Sleepyhead Unclassified Apnea Events?

What are these considered? I am starting to become convinced that I do not have sleep apnea but I have catathrenia, which is when I hold my breath and then slowly exhale when sleeping. I looked at my Sleepyhead stats yesterday and all of my apnea events are categorized as "unclassified apnea." I have an ASV machine and there were no central or obstructive events since I got the machine last summer. What does this mean?

Thanks,
Joel

SleepyHead can't classify those events because the AirCurve 10 ASV doesn't classify those events.
If you were using ResScan they would simply be put in the Apnea event basket.
The general assumption is that they are obstructive because the machine should be preventing any centrals (assuming it is optimally set to breathe for you and thus not allow centrals to happen) in the first place and anything left over would be obstructive.

So it isn't SH...it's the way the ASV machine does the event category flagging. It only offers Apnea and Hyponea as the 2 categories...SleepyHead doesn't know what to call them because the machine doesn't specify and thus they end up with the "unknown" apnea flag.

I am using a S9 model of your machine...I get the same thing...."unknown apneas" on a rare occasion along with a rare hyponea every now and then.

joeljjk11 wrote:I looked at my Sleepyhead stats yesterday and all of my apnea events are categorized as "unclassified apnea." I have an ASV machine and there were no central or obstructive events since I got the machine last summer. What does this mean?

that your machine doesn't try to figure out what kind of apnea you're having, it just treats them. and if they were central, then you wouldn't have an apnea, since the asv would make you breath.

ergo, they're all obstructive.

Okay if these are truly obstructive apnea events, what do I do to treat them? My numbers are consistently horrible and never under 6 or 7. I have tried every setting on every machine I have had and nothing ever works. This is why I am convinced I have catathrenia - not sleep apnea.

Joel

joeljjk11 wrote:Okay if these are truly obstructive apnea events, what do I do to treat them? My numbers are consistently horrible and never under 6 or 7.

increased epap.

Some past history in Dec
viewtopic.php?f=1&t=114788&p=1112697#p1112697

and my response back in Dec

Some past history for those who don't remember
viewtopic.php?f=1&t=112458&st=0&sk=t&sd=a

and several pages with different threads with various problems and how he came to be on ASV
search.php?st=0&sk=t&sd=d&author_id=75576&start=90
I don't have time to cherry pick each thread..sorry.

Like PR says...usually more EPAP to hold the airway open to prevent the airway collapsing.

This is for a different brand machine but the principle is the same no matter which machine is used in determining what pressures are needed.
http://www.isetonline.org/yahoo_site_ad ... 190318.pdf

joeljjk11 wrote:I am starting to become convinced that I do not have sleep apnea but I have catathrenia,

Is this your self diagnosis or have you had it confirmed by a doctor yet? You've been thinking this for quite some time apparently.

This is my self diagnosis. My sleep doctor is pretty much useless, I had a take home sleep study and also an in lab sleep study and it was determined that I had complex apnea. Is there a chance that apnea events can be confused with catathrenia events during a sleep study? My psychiatrist mentioned to me that they study brain waves and everything and know if they are apnea events but I don't know, it just doesn't make sense that no matter what setting I use my numbers are always terrible. If they were obstructive events, wouldn't they higher pressures being treating them?

joeljjk11 wrote: Is there a chance that apnea events can be confused with catathrenia events during a sleep study?

I don't know.
During an in lab sleep study it is very easy to spot sleep though...so if it is happening during sleep..it's easily seen.

joeljjk11 wrote: If they were obstructive events, wouldn't they higher pressures being treating them?

Not necessarily. The baseline pressure has to be high enough to hold the airway open to prevent the airway collapse in the first place.
You have to treat them just like you would if you didn't have the centrals complicating things...and remember the machine won't give a burst of pressure for an obstructive apnea or hyponea anyway...even if it can. For obstructive stuff the machine waits until the obstruction is gone and then it maybe tries to decide how best to prevent it from happening again depending on what else it might sense is going on.

Minimum EPAP...think of that as the baseline pressure holding your airway open in an effort to prevent the airway collapses in the first place..if it isn't enough to prevent the collapse then the collapse will happen especially if you spend more time down near the baseline pressure and the centrals are minimal and not keeping the overall average pressure up very far.

Think of yourself with 2 problems.
1...Obstructive sleep apnea and you treat it just like we all treat it...enough pressure to hold the airway open to prevent the collapse of the airway tissues.
2..Central sleep apnea for whatever reason and your machine treats it with that rather fast and large burst of pressure to breathe for you.
This "burst" only deals with the centrals...not necessarily with the obstructive stuff.

Your machine still needs help with determining the optimal baseline (EPAP) setting to help hold the airway open and thus prevent the collapse of the tissues....hence the EPAP minimum setting.
I know people with complex sleep apnea who need a minimum of 15 cm EPAP to hold the airway open. Just because it can go to 25 doesn't mean that it can do it for obstructive stuff or even that it will do it....so they have to have a rather sizable minimum EPAP to give the machine that optimal head start for dealing with the OSA side of things.

joeljjk11 wrote: Is there a chance that apnea events can be confused with catathrenia events during a sleep study?

Catathrenia is a rapid eye movement sleep parasomnia consisting of end-inspiratory apnea (breath holding) and expiratory groaning during sleep. Catathrenia is distinct from both somniloquy and obstructive sleep apnea. The sound is produced during exhalation as opposed to snoring which occurs during inhalation.

one wouldn't think so, though if it were, then presumably it would show up as centrals... but, I'd think that the EEG readings would raise flags.

Look at the flow - my UA's occur after an exhale eg exhale - no flow , seconds later - gasp eg - typically ends up being a cluster of CSR. It's an obstructive in the sense that the airway is closed - closed i the same way as a snorkler or diver closes the nasal passage to keep water from flooding in.. max pressure from the machine isnt enough to open the airways - but interesting that when the mask starts doing pushups on my face - I've learned and reacted.. So - I used to get these much more, but over time - they've diminished.. I've also found Auto ASV much more effective than ASV (epap also titrates), and psmin maxed at 6.. my monthly avg AHI are now 0.3.. My centrals seem to be idiopathic and mixed with obstructives.. initial diagnosis of mixed apnea with an AHI of 75 and desats into the 50's

mike_winslow wrote: ↑

Tue Feb 19, 2019 8:47 am

Look at the flow - my UA's occur after an exhale eg exhale - no flow , seconds later - gasp eg - typically ends up being a cluster of CSR.

I find that confusing, since there are no gasps/recovery breaths with CSR. It's very smooth and gentle.

mike_winslow wrote: ↑

Tue Feb 19, 2019 8:47 am

Auto ASV much more effective than ASV (epap also titrates),

It doesn't titrate, it adjusts.

Also get these same events, using a resmed 10 asv. I too have complex mixed apnea. Mine appear to be obs w Catathrenia type breath holds.