Clear Airway/Central Apnea Concerns

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Jordan1
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Clear Airway/Central Apnea Concerns

Post by Jordan1 » Fri Jun 24, 2022 7:02 am

Greetings!

I was diagnosed with moderate obstructive sleep apnea (AHI of 16.8) earlier in the year via an at-home sleep study with Lofta (the watch pat device).

I started my CPAP therapy last week with the Resmed 11 and have been experimenting with a few different masks. Some nights are mostly successful, other nights feel hard.

I'm heartened by the progress, but I have a question regarding central apneas/clear airway events that seem to be occurring nightly regardless of how well I do with obstructive events. I've attached my OSCAR data from the last few days, highlighting last night to give the experts here an idea of what I mean.

Here's the link to my OSCAR data from last night

https://imgur.com/vqfSCok

My AHI last night was 3.67 with 0 obstructive events, but a CA index of 2.57. I don't think this type of event would have been captured with the Watchpat device in my initial sleep study (though I could be wrong?).

I've never been diagnosed with any type of neurological condition apart from the occasional migraine. Should I be concerned about this, or is it within the range of normal?

I've gathered that the breathing efficiency with Resmed's ERP makes it such that my O2 sat is high and potentially leads my CNS to believe that I don't need to breathe at certain points? Should I lower the ERP to 2 or 1?

Thanks so much!
Jordan

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Pugsy
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Re: Clear Airway/Central Apnea Concerns

Post by Pugsy » Fri Jun 24, 2022 7:22 am

It's EPR Exhale Pressure Relief...not ERP.

Reducing EPR will ONLY help reduce central apnea numbers IF (big if) using EPR is the trigger for the centrals and the centrals are for sure asleep centrals. I am not 100% sure that the central you zoomed in on and linked to is a for sure asleep central (the irregular breathing doesn't look like you were sound asleep and it might be arousal related but even if every single central apnea you see flagged was the real deal sound asleep central you aren't having enough to warrant concern.
Watch the videos here
http://freecpapadvice.com/sleepyhead-free-software

Also read this thread
viewtopic/t184575/What-is-central-sleep-apnea-.html

along with this thread the last couple of pages (and the others if you want the full story) from jumblegirl and what all has been said to help her alleviate her worries about her centrals.
viewtopic/t184505/Oscar-chart.html?start=120

Though about reducing EPR.....
It is something you can for sure try....easy to change and hurts nothing to change to try it. Give it a go.

Also when you post images of your reports can you not just post a zoomed in snippet...include the overall detailed report as well along with how you feel that you slept and how you are feeling in general.
Images or numbers alone don't really tell the whole story.

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Pugsy
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Re: Clear Airway/Central Apnea Concerns

Post by Pugsy » Fri Jun 24, 2022 7:30 am

I do believe the WatchPat home sleep study does indeed include the respiratory belt thing for determining central apneas or not.
If you wore some sort of belt or device around your chest or abdomen then the home study did cover the possibility of central flagging. If an apnea event gets flagged and there is NO EFFORT to breathe then that gets a central apnea flag.
The device worn around the chest or abdomen is designed to check for effort to breathe.

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Jordan1
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Re: Clear Airway/Central Apnea Concerns

Post by Jordan1 » Fri Jun 24, 2022 9:07 am

I thought I posted my response, but it didn't seem to go through. I wanted to make sure you saw my thanks for your reply!

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palerider
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Re: Clear Airway/Central Apnea Concerns

Post by palerider » Fri Jun 24, 2022 3:59 pm

Jordan1 wrote:
Fri Jun 24, 2022 7:02 am
My AHI last night was 3.67 with 0 obstructive events, but a CA index of 2.57.
I wouldn't be concerned at all about a CAI of 2.57, or 5, maybe 10... maybe.

Centrals aren't stressful to your body like obstructives are, but if you're having boatloads of them, they can cause hypoxia. (way way more than 2.57 per hour would be required)

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

Jordan1
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Re: Clear Airway/Central Apnea Concerns

Post by Jordan1 » Sat Jun 25, 2022 7:54 am

Good to know that the physiological implications of different airway events are variable. It makes sense on reflection, but I was conceptually grouping them all together in the same "dangerousness pot."

I appreciate the point.

J

jumblegirl
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Re: Clear Airway/Central Apnea Concerns

Post by jumblegirl » Tue Jun 28, 2022 11:56 am

Hi Jordan
I also had the watchpat home study showing OSA and then had centrals show up on the APAP machine, last night I turned off EPR completely and got them down to 1 per hr (down from 4.3 and 5.3) with ahi at 2.2 down from 6 and 7 previous 2 nights. Hoping the trend continues with EPR off.

I was wondering the reason and makes sense maybe your brain thinks you have enough oxygen with the EPR on?

What mask are you using?

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Pugsy
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Re: Clear Airway/Central Apnea Concerns

Post by Pugsy » Tue Jun 28, 2022 12:09 pm

jumblegirl wrote:
Tue Jun 28, 2022 11:56 am
I was wondering the reason and makes sense maybe your brain thinks you have enough oxygen with the EPR on?
No.

Centrals come from an imbalance or not enough carbon dioxide in the blood stream and has nothing to do with oxygen.

Using EPR SOMETIMES IN SOME PEOPLE creates the bilevel pressure situation which can cause the imbalance which in turn causes the brain to think that there isn't enough carbon dioxide in the blood stream to warrant sending the breathe stimulation.

Carbon dioxide levels in the bloodstream are the driving force for the brain sending the signals to breathe.
It is NOT the levels of O2 in the bloodstream contrary to what a lot of people believe.

When the carbon dioxide levels get to a certain point the brain says "breathe human" and send appropriate signals.
When the carbon dioxide levels stay below that point the brain doesn't send any "breathe human" signals and we don't breathe.

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Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

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