Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Highlander · Post by **Highlander** » Fri Jan 25, 2019 2:32 am

I have been having really bad sleep for years and finally I did a sleep study where my AHI was 9 with no central apneas detected. I started CPAP with an AirSense 10 AutoSet. I got an SD card and have been downloading the data every day into SleepyHead for almost a month now without modifying anything. My AHI is now between 2 and 5 but the majority of the remaining apnea events tend to be clear airways (CA). Overall I feel like I am sleeping and feeling better but I am concerned about the CAs taking the majority of the apnea times. Is this normal or should I be worried and consider switching to an ASV device? I tried turning off the EPR (currently set to 2) thinking it was causing the CAs for a couple of nights but that did not decrease my CAs and instead increased my hypopneas and overall AHI so I turned it back on. My follow up appointment with my doctor is in a couple of weeks. I attached pictures of a few days of data from SleepyHead.

Thank you for any advice.

Pugsy · Post by **Pugsy** » Fri Jan 25, 2019 8:20 am

Welcome to the forum.

Go here and learn how to figure out of the centrals are real or not
http://freecpapadvice.com/sleepyhead-free-software

If not real as in you weren't asleep...they simply don't count and have to be mentally removed from the evaluation process.

An occasion central is normal and no big deal....and even if every single one of your centrals was the real deal (which I doubt) you aren't having enough of them all night long to warrant going to ASV.

Even if related to cpap use...they might reduce with time.
So doctors won't usually go to ASV right away unless the number of centrals is a LOT higher than what you are seeing...assuming they are the real deal.

Do you remember waking up during the night?
Do you take any meds of any kind? If so, what?

zheshi14 · Post by **zheshi14** » Fri Jan 25, 2019 10:46 am

What do you mean if they are real or not? And how would I go about determining so?

palerider · Post by **palerider** » Fri Jan 25, 2019 12:20 pm

Also, please fix your charts.
(instructions in the link below).

nicholasjh1 · Post by **nicholasjh1** » Fri Jan 25, 2019 12:26 pm

I had quite a few when I started, they are gone now. but of course your milage may vary. It's not unusual to start with some though.

Pugsy · Post by **Pugsy** » Fri Jan 25, 2019 12:37 pm

zheshi14 wrote: ↑
Fri Jan 25, 2019 10:46 am
What do you mean if they are real or not? And how would I go about determining so?

Real...as in asleep

Not real....as in not fully asleep

All explained in the link I posted.

palerider · Post by **palerider** » Fri Jan 25, 2019 1:27 pm

A few "centrals" are common, and nothing to be concerned about.

Highlander · Post by **Highlander** » Fri Jan 25, 2019 11:53 pm

I am not taking any medication. I may be awake during some of those but I am not 100% sure. I need to find a better way to track when exactly I am awaken to be able to correlate it.

Here are updated screenshots with better layout.

Thanks!

palerider · Post by **palerider** » Sat Jan 26, 2019 12:37 am

Highlander wrote: ↑
Fri Jan 25, 2019 11:53 pm
I need to find a better way to track when exactly I am awaken to be able to correlate it.

Actually, what you need to do is to stop worrying about a few "centrals".

And maybe turn down EPR.

chunkyfrog · Post by **chunkyfrog** » Sat Jan 26, 2019 12:48 am

We breathe differently, whether sound asleep or in transition (falling asleep or waking up)
Transitional stuff may look like centrals, but we call them sleep/wake/junk--"SWJ".
They are meaningless, but the machine may not be able to distinguish them.

ajack · Post by **ajack** » Sat Jan 26, 2019 5:22 am

The CA on the machine actually means clear airway and not central apnea. It can't tell the difference. As has been said, clear airway can be caused by a few things, including new users getting their CO2 and O2 stable. The body waits till the co2 builds up and trigger a breath. sometimes they can be a true central apnea with an O2 drop. You have a relatively low number that are clustered. I wouldn't worry and they will probably settle down in a month or so.

palerider · Post by **palerider** » Sat Jan 26, 2019 1:07 pm

ajack wrote: ↑
Sat Jan 26, 2019 5:22 am
The CA on the machine actually means clear airway and not central apnea. It can't tell the difference. As has been said, clear airway can be caused by a few things, including new users getting their CO2 and O2 stable. The body waits till the co2 builds up and trigger a breath. sometimes they can be a true central apnea with an O2 drop. You have a relatively low number that are clustered. I wouldn't worry and they will probably settle down in a month or so.

Best to just ignore ajack, he reads a lot, but understands little, and thus tends to just confuse any issue he chooses to wade into.

"clear airway' is a term made up by Respironics.... sleepyhead was originally written for Respironics machines... the 'clear airway' term is a holdover from that.

Resmed does not use the term "clear airway", anywhere, nor does any other manufacturer in the sleep disordered breathing treatment industry.

Highlander · Post by **Highlander** » Sat Jan 26, 2019 4:53 pm

Thank you all for your advises on this. For what it is worth, when I load my SD card data in ResScan 6 from ResMed, those events are called Centrals, not Clear Airways.

palerider · Post by **palerider** » Sat Jan 26, 2019 5:03 pm

Highlander wrote: ↑
Sat Jan 26, 2019 4:53 pm
Thank you all for your advises on this. For what it is worth, when I load my SD card data in ResScan 6 from ResMed, those events are called Centrals, not Clear Airways.

Yeah, another 'confusing issue' (tm) from Sleepyhead.

Hopefully, the new sleepyhead team can address this (hint hint) and other things, like inappropriate flagging of leaks on Respironics machines.

What you're having there are central apneas... yes. What pugsy and others were getting at is that they may, or may not be central *sleep* apneas. If you wake up a little, cuz you're in an uncomfortable position, and you wake up a bit to shift position, it's quite natural and common to hold your breath for a bit while doing so. Not breathing is an apnea, not trying to breathe means it's central not obstructive... but the machine can't tell whether you're still asleep, so it just flags them... as 'central apnea'.

Even if they're real, honest to goodness central sleep apneas, there aren't enough of them on your charts to be concerned about.

ajack · Post by **ajack** » Wed Jan 30, 2019 11:10 pm

Highlander wrote: ↑
Sat Jan 26, 2019 4:53 pm
Thank you all for your advises on this. For what it is worth, when I load my SD card data in ResScan 6 from ResMed, those events are called Centrals, not Clear Airways.

Well the machine can't distinguish between a true central and simply not breathing without an obstruction and registering CA, AKA clear airway. There are causes other than a true central apnea. To get yourself into a state without knowing the facts isn't a good idea. Palerider should be aware of this.

Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Re: Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Re: Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Re: Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Re: Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Re: Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Re: Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Re: Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Re: Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Re: Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Re: Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Re: Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Re: Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Re: Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?

Re: Started CPAP with AirSense 10 AutoSet. SleepyHead showing a lot of clear airway apneas. Is this normal?