urbanscribe wrote:again no Centrals ever in both in-home sleep studies PRIOR to treatment.
This is not technically true. Both tests list a small number of central events.
The English study lists:
Likely C. Apnea events = 8 with a
Likely C. Apnea Index = 1.1.
The French study lists two numbers under
Nombre d'evenements: Apnees, Centrales : Total = 6 and sur le dos (on the back) = 5.
These are quite small numbers of centrals on the sleep studies, but they are there.
Question....just what is the AHI that we are concerned with? And what is thought to be "high central" are we talking 10 centrals over the entire 7 hour night or 10 centrals per hour which would mean 70 over that 7 hours?
forgetting the sleep studies which both show 30+ events index (PER HOUR).
the current S9 autoset results show 2/3 (two thirds) of events being CA, not H or O.
for example
june 3 indexes (again PER HOUR)
H 0.13
OA 1.87
unclassified 0
CA 4.82
again no Centrals ever in both in-home sleep studies PRIOR to treatment.
this remains the question here.
worry/not worry about these centrals which average 2-5 PER HOUR every night which did not exist if you believe two at-home studies.
As pointed out earlier, you DID have some centrals on the two sleep studies. The CAI for the study in English was 1.1. The CAs make up 1/3 of the apneas scored on the French sleep study.
But getting back to the S9's data. Yes, there are more CAs than you would expect, but as Pugsy says, they are not so numerous as to cause alarm---even though they are more numerous than they were on your diagnostic home sleep studies. If a sleep doc saw this summary data, s/he would likely not be concerned---yet. For many of the 10-15% of new PAPers who have problems pressure induced CAs, the number of CAs winds up decreasing all on its own within a month or two of starting PAP therapy. And as long as the CAI is under 5, most sleep docs don't think that anything strictly has to be done about them.
And as pugsy points out, we haven't seen the daily data. If most of the CAs are being scored right at the beginning of the night, they may be sleep transitional, and hence not "real" in the sense of something that would be scored on an in-lab PSG. If most of the CAs are scored right before you get up, they may be false CAs that are the result of mis-scored wake or semi-wake breathing.
my understanding is that significantly too high pressure/volume in the lungs causes a natural reflex in the respiratory system to stop breathing, which while not CAs are REPORTED as CAs.
When this happens to PAPers, the usual result are very long chains of CAs that happen about every 1-2 minutes or so; and each chain itself goes on for 30-60 minutes (or more). So the CAI winds up being way, way above 5.0.
finally the issue here
IS NOT should i worry if i have Central Apnea/Clear Airway Events which i know how to answer
but
IS should i worry if the Autoset REPORTS Central Apnea/Clear Airway Events
and if the Autoset REPORTS Central Apnea/Clear Airway Events then how much more pressure adjustment/mask trial should i undergo before considering i now have an actual CA problem
The answer to these questions really depends on the daily detailed graphs.
If the CAs occur in long 30+ minute long chains during times in the night when you are sure you're sound asleep, then it's worth reporting the problem to the sleep doc and it may be worth capping the max pressure and seeing what happens to the OAI.
If the CAs occur during times when you might have been awake, then you don't need to worry about them. If the CAs are scattered randomly throughout the night, you don't need to worry about them--yet.
