Are Clear Airways CENTRAL APNEAS

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
mon
Posts: 107
Joined: Fri Sep 21, 2012 12:43 am
Location: Australia

Are Clear Airways CENTRAL APNEAS

Post by mon » Fri Jan 30, 2015 5:21 am

I'm just wondering whether the term CLEAR AIRWAY means Central Apneas. Does anyone know whether this is the case?

User avatar
SGearhart
Posts: 434
Joined: Fri Nov 07, 2014 8:54 am
Location: Georgia

Re: Are Clear Airways CENTRAL APNEAS

Post by SGearhart » Fri Jan 30, 2015 5:57 am

Yes they are the same. The difference is between what Resmed and Phillips-Respironics call the event of the brain forgetting to tell the body to breathe.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: CMS-50F & 50IW - SleepyHead 1.0.0-Beta

User avatar
Pugsy
Posts: 63872
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Are Clear Airways CENTRAL APNEAS

Post by Pugsy » Fri Jan 30, 2015 9:29 am

Respironics elected to call these open airway cessation of breathing Clear Airway events.
ResMed calls them Centrals.
SleepyHead was originally designed for Respironics machines so Clear Airway events stuck...If a person has a ResMed machine SleepyHead still calls these open airway cessation of breathing...Clear Airway but if ResScan is used these same events are called centrals.

_________________
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: Are Clear Airways CENTRAL APNEAS

Post by palerider » Fri Jan 30, 2015 9:36 am

SGearhart wrote:Yes they are the same. The difference is between what Resmed and Phillips-Respironics call the event of the brain forgetting to tell the body to breathe.
yes.

_________________
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
Jay Aitchsee
Posts: 2936
Joined: Sun May 22, 2011 12:47 pm
Location: Southwest Florida

Re: Are Clear Airways CENTRAL APNEAS

Post by Jay Aitchsee » Fri Jan 30, 2015 10:00 am

But neither as scored by a home sleep machine may be a true "Central Apnea" as scored in a laboratory sleep study (PSG). To be a true central apnea, the patient must be asleep. Home machines have no way to tell whether the patient is awake or asleep. In the lab, it is done by EEG. It a patient rouses and stops breathing momentarily, like when rolling over for example, the home machine may score that as a CA or Central. A lab would not.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: S9 Auto, P10 mask, P=7.0, EPR3, ResScan 5.3, SleepyHead V1.B2, Windows 10, ZEO, CMS50F, Infrared Video

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

Re: Are Clear Airways CENTRAL APNEAS

Post by archangle » Fri Jan 30, 2015 11:24 am

There are some questions about the accuracy of CPAP machines detecting "central apnea."

If you're awake, it doesn't "count" in a sleep test, but the CPAP machine doesn't know.

There are also some conditions where you may have a true central apnea, but the machine will still call it an obstructive apnea.

However, whether it says "clear airway" or "central apnea," it basically means the CPAP machine's best estimate is that it's a central apnea.

_________________
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.

BrooklynCPAPer
Posts: 48
Joined: Mon Jan 05, 2015 2:12 pm
Location: Brooklyn, NY

Re: Are Clear Airways CENTRAL APNEAS

Post by BrooklynCPAPer » Fri Jan 30, 2015 11:41 am

Glad to see this topic! Thanks to the OP.

I looked at my past week's data in SleepyHead the other day and nearly all of the calculated AHI comes from these Clear Airway Apneas. It's never been mentioned on any in-lab sleep study so I'll make the assumption for now that these are false positives unless my sleep doctor is concerned with the pattern or thinks there is concern for ComplexSA emerging.

Oddly enough, last night I had one of my best sleeps since starting CPAP with an AHI of 2.2 (including Clear Airway) - and even odder I fell asleep with the machine on but also the light on. Hopefully the light on had nothing to do with it but it's an interesting note for my sleep log just the same.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: SleepyHead Software, APAP 4-16, ClimateLineAir Hose, Medium Pillows

User avatar
RogerSC
Posts: 1891
Joined: Sat Jul 21, 2012 1:11 pm

Re: Are Clear Airways CENTRAL APNEAS

Post by RogerSC » Fri Jan 30, 2015 11:57 am

BrooklynCPAPer wrote:Glad to see this topic! Thanks to the OP.

