What can I do about many CA's...data posted

I have the System 1 auto bipap, have data from a week
I have the software to see all my data
with my old tank auto bipap I was staying consistant at 2.0 or below AHI

With this new machine I am seeing alot of Clear Airway CA's
a few days they are at the beginning and ending of sleep time, but many days they are all through the night.
Average CA Index 2.1. On the minute by minute I see one right after a preasure pulse but not every time.

here are the numbers from last night

CA 3.6
OA 0.3
H 0.7
FL 0.1
vs 0.0
RE 0.6

AHI 4.6

90% IPAP Pressure
11.0
90% EPAP Pressure
8.0

no large leaks


also can someone explain to me how to get data posted here from the pdf file?
I know that would be better yet

OOOPS! forgot the quote

soulfixinman wrote: also can someone explain to me how to get data posted here from the pdf file?
I know that would be better yet

Check out this thread. It should give you what you need.

viewtopic/t52374/viewtopic.php?f=1&t=51 ... 84#p469684

Cheers,

Dave

Here is my data from last night, anyone have any ideas how to lower the CA's ?

Did your original (or any subsequent) sleep studies show any Centrals?


Den

I am also presently using the System One Auto Bipap and have noticed the same thing, namely that the majority of my events are CAs. The sleep doctor I went to to discuss this was useless, so I'm going to have to go and look at my own raw data during the sleep study to see whether there were many centrals (the write-up, which was a careless one, did not note any centrals).

There are a couple of things I want to try. First, I'm using a Fitlife total face mask and I'm wondering whether the amount of enclosed air over my face could be affecting the readings such that the "pulse method" of differentiating between CA's and OA's may not be so accuate; accordingly, I'll get a couple of my other masks out of the closet and see whether that has any effect on the readings. Second, I'm also going to try a couple of nights with a recording oximeter to see how things line up.

In any event, I'm wondering what types of CA numbers others are getting with the System One (APAP or BIPAP) and which types of masks they are using when getting these numbers.

yes I am wondering about all these CA's with the System one too, I dont feel any different in the morning, and if you took away all the CA's my AHI would be right where it was on the tank auto bipap, I have a good sleep doctor and I guess it will be best to discuss all this with him.
Till then I was looking for some things to try as far as pressure settings etc.

Wulfman wrote:Did your original (or any subsequent) sleep studies show any Centrals?


Den

I will have to get a copy of it, I don't however remember any major discussion about Centrals with my sleep doctor.

Your sleep doctor might not have mentioned it because it is below the threshold of where they can treat it. The number shows CA (clear airway) events at 3.6 per hour. Just like obstructive apnea, some are perfectly normal. So, sleep doctors and insurance will not do anything unless it exceeds 5.0 per hour. Also, remember that the machines do not really measure if this is a central apnea. Only that they observed the airway appears to be open. If you were had aroused enough that you were just barely awake then had to go back asleep you might have "central apneas" that are perfectly normal (and are appropriately not counted by sleep labs).

So, based on the numbers you have those events, but we do not know if they are in fact central apneas, only that they your airway was open. Also, we the CA events per hour does not exceed 5 ... and is thus considered "normal".

Hope that helps explain the data a bit better.

Are you mouthbreathing? This might read out as a clear airway.

guest also wrote:Are you mouthbreathing? This might read out as a clear airway.

SFM,

In view of the fact that you're using a nasal mask, this makes sense.
Tape your mouth for a few nights and see if the CA's they are lessened.


Den

The number shows CA (clear airway) events at 3.6 per hour. Just like obstructive apnea, some are perfectly normal. So, sleep doctors and insurance will not do anything unless it exceeds 5.0 per hour.

I've often wondered about this and will illustrate my "wonderment" with two hypothetical examples. In the first, someone has an AHI (based on OA and hypopneas) of 6. Although perhaps borderline, this would justify treatment for obstructive apnea, e.g., CPAP, correct? In the second, the person has 2 OA's an hour, 2 hypnopeas an hour, and 4 centrals an hour, totalling eight events an hour. For purposes of making a treatment decision, are the OA's and hypopneas considered separately from the centrals, and since neither exceed 4 per hour, there is no treatment? This seems odd to me in that assuming in the two examples the durations of each type of event averages about the same, the effects of the various events (in terms of desaturations and so forth) in the second example would be greater.

Put another way, if there are fewer than 5 centrals per hour, do we really ignore them (for purposes of treatment), or does this judgment have to take into account what else is going on?

I may be wrong but I have always assumed that AHI, at least as reported by my S8 Elite II, includes central apneas (though it doesn't break them out because it can't distinguish them from obstructive apneas). In any case, what would be the point of not including Centrals in the AHI calculation? An obvious problem with doing so is the problem you cite in your example.

JohnBFisher wrote:Your sleep doctor might not have mentioned it because it is below the threshold of where they can treat it. The number shows CA (clear airway) events at 3.6 per hour. Just like obstructive apnea, some are perfectly normal. So, sleep doctors and insurance will not do anything unless it exceeds 5.0 per hour. Also, remember that the machines do not really measure if this is a central apnea. Only that they observed the airway appears to be open. If you were had aroused enough that you were just barely awake then had to go back asleep you might have "central apneas" that are perfectly normal (and are appropriately not counted by sleep labs).

So, based on the numbers you have those events, but we do not know if they are in fact central apneas, only that they your airway was open. Also, we the CA events per hour does not exceed 5 ... and is thus considered "normal".

Hope that helps explain the data a bit better.

thanks John yes that does help, especially that an AHI index is events per hour, I had forgottan that.
I have been going along just fine with no problems for over two years with my auto bipap tank, no mouth breathing problems and AHI mostly at 2.0 or less. Now I get this new machine and the data keeps giving me higher AHI's, it is just kinda hard to ignore. But I must say I feel as good as always in the morning, but wonder if I did lower whatever is causing the CA's would I feel even better.

Wulfman wrote:

guest also wrote:Are you mouthbreathing? This might read out as a clear airway.

SFM,

In view of the fact that you're using a nasal mask, this makes sense.
Tape your mouth for a few nights and see if the CA's they are lessened.


Den

I must say I can't be 100% sure but I really don't think I have this problem, I never wake with a dry mouth from mouth breathing and I think I would wake right up with the preasure thing that happens when you open your mouth.

Last nights data if anyone is interested....looks about the same