Clear airway event question

Hello, been lurking here awhile but I decided to post. Ive searched and read about clear airway apneas but I wasn't sure if any of these apply to be since i have mostly CSA events. I'll get to the point ASAP. Im a 38 year old male, not super fit but not overweight or out of shape.

Was diagnosed with sleep Apnea in late 2018 but was still having a high AHI even with my CPAP machine, then was given a sleep study in the hospital (as opposed to the "at home" one I had) and my Sleep doctor said I am having central apneas and not obstructive so they switched me from the Philips Dreamstation to the Res Med Air Curve 10 v auto which is a BiPap machine. My number improved a bit. During my last visit with my sleep Dr., she said that with CSA having an AHI under 10 is "acceptable." I've always operated under the premise, although I've always shot for under 5. It fluctuates and some nights its a 2 and some it's an 8 or 9. It usually stays in that range. Never thought twice about it.

Randomly I was wondering if I was getting enough REM sleep so I thought if I downloaded Oscar it would tell such a thing, but after research I realize it doesn't. No biggie. Anyways I started clicking around and noticed my clear airway events was in the 50's last night(!!!) but the previous night it was 16. Some nights it is lower and some nights it's higher. I have next to no obstructive apneas.

Here is my question: Is there anything I can do or does it even matter? I am admittedly freaked out after seeing this as I was under the impression that I was getting "good" sleep even though I wake up a few times a night. I feel WAY better in the morning if I am using the machine and I only DIDNT use it when I had a faical/nose injury.

My doctor was kind of frustrated (or at leased seemed so) with me last visit and I dont know why. She asked if I was taking opiates... I am NOT and never have. She asked if I was stressed and I told her I have a stressful life and a stressful job. I pretty much take away people's driving licenses for a living and deal with angry people all day. She recommended breathing exercises and some over the counter stuff such as ashwagandha as a natural anti anxiety medicine but at the end of the conversation she said "Well I cant cure central sleep apnea". I'm going to try and post some stuff here from last night and hopefully someone can offer some advice. I'm not sure if I need to bring anything to my doctors attention. She gets all my info from my machine remotely and I assume she can see everything that Oscar displays... Am I over thinking this? I've tried to provide the pie chart, but im not sure if anything else is needed. I've tried to not go overkill with the info from oscar.

Forgive me if I am forgetting anything or giving too much information.

Omit the pie chart...it's really not all that useful. We can tell what we need from from the AHI bar graphs above the pie chart.
Do include those graphs on the right side though...please
In this format
viewtopic/t158560/How-to-post-images-for-review.html

Are you actually asleep when you see the central/CA flagged events?

Can you also post a detailed report from a night with a much lower AHI and less centrals.

Central apnea can be treated...just not well (if at all) with the VAuto.
Your doc apparently doesn't know about other machines that can deal with OSA and central apnea??
https://www.resmed.com/en-us/healthcare ... ve-10-asv/

I am curious as to why some nights a nice low AHI (a few centrals are actually normal and no big deal) and why some nights obviously more than we want.
First thing to do...confirm if you were actually asleep or not..
so watch all the videos here
http://freecpapadvice.com/sleepyhead-free-software

BTW...the opiates question is a very legitimate question when we see people having a lot of central apneas.
With a central apnea the person isn't even trying to breathe...no air flow but the airway is open.
As opposed to an obstructive apnea (or hyponea) where there is no air flow because soft tissue is blocking the airway and no flow or reduced flow is going on.

Opiates are well known to suppress respiration in some people...cause them to simply not breathe as much as they should.
It is one of the first questions I always ask someone here who has reports showing a lot of centrals.
I have seen it happen...someone on some sort of opiate (or even methadone) and they have a large number of centrals from the medication. We don't cast stones here...people most often have very legitimate reasons for various pain meds and methadone is also used for pain management as well as getting off the hard stuff.

Now it is not a given that opiates will always cause central apneas to be a problem in everyone. A lot depends on the person own general health and the dosage that someone is taking.
I mention this because I don't want someone to read this and they are taking some sort of pain meds that might suppress respiration and they see 3 or 4 centrals through the night and think "OMG, my pain meds are a problem".
I don't want people to panic. Just because something can cause a problem for one person doesn't mean it is going to cause a problem for the next person.

3 or 4 centrals throughout the night (or even a few more) is actually normal and no big deal. Centrals aren't a problem unless present in large numbers consistently...we know they are for sure asleep centrals..or they cause desats.

When someone has nights with AHI of 2 ish...so we know the central count/average per hour isn't very high and then nights with AHI 8 or more primarily central....it makes me wonder why the big difference.
Normally if a person has a problem with the number of centrals...it's going to show up every night and usually all night. Not some nights and not other nights.

Thank you for you patience with me and I understand the opiate question I was just taken aback by that because I know the devastation the opiate crisis has caused here in the US and I just wasn't expecting such a question as I am drug tested and have to pass serious background/security checks to perform my job. Anyways, here is a detailed shot from the original night I tried to ask about and another from last night. I can't speak for the other night, but as for last night I noticed most of my events seem to come late in the morning when I am tossing and turning. I always try to sleep on my sides, sometimes on my back, but for some reason I like to sleep on my stomach/chest when I'm having trouble sleeping which kind of smooshes my face against the pillow, which coincides with the events, although I've slept like this late in the morning before and had an AHI under 3.. I'm not sure if this relevant or not. Again, thank you. I have much gratitude for the time and effort you put into replies. So here is my original info from my first post, (hopefully in the right format) versus last night which is considered a "lower" night for me. If I can provide any other info it please let me know. Also, I would not have even blinked an eye at any of this I just seem to be waking up 4-7 times a night. It says I'm getting 6.5-8.25 hours of usage, but it doesn't feel like the "best" sleep when I keep waking up.

DMVclerk wrote: ↑

Sun Aug 22, 2021 7:23 am

I just seem to be waking up 4-7 times a night. It says I'm getting 6.5-8.25 hours of usage, but it doesn't feel like the "best" sleep when I keep waking up.

If you remember waking up 4 to 7 times a night I am betting you actually wake up a lot more than that...
and it doesn't feel like "best" sleep because it simply isn't.
Fragmented sleep will totally trash sleep quality and make us feel like crap no matter how many hours of "sleep" it says we get.
Fragmented sleep will mess with the normal progression of each sleep cycle into the next so that we get the needed percentages in each sleep stage for the restorative powers of sleep to work their magic.
BTW...6 1/2 hours of "sleep"...not enough even without it being fragmented to expect to feel decent.

Did you watch the videos for how to determine arousal/awake breathing flow rate vs asleep?

I do have one idea to try though to see if it makes any difference in the number of CA/centrals.

Change your PS from 4 to 2 and see what happens.
Sometimes some people will see centrals pop up just from PS.
I have a friend who gets about 15 centrals per hour with PS of 4...but with PS of 3 they essentially go away.
No guarantees but something worth trying.

DMVclerk wrote: ↑

Sun Aug 22, 2021 7:23 am

Thank you for you patience with me and I understand the opiate question I was just taken aback by that because I know the devastation the opiate crisis has caused here in the US and I just wasn't expecting such a question as I am drug tested and have to pass serious background/security checks to perform my job.

I've taken lots of opiates, because I've been prescribed various things for pain, up to and including morphine. "opiates" covers a very broad spectrum, and lots of people use them for legitimate purposes. I've only had morphine and fentanyl in the hospital.

There's a big difference between "use" and "abuse".