Quick question

[erynfaith]

Hia I was looking though my past sleepyhead reports and I came across 2 nights that had CA -Clear Airway in the report. it's not happening all that often as you can see once each night on those I found, but what does Clear Airway mean?

[Pugsy]

Clear Airway/Central apnea event....that's where the airway is open (not blocked by floppy airway tissues) and there's no air flow.
Hold your breath for 10 seconds...that's pretty much what a 10 second CA is...the airway is open but no air is moving.

It's normal to have a few CAs/centrals get flagged on these reports. Some might be irregular breathing getting flagged by mistake if you happen to be awake or semi awake.
Some might simply be sleep onset centrals getting flagged and those are entirely normal to have get flagged.

CAs/Centrals are only a problem when present in large numbers or causing sleep disruption or oxygen level desaturations. A handful here or there...normal and not a big deal.

[erynfaith]

I figured. Since I started I think I've only had 3 obstucted come up 2 CAs and the rest are hypopneas. the apneas were worse before I asked for my pressure to be reduced. but my usual AIH is less then 1 right now.

[Pugsy]

To be clear for anyone reading this and worrying about the number of "centrals"...real or not...we can't fix centrals with regular cpap/apap machines by tweaking the pressures (usually people try to kill them with more pressure) except in some special circumstances. I know the knee jerk reaction is to see the AHI and think "OMG it's too high and I have too many centrals...I must need more pressure" but that's not usually the way to go.
This is why you see us ask for the AHI breakdown when someone comes here and says "my AHI is too high" and we ask them what that AHI is composed of as in the breakdown into each apnea category.
More pressure may or may not be needed and it's always best to figure out if what you are wanting to fix with more pressure is actually fixable with more pressure.
APAP mode machines will NOT try to reduce centrals with more pressure...it's in the algorithm...they ignore centrals. If someone sees a pressure increase near a flagged central it's just a coincidence and likely the pressure increase is because of some sort of obstructive tissue apnea event happening.

Now there are some situations where more pressure does help but that's only when there's a bunch of OAs/hyponeas possibly causing arousals and it's the arousal that is maybe waking the person up and we are seeing post arousal centrals secondary to the wake up but that's an unusual situation.

The presence of centrals doesn't mean anything bad is going on and there's no need for panic.
Should the centrals be present in numbers that is creating a problem then it's usually real simple to take care of them with a different type of machine. Not a big deal and no need to panic.

It's also real important to look at the detailed graphs to see where they are being flagged. If they are in close proximity to a known awake time there's a good chance they are awake/semi awake breathing irregularities getting flagged by mistake and thus would be ignored.

[erynfaith]

sorry I didn't mean to make someone panic. the reason for my pressure drop wasn't my AIH it was I was getting really bad Aerophagea-- I still get it but not as bad now. Thanks for the input though

[Pugsy]

Oh...I didn't mean you were causing a panic...it's just that we get the "OMG my AHI is high I need more pressure and why isn't more pressure fixing the centrals" post just about every time we talk about centrals or Clear Airway events. I was just trying to diffuse things in case another newbie reads about what those CAs mean and hears "centrals" and goes into panic mode. I wish I had a dollar for every time someone had to diffuse that bomb.

You weren't worried...I knew that but someone else new to therapy might get worried and I was just trying to save them from getting all upset and worried about something that wasn't worth worrying over.