Should I be freaking out or is too much info dangereous?

[moondoggy]

OK. I've only had my CPAP machine for 30 days and I installed the Sleepyhead software and the ResScan software so I could look at my nightly results. Today I was looking Sleepyhead and it said my AHI was 2.03 last night with Hypopnea of 1.11, Apnea of 0.00, Obstructuve 0.18 and Clear Airway of 0.74. I had 10 Event Flags. The ResScan shows pretty much the same AHI (2.0) but classify Apnea is Unknown, Obstuctive, Central and Hypopnea. On ResScan events it showed that I had 4 events of the Central Type. I google Central Apnea and the definition I found said "Central sleep apnea is when you repeatedly stop breathing during sleep because the brain temporarily stops sending signals to the muscles that control breathing." After reading this definiton I kind of freaked out and then thought I would check with the boards to determine if I should be worried or not. My concern stems from the fact that in late November I was diagnosed as having a case of Pericarditis (inflamation of the heart) and have had 6 AFib events in the first 60 days following my diagnosis of Pericarditis. I was originally told that the AFib events were related to the irritation to the heart cause by the inflamation but my cardiologist has suggested that my Afib may have been caused by sleep apnea and since I was subsequently diagnosed with Sleep Apnea that is why I have my CPAP machine. I was thinking that my problem was obstructive apnea so this reading off the ResScan software has me freaked out that something else is happening to me. Can anyone comment on this and let me know if I should be concerned or whether I'm just freaking out unnecessarily?

[jamiswolf]

Moondoggy wrote: freaking out unnecessarily?

Yes you are "freaking out unnecessarily". Your numbers look good. You just need more time on cpap therapy.

Relax, I know you're upset by the medical issues that are presenting themself.. but if you focus on the cpap therapy, you're doing good. So carry on.
J

[Pugsy]

You are freaking out unnecessarily.
1. It take a whole lot more centrals than you are having to make a diagnosis of central sleep apnea.
2. We all have a few "centrals" occasionally real or not.
3. The machine is limited in the fact that it can only measure air flow and doesn't have the benefit of thoracic effort or EEG brain wave data which is necessary to determine if a central is a "true" central. This additional data is needed to evaluate just how much of an impact centrals are having.
4. The machine doesn't know if you are awake or not. Centrals are common during sleep onset and wouldn't be scored in a sleep lab setting.

If you are concerned...of course discuss this with your doctor but less than 1 "central" per hour (even if the real deal) is not very exciting and you may have nights with more and a few nights with none.

[derek70]

How can a CPAP detect a CA with only air flow?
Central Apnea reported by CPAP is only a guess.
The only way to be sure if it was a Central Apnea is during a Sleep Study with a belt in your chest.
How can a CPAP machine could know if your brain haven't sent a signal to your muscles to breathe?

[jamiswolf]

How can a CPAP detect a CA with only air flow?
Central Apnea reported by CPAP is only a guess.
The only way to be sure if it was a Central Apnea is during a Sleep Study with a belt in your chest.
How can a CPAP machine could know if your brain haven't sent a signal to your muscles to breathe?

Derek, I agree that a chest strap is better...but most modern cpap machines use a air pressure pulse to determine if the apnea is obstructive or central...and fairly accurately.
J

[chunkyfrog]

Your numbers are good.
You will be fine.
I had to wait 5 months before I had data.
Ignorance is not your friend unless you make a living preying on the ignorant.

[DreamDiver]

How can a CPAP detect a CA with only air flow?
Central Apnea reported by CPAP is only a guess.
The only way to be sure if it was a Central Apnea is during a Sleep Study with a belt in your chest.
How can a CPAP machine could know if your brain haven't sent a signal to your muscles to breathe?

With regards to what the S9 and the System One are capable of recording, the term 'Central Apnea' is a misnomer. As others have suggested, the machine can't really detect whether you are having a central apnea because it doesn't use effort belts. They should instead be considered as 'Open Airway' apneas -- not central apneas.

All of my apneas are open-airway apneas except maybe 1 every other month. If you look at some of my earlier posts about the S9, you'll see I freaked out too. I have no obstructive apneas according to the S9. Apparently though, there is a class of apnea that is neither central, nor measurably obstructive using the S9 or the System One, yet the apneas are well controlled with xPAP therapy. PR System One actually labels them 'open-airway' apneas, if I remember correctly. If you have an AHI of around 5 or less while using CPAP and you have controlled your large leaks, you are getting therapy. If you're around 2 or less, you should be noticing really decent results. If you're still concerned, you can always have a talk with your sleep doctor.

[idamtnboy]

How can a CPAP detect a CA with only air flow?
Central Apnea reported by CPAP is only a guess.
The only way to be sure if it was a Central Apnea is during a Sleep Study with a belt in your chest.
How can a CPAP machine could know if your brain haven't sent a signal to your muscles to breathe?

Resmed would strongly disagree with you with regard to the S9 series and CAs. That's why they label those apneas as Central Apneas in Resscan and in their literature. You can read their discussion and research results here:
http://www.resmed.com/us/assets/documen ... -paper.pdf
Here's the conclusion in the paper.

The enhanced AutoSet algorithm on the S9 AutoSet now includes CSAD [edit: Central Sleep Apenea Detector] for the classification of apneas using the FOT [edit: Flow Oscillation Technique]. CSAD was extensively tested using patient simulators, normals simulating obstructive and central apneas and clinical trials. CSAD correctly identified and the enhanced AutoSet correctly treated obstructive, central and unknown apneas with a very high degree of accuracy. The enhanced AutoSet and CSAD algorithms have been shown to treat patients appropriately, including those with predominantly central apneas, and without causing disturbance to sleep.

In that paper Resmed comes across pretty adament that with 95% accuracy what they say is a Central is in fact a Central Apnea.

[moondoggy]

Thanks everyone for your prompt feedback as it makes me feel a bit better. Since I had the Pericarditis back in late November it's just been one thing after another. All the Afib events, having to go on a bunch of heart drugs that don't make me feel normal anymore, having additional side effects from some of the drugs, being told that my Afib events might be related to sleep apnea and then being diagnosed with Sleep Apnea all in less than 90 days has not been good for my physical and mental health. Every strange feeling, every little twitch makes me wonder what's next and I certainly don't need another "next" of anything related to my health. At least with the feedback you've provided I can relax a bit knowing that the therapy apears to be working. Thanks again.