Clear airway events?

MJP928 · Post by **MJP928** » Fri Mar 03, 2017 3:45 pm

I am having a lot of events per night and I recently downloaded sleepyhead software and it appears I am having mostly clear airway events. Anyone have any ideas on what this means? How do I fix???? Thanks!

Julie · Post by **Julie** » Fri Mar 03, 2017 4:04 pm

Post the SH graphs - can't advise on what we can't see . Can't you find a landline?

MJP928 · Post by **MJP928** » Fri Mar 03, 2017 4:10 pm

ChicagoGranny · Post by **ChicagoGranny** » Fri Mar 03, 2017 4:13 pm

MJP928 wrote:I am having a lot of events per night and I recently downloaded sleepyhead software and it appears I am having mostly clear airway events. Anyone have any ideas on what this means? How do I fix???? Thanks!

How many threads are you going to start about this subject? Stick to one.

Why are you using the worthless Photobucket? The instructions say multiple times to use Imgur.

ChicagoGranny · Post by **ChicagoGranny** » Fri Mar 03, 2017 4:16 pm

You also didn't follow the instructions to format the graphs properly. Go back to the instructions.

OkyDoky · Post by **OkyDoky** » Fri Mar 03, 2017 4:19 pm

ChicagoGranny wrote:
MJP928 wrote:I am having a lot of events per night and I recently downloaded sleepyhead software and it appears I am having mostly clear airway events. Anyone have any ideas on what this means? How do I fix???? Thanks!
How many threads are you going to start about this subject? Stick to one.

Why are you using the worthless Photobucket? The instructions say multiple times to use Imgur.

It does make it a lot easier to see what is needed if you follow the instructions. Take a deep breath and read them again.
Also it would have been much easier if you had continued in your first thread.

MJP928 · Post by **MJP928** » Fri Mar 03, 2017 4:24 pm

Sorry I am not familiar with all of this. I will go back to original thread.

Pugsy · Post by **Pugsy** » Fri Mar 03, 2017 4:48 pm

Clear Airway events are centrals...the airway is open but there is no breathing.
SleepyHead calls all centrals Clear Airway events which is really a Respironics term.
If you were using ResScan (ResMed's software) those Clear Airway events would be called Centrals.

You need to be talking to your doctor about these centrals. You had them on your diagnostic sleep study...the machine you are using can't deal with centrals. You had the centrals before you ever started cpap therapy for your obstructive sleep apnea so the centrals aren't necessarily caused by cpap pressure but it could make them worse especially using the auto adjusting pressure mode.

Your doctor needs to get involved and try to figure out a different approach to resolving your problem.
It appears that you have both central sleep apnea and obstructive sleep apnea. The machine you have right now can only deal with obstructive sleep apnea.

There might be a couple of little things to try with this current machine but I don't hold out much hope with this many centrals. You really need to be talking to your doctor about these results.

Rob K · Post by **Rob K** » Fri Mar 03, 2017 11:15 pm

I'm still learning to interpret the graphs. On the OP's graph I see groups of CA's that correspond with increased leak rate. When the leak rate is low there are fewer CA's. The pressure doesn't seem to be varying very much so it doesn't seem like increased pressure it causing the leaks. To me it looks like a leaking mask is making the centrals quite a bit worse. Is it a lot more complicated than I'm thinking?

Pugsy · Post by **Pugsy** » Fri Mar 03, 2017 11:51 pm

Rob K wrote:To me it looks like a leaking mask is making the centrals quite a bit worse. Is it a lot more complicated than I'm thinking?

Leaks don't cause centrals per se. Now what could maybe happen is a leak wakes a person up and then the "central" that might get flagged might be a post arousal central or Sleep/Wake/Junk central (the person isn't full asleep and unless you are asleep they don't count).
Hold your breath for 10 seconds. That's a "central" in that no air is moving and it last 10 seconds and the airway is open. We pause our breathing all the time when awake and don't realize it. We can easily hold our breath for 10 seconds and not realize we are even doing it.

