General Q on CA's

I've been meaning to ask a general question about CA's on a ResMed Airsense 10 Autoset setup. I have been using nasal pillows for a bit now with a cervical collar and sleeping very well. Switched to a FFM last night due to nasal congestion with no collar needed to keep my yap closed . I noticed I am definitely much better rested with the pillows and that I have quite a few more CA's with the FFM. Just trying to understand why.

In looking at the OSCAR reports (below with pillows first then FFM) the only obvious thing to my inexperienced view is that the pressure seems to be about 3 cmH2O higher with the FFM, the flow limit is a bit wonkier with the FFM, and the leak rate is a bit higher with the pillows. Nothing jumps out. It is possible I just don't use the FFM often and am not used to it since switching full-time to pillows, but realize it could also be not using a cervical collar as well.

Not complaining about anything, just want to try and understand it. Thanks to this board I am sleeping very well overall after taking a lot of the advice given to me to heart and am forever grateful for that.

the CA's may be TAs, or Transition Apneas, which occur when you're going between awake and asleep breathing, also known as Sleep/Wake Junk on the forum here.

FFMs tend to push the lower jaw back thus occluding your airway, and requiring more pressure to keep the airway open. If I remember (it's been years) when I switched to a pillow mask from a FFM, my required pressures dropped 2 or 3cm.

If you want to understand a bit about centrals you first have to figure out if you were really asleep when it was flagged or if the flagged central is nothing more than an awake pause in breathing.

Watch the videos here...especially the last one.

http://freecpapadvice.com/sleepyhead-free-software

Bear in mind that while this talks mainly about central apneas....we can have "false positive awake breathing" flagging occurring in any event category. It's not limited to just centrals.

A while back I had a night where my AHI was 9.4....unusual for me for sure. A nice mix of all the categories.
I took the time to zoom in on all the events flagged and 95% of them were false positive and I was awake.
Didn't surprise me...had a horrible night's sleep due to back pain that night. I remembered a LOT of tossing and turning.
The increased AHI was really just a symptom of crappy sleep quality. My normal AHI runs between 1 and 2 with 75% being false positives...I still have the pain issues messing with my sleep so that doesn't surprise me either.

Awake flagged events...simply don't count when it comes to evaluating apnea therapy itself.
We have to be asleep for it to matter.
Now it might point to crappy sleep but a lot of awake flagged events is just a symptom of the poor sleep and not necessarily the cause of the poor sleep.

Pugsy wrote: ↑

Fri Jul 16, 2021 4:11 pm

If you want to understand a bit about centrals you first have to figure out if you were really asleep when it was flagged or if the flagged central is nothing more than an awake pause in breathing.

[snip]

Awake flagged events...simply don't count when it comes to evaluating apnea therapy itself.
We have to be asleep for it to matter.
Now it might point to crappy sleep but a lot of awake flagged events is just a symptom of the poor sleep and not necessarily the cause of the poor sleep.

Spot on as always. I compared it to my sleep gadget and the times coincide to an awake event. Thanks once again!

I thought the PAP machine can't tell whether the user is awake or asleep. How can you tell?

clownbell wrote: ↑

Sun Jul 18, 2021 11:28 pm

I thought the PAP machine can't tell whether the user is awake or asleep. How can you tell?

The machine may not be able to tell, (or they won't let it) but it's pretty easy for someone with an experienced eye to look at the flow chart and tell whether it was awake or asleep breathing.

Jlfinkels wrote: ↑

Fri Jul 16, 2021 4:50 pm

Pugsy wrote: ↑

Fri Jul 16, 2021 4:11 pm

If you want to understand a bit about centrals you first have to figure out if you were really asleep when it was flagged or if the flagged central is nothing more than an awake pause in breathing.

[snip]

Awake flagged events...simply don't count when it comes to evaluating apnea therapy itself.
We have to be asleep for it to matter.
Now it might point to crappy sleep but a lot of awake flagged events is just a symptom of the poor sleep and not necessarily the cause of the poor sleep.

Spot on as always. I compared it to my sleep gadget and the times coincide to an awake event. Thanks once again!

While Pugsy is almost always spot on, you are giving your sleep gadget way too much credit. Unless, your sleep gadget is a home PSG.