I looked at my past week's data in SleepyHead the other day and nearly all of the calculated AHI comes from these Clear Airway Apneas. It's never been mentioned on any in-lab sleep study so I'll make the assumption for now that these are false positives unless my sleep doctor is concerned with the pattern or thinks there is concern for ComplexSA emerging.

Oddly enough, last night I had one of my best sleeps since starting CPAP with an AHI of 2.2 (including Clear Airway) - and even odder I fell asleep with the machine on but also the light on. Hopefully the light on had nothing to do with it but it's an interesting note for my sleep log just the same. :)
Yes, a non-ASV cpap machine can't do anything about centrals. I'm in the same situation, no centrals in my sleep test, yet using cpap I have centrals. Not very many, my AHI is currently almost always under 2, sometimes under 1, but centrals are mostly what I see, as well, few OA's. My AHI last night was 1.9, all centrals. However, keep in mind that you don't see the OA's that the cpap machine prevented, only those that it didn't prevent. So it's really hard to know how many OA's you would have had if you weren't on cpap.

When I've asked my sleep doctor about these centrals, he basically says that I have too few to worry about. And mentions that they can be from something as normal as holding your breath while you roll over in bed (which I do quite a lot, the rolling over part, that is *smile*). He can't prescribe an ASV unless I have a lot more centrals (as you mention, complex apnea). Hard to tell if these centrals are "false positives" or not, and at the number that you and I are having them, it really doesn't matter one way or the other.
Last edited by RogerSC on Fri Jan 30, 2015 1:12 pm, edited 1 time in total.

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

Re: Are Clear Airways CENTRAL APNEAS

Post by archangle » Fri Jan 30, 2015 12:28 pm

BrooklynCPAPer wrote:Glad to see this topic! Thanks to the OP.

I looked at my past week's data in SleepyHead the other day and nearly all of the calculated AHI comes from these Clear Airway Apneas. It's never been mentioned on any in-lab sleep study so I'll make the assumption for now that these are false positives unless my sleep doctor is concerned with the pattern or thinks there is concern for ComplexSA emerging.
In my opinion, false positive CA are rare except when you're awake. If you're seeing CA while you know you're asleep on an A10 machine, they're probably real.

_________________
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
SGearhart
Posts: 434
Joined: Fri Nov 07, 2014 8:54 am
Location: Georgia

Re: Are Clear Airways CENTRAL APNEAS

Post by SGearhart » Fri Jan 30, 2015 1:21 pm

I know some people that can go to sleep in mid sentence and then there's people, like me, that require at least 30 minutes to fall asleep. I've found that if you use the ramp feature on the Resmed. it won't record any events while it's in the Ramp mode. This allows me to get to sleep before it starts keeping score.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: CMS-50F & 50IW - SleepyHead 1.0.0-Beta

User avatar
Jay Aitchsee
Posts: 2936
Joined: Sun May 22, 2011 12:47 pm
Location: Southwest Florida

Re: Are Clear Airways CENTRAL APNEAS

Post by Jay Aitchsee » Fri Jan 30, 2015 2:58 pm

archangle wrote:
BrooklynCPAPer wrote:Glad to see this topic! Thanks to the OP.

I looked at my past week's data in SleepyHead the other day and nearly all of the calculated AHI comes from these Clear Airway Apneas. It's never been mentioned on any in-lab sleep study so I'll make the assumption for now that these are false positives unless my sleep doctor is concerned with the pattern or thinks there is concern for ComplexSA emerging.
In my opinion, false positive CA are rare except when you're awake. If you're seeing CA while you know you're asleep on an A10 machine, they're probably real.
Arch, how do you "know" you're awake? How do you "know" that you are not in a short period of arousal that you don't remember when the CA was scored? My position (see my post a few up) is that, unless you are being monitored by EEG, you can't know whether CA's scored by a home machine are "real" or not. Looking at the flow wave chart, I think one can make a good guess, but without special equipment, I don't see how anyone can "know".

