How many Central Apenas are too many?

[skiing4]

New here and new to CPAP. I was diagnosed with OSA about 1 month ago and have been using CPAP for 1 week now. I seem to be adapting okay with an average usage of just under 7 hours/night. My original AHI was 56 with 49 OA and 4.6 CA. My sleep doc diagnosed OSA and APAP. My first few nights a averaged just under 1.0 AHI with the last 2 nights around 2.75 AHI. OAs have been averaging less then 1 but my CAs have gone from .5 the first 4 nights to averaging 2 the past 2 nights (2.5 high) . Also, my 95% pressure has gone down from 11 to 8.7 these past 2 nights and leaks are all very low.

A certainly realize my combined AHI is acceptable with a 2.78 average. My question is are CA's scored the same as OAs, in that anything under 5 is acceptable?

Thanks!

[ameriken]

It is not unusual for some folks to see an increase in centrals when on cpap....aka 'complex sleep apnea'. But just like osa, csa is still scored the same....5 and under constitutes normal breathing. So yes, they are scored in the same manner and all add into your total AHI, and as long as you are 5 and under and feel ok, it's working. When you're AHI goes above 5 and there is a correlated increase in fatigue, that may be the time to speak to the doc about some adjustments, or perhaps even a bipap.

[skiing4]

Thanks! I was thinking that but wanted some confirmation. Still waiting for the "refreshed" feeling though!

[ameriken]

Thanks! I was thinking that but wanted some confirmation. Still waiting for the "refreshed" feeling though!

Well, the refreshed feeling could come tomorrow morning, in a few more days, a few more weeks, or for some of us, we're still waiting and trying after a few months of slow progress. Just keep going, stay close to the forum, and post any other issues you have. Good luck!

[skiing4]

Thanks. I do think I am seeing some improvement. I seem to be getting more done in the past few days, I'm drinking less coffee and my attitude seems better. If I keep moving/working I don't feel as tired but when I sit and relax I start yawning/feel like taking a nap. I'm probably expecting too much right off the bat. . . I felt real good after my titration study. . but maybe it was "in my mind."

I'm young and work in the medical field so I see the result of poor health on a daily basis. . . I'm not about to give up and am in it for the long haul.

My wife sure is getting better sleep though!!!

[ameriken]

Thanks. I do think I am seeing some improvement. I seem to be getting more done in the past few days, I'm drinking less coffee and my attitude seems better. If I keep moving/working I don't feel as tired but when I sit and relax I start yawning/feel like taking a nap. I'm probably expecting too much right off the bat. . . I felt real good after my titration study. . but maybe it was "in my mind."

I hear ya, it's so hard to tell sometimes. Many folks say there is a 'sleep debt' (do a search here for those two words, you'll probably quite a few results) that needs to be paid back, and the theory is you may not feel good right away because your body is getting rest it wasn't getting before and needs time to get caught up. And on the other hand, some may not feel better because their pressures aren't optimal and need to be readjusted (which most of us here on the site tend to do on our own). Yet others slap on the mask and feel great the next day. Fixing sleep apnea is not just about getting sleep, but more importantly about restoring breathing when you sleep and if that breathing isn't restored to where it should be, then one probably needs some adjustments and perhaps a talk with the doc.

It seems like you're off to a great start and headed in the right direction by watching your reports and being aware of how you feel. So, keep on keepin' on!

[flocof]

<I felt real good after my titration study. . but maybe it was "in my mind.">

Hi there, I don't think it was your imagination...I was the same...I felt sooo good just after first using the machine for about a week...Sadly it didn't last! I feel a lot better, I don't feel like I have bee run over by a truck in the mornings anymore, but I still do not feel rested. My original AHI was 60, I have only managed to get AHI down to 7 once, and most of the time it is a mixture of CA and OA's and average around 12
I have to wait 7 months for another sleep study for complex sleep apnea....so frustrating! But that is our public health system in Australia! At least it is free of charge! but then one could die waiting!
Keep on persevering and good luck

[Kairosgrammy]

Glad you asked this quetion. My central apneas have increased also but not alarmingly so, my AHI is still staying under 1 most nights and I feel better. As far as your feeling better, it takes time. You had very severe osa from what you said so a lot of sleep debt to pay off. It gets better. You are already doing better than a lot do because many couldn't even do 2 or 3 hours a night. 7 hours is great. For me, feeling better was very gradual. One afternoon, I was at school (school based speech path) working with some children and I realized I felt good, wasn't yawning and I thought, well finally!!!

