Only diagnosed with OSA, but Central Apnea > 2

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pfu
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Only diagnosed with OSA, but Central Apnea > 2

Post by pfu » Sun Oct 19, 2014 9:29 pm

Hi everyone,

I've been on a machine that measures AHI (ResMed S9 AutoSet, but with constant pressure at 8.6cmH20 as per doctor's prescription) for a year at this point. I had previously on a machine that didn't have that capability.

Although I've only been diagnosed with obstructive sleep apnea, the machine has been recording significant central apnea.

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I've also noticed that the episodes of central sleep apnea are clustered towards the end of the sleep. This is a pattern that I often see.

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I frequently wake up from an unpleasant dream and feel depressed on nights that look like the above chart.

I'm wondering if this is significant enough to seek a different diagnosis (e.g. mixed sleep apnea).


Thank you for reading.

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palerider
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Re: Only diagnosed with OSA, but Central Apnea > 2

Post by palerider » Sun Oct 19, 2014 9:31 pm

cheer up, cai of 2 isn't significant.

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raftergirl
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Re: Only diagnosed with OSA, but Central Apnea > 2

Post by raftergirl » Mon Oct 20, 2014 6:04 am

I'm sure Pugsy will be along to explain this better than I can. I asked the same question.....no CA on my sleep study, but a fair amount showing up when I look at my SleepyHead data. Mine were also clustered in the beginning and end of sleep, with a few during the night. Pugsy explained it as awake breathing that gets flagged as CA by the machine. I do awaken briefly during the night, but go right back to sleep, so those are probably the ones flagged during the night. I was a bit concerned about them until it was explained, and I saw the pattern.

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Pugsy
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Re: Only diagnosed with OSA, but Central Apnea > 2

Post by Pugsy » Mon Oct 20, 2014 8:32 am

Actually I wasn't going to say anything because what I would have said has been covered.

CA index of 2 per hour...is insignificant and no doc would worry about them even if every one of them was the real deal.

The large cluster at the end of the night is probably Sleep/Wake/Junk from being half awake or in and out of sleep right before you finally turn off the machine.

Some central apnea happenings are real and are just a normal thing that happens. Sleep onset centrals as we transition to sleep is normal. We all have them. They are only a problem if we have large number of them that causes desats or a gazillion wake ups.
The machine can and will flag awake/semi awake breathing irregularities by mistake....as the machine doesn't know if we are awake or not.

This number of centrals shown...isn't enough to change the diagnosis to include central sleep apnea or complex sleep apnea....even if everyone of them was the real deal.

But if it bugs you....by all means run it by your doctor to be sure.

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archangle
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Re: Only diagnosed with OSA, but Central Apnea > 2

Post by archangle » Tue Oct 21, 2014 10:46 am

Zoom in on the CA's and see how long they are. If they're 60 seconds long, it means a lot more than if they're 11 seconds long.

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Paralel
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Re: Only diagnosed with OSA, but Central Apnea > 2

Post by Paralel » Tue Oct 21, 2014 12:56 pm

CAs near the time one wakes up in particular are not uncommon, so nothing to be concerned about at this point.

pfu
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Re: Only diagnosed with OSA, but Central Apnea > 2

Post by pfu » Thu Oct 23, 2014 10:22 pm

Thank you everyone for your insights.

I'm a lot less worried now.

A typical CA episode lasts 10 to 20 seconds for me.

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AHI shoots up towards the end of the night with a cluster of CA episodes.

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I do wake up feeling out of breath and sometimes with elevated heart rate. I do have to consciously take deep breaths for the out-of-breath feeling to subside.