Central Apnea

According to Sleepyhead, it seems 95% of my events are considered central apnea or "clear airway" according to Sleepyhead.
I notice that the S9 does not seem to respond to CA events with an increase in pressure in fact it can be seen decreasing pressure during periods with many closely grouped CA events.

It seems logical that an apnea event where the airway is open does not require and can not be fixed with PAP.
But I do recall someone saying that it is debatable whether these machines are very good at distinguishing CA from OA events. Maybe many of those CA events are really OA.
I'm wondering if I should try changing from APAP mode to CPAP mode.

My sleep test was a home test with a borrowed machine. It did not distinguish between CA and OA events and my AHI was 15.

Any thoughts on this?

Jerry, how many CA events per hour? Unless there are quite a few or long clusters, we don't usually worry about them. What pressure are you using? What pressures are indicated during apnea events? Posting some data would help with interpreting this.

Pressure increases result mainly from flow limitations and snores, and the machine does not try to "treat" an apnea of any kind with a pressure increase.

Oops, last image was zoomed in.

Can you zoom it in a little? Hard to tell what is going on.

Lots of reason for CA's to occur, so best is to have an official sleep study and follow up with a sleep disorder doc to find out what is going on.

You can see the "pressure pulse" on mine here (upper right corner shows four in a row.... basically I just stop breathing at night):

Yes, a full sleep study is something I really should do.

How is your sense of smell?

I lost my sense of smell over the years, never thought much about it.... but everyone is my family kept saying my faithful border collie needed a bath and she really did!

Time to talk with your Primary Care Physician (PCP) and have them send you to a sleep specialist to see what is going on.

SailorJerry wrote:But I do recall someone saying that it is debatable whether these machines are very good at distinguishing CA from OA events. Maybe many of those CA events are really OA.

In my opinion, if it says "CA," it's probably a central. Some of the ones flagged as obstructive may be centrals as well.

"Central" means your brain is not making an effort to breathe. "Clear airway" means your airway is not blocked, which is what the machines detect. You can have a "no effort" central apnea, but have your airway close up at the same time.

Also, don't forget that neither central nor obstructives "count" if you're awake, and the machine doesn't know whether you're awake or not.

SailorJerry wrote:It seems logical that an apnea event where the airway is open does not require and can not be fixed with PAP.
But I do recall someone saying that it is debatable whether these machines are very good at distinguishing CA from OA events. Maybe many of those CA events are really OA.?

centrals can't be fixed with a simple pap, they need a more complex unit, like an ASV (vpap adapt, or prs1 autoSV).

there is some unsubtantiated ruminating that at higher pressures (higher than yours) the machines may not be able to tell the difference, it is documented that machines can't determine the difference at high leak rates (over 30ish for resmeds) and they start reporting unknown apnea types.

they are however, pretty good at determining the type at the pressures and leak rates you've got.

for some people, the extra co2 blowoff that EPR can cause can exacerbate centrals... I'd suggest turning off EPR first, and seeing what happens. if you don't want to go to zero right away, drop it to 1 for a few nights, then to zero... it may not help any, but it might.

I did great most of the night. My Bordie Collie was not amused, and woke me up. Odd thing is I woke up, but other than groggy didn't think much of until I was curious to see what was going on. Need to talk to my MDS (movement disorder specialist) about central apnea.

I really need to get an oxygen meter to get a better idea of what my SatO2 is doing during those periods.