Thanks! I was thinking that but wanted some confirmation. Still waiting for the "refreshed" feeling though!

[skiing4]

Thanks everyone. I got 8.8 hours on the APAP last night. . .granted I woke up a few times but wow. . . I haven't slept that many hours in a LONG time. Feel pretty good today and my nostrils don't hurt front he Swift FX. AHI at 2.4 with 1.5 CAs. I think I'll quit worrying about it. Funny. . . being in the medical field I'd think I wouldn't get so worried about things. I'm only 42 and had all sorts of bad things running through my mind when researching CAs. Think I'm making progress. . .

[Kairosgrammy]

I just realized something. CA doesn't stand for central apneas (I actually knew that, just didn't process it with your post) it stands for clear airway apneas. They are not necessarily indicative of central apneas although they can be a part of the picture.

New here and new to CPAP. I was diagnosed with OSA about 1 month ago and have been using CPAP for 1 week now. I seem to be adapting okay with an average usage of just under 7 hours/night. My original AHI was 56 with 49 OA and 4.6 CA. My sleep doc diagnosed OSA and APAP. My first few nights a averaged just under 1.0 AHI with the last 2 nights around 2.75 AHI. OAs have been averaging less then 1 but my CAs have gone from .5 the first 4 nights to averaging 2 the past 2 nights (2.5 high) . Also, my 95% pressure has gone down from 11 to 8.7 these past 2 nights and leaks are all very low.

A certainly realize my combined AHI is acceptable with a 2.78 average. My question is are CA's scored the same as OAs, in that anything under 5 is acceptable?

Thanks!

[Kairosgrammy]

I just realized something. CA doesn't stand for central apneas (I actually knew that, just didn't process it with your post) it stands for clear airway apneas. They are not necessarily indicative of central apneas although they can be a part of the picture.

New here and new to CPAP. I was diagnosed with OSA about 1 month ago and have been using CPAP for 1 week now. I seem to be adapting okay with an average usage of just under 7 hours/night. My original AHI was 56 with 49 OA and 4.6 CA. My sleep doc diagnosed OSA and APAP. My first few nights a averaged just under 1.0 AHI with the last 2 nights around 2.75 AHI. OAs have been averaging less then 1 but my CAs have gone from .5 the first 4 nights to averaging 2 the past 2 nights (2.5 high) . Also, my 95% pressure has gone down from 11 to 8.7 these past 2 nights and leaks are all very low.

A certainly realize my combined AHI is acceptable with a 2.78 average. My question is are CA's scored the same as OAs, in that anything under 5 is acceptable?

Thanks!

[Pugsy]

Actually...Respironics wasn't comfortable calling their open airway cessation of breathing events centrals and ResMed was comfortable. They are both open airway cessation of breathing and SleepyHead calls them both "Clear Airway" even with ResMed machine data. Jedimark originally was using a PR S1 machine when he developed the first SleepyHead version.
ResMed's SleepyHead Clear Airways would be called Centrals if using ResScan software.
So they are really pretty much the same. Both machines are reporting the same thing...and both machines have the same limitation as to knowing with absolute certainty that the events are "true centrals" because of the absence of EEG or thoracic effort data. So it is okay to use the term clear airway and central with either machine because either machine is recording a cessation of breathing with the airway open as opposed to obstructive.
One just has to remember that not all open airway cessation of breathing events are "true" centrals because of the machine's sensing limitations.
So not all "centrals" are worthy of panic mode.

A central (clear airway) index of 2 is nothing to go into panic mode over even if they were "true" centrals.

[skiing4]

So explain this one. . . We had a freinds/family gathering last night and had 4-5 beers over the course of the night. Got to bed later then usual and got about 6.5 hours sleep. Woke up with the lowest AHI I've seen yet. . . . .72 with .23 CA Sleepyhead also shows I turned off the machine for 20 minutes in the middle of the night. . . Don't know anything about THAT. . . My wife said I never woke up.

I would think alcohol would RAISE CAs as it is a CNS depressant. . . . Weird. . .

[Pugsy]

Alcohol also messes with sleep architecture..sleep stage cycles. If a person happens to normally have more events in REM sleep stage (which is common to have more) and the alcohol causes a reduction in REM sleep then it is quite possible that a reduction in AHI is from the reduction of events that would normally have occurred in REM and with less REM...you get less events.

[skiing4]

Gotcha. . . So better numbers but worse sleep. . .