Some of the OP's centrals could very likely be awake breathing getting flagged by mistake especially those centrals close to a break in the therapy line where it's obvious they turned the machine off. SWJ is suspect during those potential awake times but there is also a large number of centrals happening not associated with what might be awake times.
Centrals were present in fairly large numbers on the diagnostic sleep study where no cpap was used at all so there's no leak to maybe cause an awakening/arousal.
In the diagnostic sleep study any centrals mentioned as part of the AHI are real centrals. The sleep tech would be able to see if a person was asleep or not and if they weren't asleep the centrals wouldn't be included in the AHI.

So some of what we see here could very well be related to arousals...but I don't think all of them are and in situations like this where there are so many centrals that we can't explain them all away the best thing for someone to do is be evaluated by a sleep doctor and let the doctor decide if the centrals are real or not. When it comes to centrals in these numbers...always best to play it safe and get the doctor to earn is fees.
We can sometimes poo poo enough centrals away but I am not so sure that we should do that in this situation. There's just too many of them for us to say "oh, you probably woke up from the leaks and you held your breath while awake so don't worry about it"
When in doubt be cautious and treat the centrals as if they are real until they are proven not real.

palerider · Post by **palerider** » Fri Mar 03, 2017 11:57 pm

Pugsy wrote:We can sometimes poo poo enough centrals away but I am not so sure that we should do that in this situation. There's just too many of them for us to say "oh, you probably woke up from the leaks and you held your breath while awake so don't worry about it"
When in doubt be cautious and treat the centrals as if they are real until they are proven not real.

it's good to dig in when there's centrals like that, and look at them, see if they look like they're post arousal breath holding, or true centrals... something you can't see without zooming in to the breath level.

Pugsy · Post by **Pugsy** » Sat Mar 04, 2017 12:20 am

palerider wrote: it's good to dig in when there's centrals like that, and look at them, see if they look like they're post arousal breath holding, or true centrals... something you can't see without zooming in to the breath level.

True but I don't think the OP has the skill set yet to do that level of work and I don't have the time...plus the diagnostic sleep study had a substantial number of centrals so we know those were real and they aren't likely to disappear with apap....so some of those are most likely real.

Now if no centrals of significance were noted on the diagnostic sleep study...might be a different story and maybe some one could do the microscopic work but in this situation with this number of centrals and the diagnostic study history...I would still stress alerting the doctor.
I just don't think we can explain away enough centrals to get down to an acceptable number to let slide by.

palerider · Post by **palerider** » Sat Mar 04, 2017 12:22 am

Pugsy wrote:
palerider wrote: it's good to dig in when there's centrals like that, and look at them, see if they look like they're post arousal breath holding, or true centrals... something you can't see without zooming in to the breath level.
True but I don't think the OP has the skill set yet to do that level of work and I don't have the time...plus the diagnostic sleep study had a substantial number of centrals so we know those were real and they aren't likely to disappear with apap....so some of those are most likely real.

Now if no centrals of significance were noted on the diagnostic sleep study...might be a different story and maybe some one could do the microscopic work but in this situation with this number of centrals and the diagnostic study history...I would still stress alerting the doctor.
I just don't think we can explain away enough centrals to get down to an acceptable number to let slide by.

Agreed, I should have prefaced my comment with "in general" not meaning specifically in this case.

Rob K · Post by **Rob K** » Sat Mar 04, 2017 12:28 am

So it is far more complicated then I was envisioning. I have a lot to learn. I'll stick to reading for now. I know you all are very busy with people that really need the help. Thanks for taking the time to explain.

I've been studying everybody's graphs to better understand my own.

Pugsy · Post by **Pugsy** » Sat Mar 04, 2017 12:37 am

Rob K wrote:So it is far more complicated then I was envisioning. I have a lot to learn. I'll stick to reading for now. I know you all are very busy with people that really need the help. Thanks for taking the time to explain.

No,no...speak your thoughts. It's how everyone learns....not just you and I don't mind explaining.

In a sense leaks can "cause" centrals but just quite like I think you were thinking.
In some situations anything that causes an awakening/arousal can "cause" a central but it not really causing them...they are just a secondary by product of something else happening.

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