA events itself?

Is there any other way to see them in the data that is there? (Flow waveform, pressure adjustments, etc.)
jedimark says he's not seen anything that looks like a central/clear airway flag in the data, though he hasn't seen any data from the latest firmware revisions.

loan 'em your PRS1

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
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.

sawinglogz
Posts: 400
Joined: Mon Aug 27, 2012 12:53 pm

Re: Detecting central apneas w/o sleep lab?

Post by sawinglogz » Thu Aug 28, 2014 6:45 am

So if they were suffering from complex apnea, how would you tell?

Do the CAs get incorrectly marked as OAs?

_________________
Mask: Mirage Liberty™ Full Face CPAP Mask with Nasal Pillows With Headgear
Additional Comments: EEP=5-15, PSmin=4, PSmax=19, Max=25 cm H2O, SleepyHead software

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Detecting central apneas w/o sleep lab?

Post by Pugsy » Thu Aug 28, 2014 7:36 am

sawinglogz wrote:Do the CAs get incorrectly marked as OAs?
By which machine are you referring to? Incorrect flags are always a possibility but in general with the PR S1 and the S9 it's fairly accurate.
sawinglogz wrote:So if they were suffering from complex apnea, how would you tell?
With a machine that didn't flag centrals? There's not much to go on. We don't know if the Icon would flag centrals as OAs. I don't even know how their algorithm in auto mode works...does it ignore centrals and not increase the pressure which might give a clue.
Long time ago with the Respironics M series machines I saw reports from people who ended up going to ASV and it was the hyponea count that was whacko...not the OA count.

If someone is really concerned about complex sleep apnea then they need to use a machine that will flag centrals for sure and is known to be accurate....that would be the PR S1 or ResMed S9.
That's one of the reasons we stick with these 2 main brands of machines when we recommend machines....they cover the "what ifs" that sometimes might pop up. Like "what if this person ends up with Comp SA?'

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
palerider
Posts: 32300
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Detecting central apneas w/o sleep lab?

Post by palerider » Thu Aug 28, 2014 9:29 am

Pugsy wrote:
sawinglogz wrote:Do the CAs get incorrectly marked as OAs?
By which machine are you referring to? Incorrect flags are always a possibility but in general with the PR S1 and the S9 it's fairly accurate.
op was asking about a friends icon auto

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
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.

User avatar
palerider
Posts: 32300
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Detecting central apneas w/o sleep lab?

Post by palerider » Thu Aug 28, 2014 9:31 am

sawinglogz wrote:So if they were suffering from complex apnea, how would you tell?

Do the CAs get incorrectly marked as OAs?
perhaps a little more background, and some images would help.

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
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.

User avatar
Pugsy
Posts: 63941
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Detecting central apneas w/o sleep lab?

Post by Pugsy » Thu Aug 28, 2014 9:38 am

palerider wrote:op was asking about a friends icon auto
I assumed so but since the suggestion to loan the friend the PR S1 ASV machine had been made I just wanted to make sure.
I flunked mind reading 101 in college.

I don't know enough about the Icon auto algorithm to make any guesses as to what it reports or how it functions or might flag Centrals should there be a large number of them present.
I prefer to stick to tried and true and they aren't always perfect.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

User avatar
palerider
Posts: 32300
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Detecting central apneas w/o sleep lab?

Post by palerider » Thu Aug 28, 2014 9:46 am

Pugsy wrote:
palerider wrote:op was asking about a friends icon auto
I assumed so but since the suggestion to loan the friend the PR S1 ASV machine had been made I just wanted to make sure.
I flunked mind reading 101 in college.

I don't know enough about the Icon auto algorithm to make any guesses as to what it reports or how it functions or might flag Centrals should there be a large number of them present.
I prefer to stick to tried and true and they aren't always perfect.
I asked JM about it, and he said he hasn't seen any indication in the icon auto data stream of any kind of central flags, that's why I thought maybe set the asv to cpap mode (if it does that) and loan it to the friend for a nap

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
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.

User avatar
archangle
Posts: 9294
Joined: Sun Mar 27, 2011 11:55 am

Re: Detecting central apneas w/o sleep lab?

Post by archangle » Thu Aug 28, 2014 6:07 pm

Remember that even if it doesn't list "central apnea" in the results, almost any data capable machine will detect them as an apnea, it just can't tell it's central vs. obstructive.

Isn't there one of the ASV machines that won't ever flag a central when it's in ASV mode?

I find when I look at my Flow Rate waveforms, that my centrals tend to start on the end of an exhale, and obstructives start at the end of an inhale. I don't know if this is usually the case.

_________________
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: Also SleepyHead, PRS1 Auto, Respironics Auto M series, Legacy Auto, and Legacy Plus
Please enter your equipment in your profile so we can help you.
Click here for information on the most common alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check for yourself.

Useful Links.

User avatar
palerider
Posts: 32300
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Detecting central apneas w/o sleep lab?

Post by palerider » Thu Aug 28, 2014 6:34 pm

archangle wrote:Isn't there one of the ASV machines that won't ever flag a central when it's in ASV mode?
the s9 adapt won't let you *have* a central.

as the flow starts to taper off, before it even hits zero, the adapt is ramping up the pressure support to keep your minutevent to target levels.

you can see, comparing the flow, and the mask pressure, how mask pressure increases and flow continues.

here's someone trying to have centrals on an asv:
Image

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
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.