sack time wrote:Thank you! Would you mind explaining this to me...I mean the part about Clear Airway. So Clear Airway Events (or potential Central Apneas...is that what they are?). These are just something we have to live with and are not treatable? I'm not certain I understand.
Clear Airway or Central apneas are when the airway is open and no air is moving.
As opposed to obstructive apneas and/or hyponeas where no air is moving because airway tissues have collapsed and are either partially or fully blocking the airway preventing the air movement.
Hold your breath for 10 seconds...that's pretty much what a central is...no air is moving but the airway is still open...you could move the air but choose not to since you are holding your breath. Needs to last a least 10 seconds to earn a flag (that's the way it is for all the apneas).
Seeing a few centrals here or there is nothing to be alarmed about and in fact it can be entirely normal.
There are central apneas which are normal called sleep onset centrals or sleep stage transition centrals. For some reason we just don't breathe.
Seeing a handful of centrals on your reports doesn't mean that you have central apnea. Most doctors won't give centrals a second glance until you start seeing over 5 per hour average or they are causing significant problems with desats or in the case of sleep onset centrals if you have so many that they keep bouncing you out of sleep.
Some centrals you see flagged could be real and some could be what we call SWJ sleep/wake/junk where the awake breathing irregularities are getting flagged by mistake....they aren't real in other words.
In your case even if every single one of your centrals were the real deal you aren't having enough of them to be a problem.
Centrals can't be fixed with more pressure from cpap/apap machines because the airway is already open...cpap/apap machines work by holding the airway open and if the airway is already open it isn't doing anything special.
People who have enough centrals to be a problem will need a different type of machine that will go about doing the pressure thing in a manner that your machine can't do. That's where the ASV type of bilevel and some of the other specialty bilevel machines come in.
They can go much higher and do it faster than your cpap/apap.
Central apneas are treated with a burst of pressure to sort of jump start your breathing...like maybe a 10 to 15 cm increase in say 15 seconds. Cpap/apap machines can't do the increase in pressure fast enough to jump start the breathing and/or they can't do back up rates where the machine will breathe for you if you don't breathe on your own.
People get all in a panic over a handful of centrals when there's usually no cause for concern.
1...some are going to be SWJ centrals and not real and simply don't count anyway
2...some are going to be maybe real as in a sleep stage transition but as long as they aren't extremely numerous or causing problems we just shrug our shoulders.
Centrals aren't scary even if someone has a truckload of them....all it means is they get a different type of machine to deal with them.
Your centrals...no where near numerous enough for doctors to worry about.
You can mention them to your doctor but he isn't going to be concerned about such a small number especially since you are new to therapy.
Even if your entire AHI of 3 was totally completely centrals....still not enough to earn the central apnea diagnosis or ASV machine.
And yes...it wouldn't be unusual for everyone to have a few centrals here and there...real or not. Not a big deal in the numbers you are seeing.
Centrals can be treated if they need to be treated....just not with your cpap/apap machine.
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