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: S9 Auto, P10 mask, P=7.0, EPR3, ResScan 5.3, SleepyHead V1.B2, Windows 10, ZEO, CMS50F, Infrared Video

BrooklynCPAPer
Posts: 48
Joined: Mon Jan 05, 2015 2:12 pm
Location: Brooklyn, NY

Re: Are Clear Airways CENTRAL APNEAS

Post by BrooklynCPAPer » Fri Jan 30, 2015 3:38 pm

Jay Aitchsee wrote:
Arch, how do you "know" you're awake? How do you "know" that you are not in a short period of arousal that you don't remember when the CA was scored? My position (see my post a few up) is that, unless you are being monitored by EEG, you can't know whether CA's scored by a home machine are "real" or not. Looking at the flow wave chart, I think one can make a good guess, but without special equipment, I don't see how anyone can "know".
I'm curious what others think about this too - a lot of my Clear Airways tend to be clustered together and I'm a very active sleeper to say the least so it's totally plausible that I'm rolling about and the machine is registering it as CAs.

I'll circle back with what the sleep doc says after Tuesday when I show him the data for the past month in case it's useful for someone else or the OP.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: SleepyHead Software, APAP 4-16, ClimateLineAir Hose, Medium Pillows

User avatar
Pugsy
Posts: 63872
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Are Clear Airways CENTRAL APNEAS

Post by Pugsy » Fri Jan 30, 2015 3:53 pm

Don't forget that some centrals are simply normal to experience anyway and don't mean something bad is happening...
like a sleep onset central and that doesn't limit itself to the first of the night because we often have brief arousals or mini awakenings during the night (that we may or may not remember) and with each arousal there can be a new sleep onset stage transition and thus another chance for another central to happen. They are "real" but considered a not so unusual occurrence and nothing to be alarmed about.

_________________
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
Jay Aitchsee
Posts: 2936
Joined: Sun May 22, 2011 12:47 pm
Location: Southwest Florida

Re: Are Clear Airways CENTRAL APNEAS

Post by Jay Aitchsee » Fri Jan 30, 2015 7:47 pm

Pugsy wrote:Don't forget that some centrals are simply normal to experience anyway and don't mean something bad is happening...
Right, that's kind of what I was trying to say when I got carried away with the "real" part

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: S9 Auto, P10 mask, P=7.0, EPR3, ResScan 5.3, SleepyHead V1.B2, Windows 10, ZEO, CMS50F, Infrared Video

User avatar
packitin
Posts: 469
Joined: Tue Jul 15, 2008 10:31 am
Location: Blue Ridge Mts. of Va.

Re: Are Clear Airways CENTRAL APNEAS

Post by packitin » Sat Feb 25, 2017 9:30 am

I was just curious, since the topic here is centrals, how many of you, if any, have been the victim of viral encephalitis, like I have.
I've found very little data or topics on it. There seems to be some "hints" that this is the case, but no hard data. For example, here is a statement of a little more than a year ago from a reliable source:

http://www.webmd.com/sleep-disorders/gu ... ep-apnea#1
Conditions that may be associated with central sleep apnea include the following:
• Congestive heart failure
• Hypothyroid Disease
• Kidney failure
• Neurological diseases, such as Parkinson's disease, Alzheimer's disease, and amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease)
• Damage to the brainstem caused by encephalitis, stroke, injury, or other factors

that seems to imply that there is a connection, but does not give any indication of what it is.

So, my question is, what is your opinion and what other activities, or should I say, accidents, such as a frontal lobe injury, such as I've had from a bike wreck, could be conjectured as relating to the possible increase of centrals.
Resmed Vauto S Bilevel
Airfit n30