ResMed apnea type CA/OA recognition problem

[pcstud]

I encountered a problem with incorrect recognition of the type of apnea at the pressure above 15cm H2O in AirCurve. Central apneas are mistakenly diagnosed as obstructive and the pressure rises, which exacerbates the problem even more.

I am curious if my problems are incidental, or maybe it happens in other people

[Pugsy]

These machines aren't perfect when it comes to the name calling for events especially when awake breathing is going on to confuse things even more.
They do the best they can but sometimes they do stick the wrong label on something.

[LSAT]

You title it ResMed but your profile shows Respironics products. AirCurve?

[pcstud]

You title it ResMed but your profile shows Respironics products. AirCurve?

I have both

[Jay Aitchsee]

Central apneas are mistakenly diagnosed as obstructive and the pressure rises

What makes you think that?

[Pugsy]

Machines won't increase the pressure for a central apnea. If people are seeing a pressure increase and at the same time there is seen a central apnea flag then the pressure increase isn't from the central being mislabeled.
The pressure increase is because there is something that is obstructive in nature that the machine is sensing happening...if no other events flagged then most likely either its snores or flow limitations happening that we don't always see so easily that is causing the pressure to increase.

Just because someone has a central doesn't mean that they won't/can't something obstructive related going on at the same time or near the same time.

[pcstud]

Central apneas are mistakenly diagnosed as obstructive and the pressure rises

What makes you think that?

I can see on Sleepyhead that with high EPAP, when there should be no obstruction, the AirCurve registers the obstructive apnea and raises the pressure... which causes even more apnea. I'm not 100% sure, but it seems to me that apnea is badly diagnosed.

[pcstud]

Machines won't increase the pressure for a central apnea. If people are seeing a pressure increase and at the same time there is seen a central apnea flag then the pressure increase isn't from the central being mislabeled.
The pressure increase is because there is something that is obstructive in nature that the machine is sensing happening...if no other events flagged then most likely either its snores or flow limitations happening that we don't always see so easily that is causing the pressure to increase.

Just because someone has a central doesn't mean that they won't/can't something obstructive related going on at the same time or near the same time.

I am diagnosed with obstructive apnea and with well set CPAP sometimes I have even 0-1 AHI. The problem is when the pressure is too high, because then central apnea appears.

At this particular pressure the maximum was too high. One badly diagnosed apnea caused an avalanche of subsequent apnea.

[Pugsy]

What makes you think it's a "badly diagnosed" anything that is causing the central?
Maybe it's the higher pressure that a real obstructive event of some sort might need to prevent the airway collapse.
Maybe you are part of the small percentage of people that there is a line where above so and so pressure you get centrals happening because of a breathing instability. That's not the fault of the machine...that's your body responding with the unstable breathing that ends up with centrals happening.
Maybe the central isn't a real central and instead the central gets flagged because the obstructive stuff causes an arousal.
So maybe you weren't really asleep when that central flag happened.
Maybe what you had was a sleep onset central which is normal and no big deal and to be expected.

There's a lot of maybes here...lots of maybes why that central got flagged and has nothing to do with mislabeling of anything.

But is the machine algorithm perfect for everyone in every situation??? Of course not. Nothing is ever perfect.

Does the machine ever make mistakes?? Well...I see it make mistakes with me...I see it flag OAs when I am obviously awake...and I see it respond with more pressure because that is what it does for OAs. It has no idea if I am awake or not.
Do I sometimes see the pressure go up and the only flag is a central flag...yeah but if I look closely I usually have a flow limitation or snore happen when I see it.

[palerider]

I encountered a problem with incorrect recognition of the type of apnea at the pressure above 15cm H2O in AirCurve. Central apneas are mistakenly diagnosed as obstructive and the pressure rises, which exacerbates the problem even more.

What makes you think that? FOT is pretty accurate at differentiating between the two.

[palerider]

Central apneas are mistakenly diagnosed as obstructive and the pressure rises

What makes you think that?

I can see on Sleepyhead that with high EPAP, when there should be no obstruction, the AirCurve registers the obstructive apnea and raises the pressure... which causes even more apnea. I'm not 100% sure, but it seems to me that apnea is badly diagnosed.

Why do you think "should be" no obstruction?

[pcstud]

Central apneas are mistakenly diagnosed as obstructive and the pressure rises

What makes you think that?

I can see on Sleepyhead that with high EPAP, when there should be no obstruction, the AirCurve registers the obstructive apnea and raises the pressure... which causes even more apnea. I'm not 100% sure, but it seems to me that apnea is badly diagnosed.

Why do you think "should be" no obstruction?

I have been following my results for a long time. There is a limit value above which I do not snore, I do not have hypopnea or apnea. This time the pressure was much higher, so I do not suspect obstruction. Well, unless too high pressure can cause obstructive apnea?

[pcstud]

I encountered a problem with incorrect recognition of the type of apnea at the pressure above 15cm H2O in AirCurve. Central apneas are mistakenly diagnosed as obstructive and the pressure rises, which exacerbates the problem even more.

What makes you think that? FOT is pretty accurate at differentiating between the two.

I always thought so. My observation is that the problem appears at a pressure higher than 15cm. That's why I asked here if anyone has similar observations.

[Dog Slobber]

Instead of posting your interpretation of the SleepyHead graphs, you should post the graphs themselves.

[pcstud]

I don't think it's anything that's contributed to the discussion... but here you go.