"False" CA's but isn't it still Apnea?

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scf
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"False" CA's but isn't it still Apnea?

Post by scf » Sun Jan 23, 2022 11:13 am

I understand that my 50-80 CA's every night are probably not true central apneas, but related to tossing and turning, etc. However, when I look at OSCAR it shows that during the supposed CA's there is still no breathing, sometimes for to 20 seconds. Surely I don't hold my breath for that long. So my OA"s are well controlled, but aren't I still having problems. I have to repeat my pulse ox next week because one I did before Christmas showed that my O2 level dropped significantly. I don't know as much about all this that I thought I did.
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ChicagoGranny
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Re: "False" CA's but isn't it still Apnea?

Post by ChicagoGranny » Sun Jan 23, 2022 11:30 am

scf wrote:
Sun Jan 23, 2022 11:13 am
"FALSE" CA'S BUT ISN'T IT STILL APNEA?
You can call it apnea, but it you are awake, it's not sleep apnea.

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Re: "False" CA's but isn't it still Apnea?

Post by palerider » Sun Jan 23, 2022 12:05 pm

scf wrote:
Sun Jan 23, 2022 11:13 am
However, when I look at OSCAR it shows that during the supposed CA's there is still no breathing, sometimes for to 20 seconds. Surely I don't hold my breath for that long.
What makes you think that?

'apnea' = temporarily not breathing. one holds ones breath all the time during he day, unconsciously.

If your sleep disturbed breathing isn't well controlled, you may have a lot more transition apneas that show up as you go back to sleep after something else disturbs your sleep.
scf wrote:
Sun Jan 23, 2022 11:13 am
related to tossing and turning,
Why are you tossing and turning so much?

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Miss Emerita
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Re: "False" CA's but isn't it still Apnea?

Post by Miss Emerita » Sun Jan 23, 2022 12:56 pm

CAs after arousal may be pauses after exhaling, rather than breath-holding. Have you learned how to identify a likely arousal by zooming in on the flow rate in Oscar? It'd be worth scrolling through the night to see how often your CAs are preceded by arousals. See example below. In general arousals are reflected in breathing that is less regular than asleep breathing, often with greater amplitude.

It's good you're repeating the oximetry. Let us know the results. An occasional drop below 89 or 90 is not a cause for concern, but extended periods of low O2 sats might need some attention from your doctor.
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Re: "False" CA's but isn't it still Apnea?

Post by scf » Mon Jan 24, 2022 9:15 am

Thank you for taking time to answer my question. I squirm during the night because of back pain. Technically I do not turn over, I only turn once during the night. I know we all hold our breath off and on during the day. It seems like 50-81 times is excessive. And the CA’s are all preceded by erratic flow rates which is why I called them false CA’s. This is a typical graph…
CFD2F3AC-2C44-4433-836B-9090ED9D7CBA.jpeg
CFD2F3AC-2C44-4433-836B-9090ED9D7CBA.jpeg (22.58 KiB) Viewed 3613 times
I was on a course of prednisone recently for 10 days during which my AHI was less than 1 rather than 5-14. No back pain because of the anti-inflammatory action of prednisone, so I know these are not true CA’s.
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Re: "False" CA's but isn't it still Apnea?

Post by chunkyfrog » Mon Jan 24, 2022 10:44 am

You might still be experiencing the effects of stopping prednisone.
Amazing drug, but the body learns to like it a little too well.

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Re: "False" CA's but isn't it still Apnea?

Post by palerider » Mon Jan 24, 2022 11:09 am

scf wrote:
Mon Jan 24, 2022 9:15 am
Thank you for taking time to answer my question. I squirm during the night because of back pain. Technically I do not turn over, I only turn once during the night. I know we all hold our breath off and on during the day. It seems like 50-81 times is excessive. And the CA’s are all preceded by erratic flow rates which is why I called them false CA’s.
Some may be false, but without examining them, I can't even guess.

If you're in pain, and moving around, you very well may be holding your breath that often. You should be focusing on the *index*, the per hour numbers, not total, because that only tells part of the story.

"I drank a gallon of water" could be very bad and lead to death if you did it in a half hour period... or it could mean you're dehydrated if that was over a period of week.

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Re: "False" CA's but isn't it still Apnea?

Post by zonker » Mon Jan 24, 2022 11:34 am

this may be a totally whack idea, but have you tried sleeping prone?
people say i'm self absorbed.
but that's enough about them.
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Miss Emerita
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Re: "False" CA's but isn't it still Apnea?

Post by Miss Emerita » Mon Jan 24, 2022 12:18 pm

In the snippet you provided, the CAs come as you pause after exhaling; you're not holding your breath. You're right that there's arousal breathing at the start of this interval, though whether that disruption accounts for the later CAs is hard to say.

But I'm intrigued that with pain relief your CAs dropped. That really does suggest that the CAs in general are arousal-related.

Have you talked to your rheumatologist (or other doctor) about ways to minimize pain at night? E.g., as Zonker suggests, by using a different sleep position? Or using pillow to prop one part of you or another? I have chronic hip tendon pain at night and side-sleep. I find it useful to use a pillow that runs from my knees to my ankles -- that's just an example.

I really hope you can have a long-lasting remission from pain.
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Re: "False" CA's but isn't it still Apnea?

Post by scf » Mon Jan 24, 2022 2:24 pm

chunkyfrog wrote:
Mon Jan 24, 2022 10:44 am
You might still be experiencing the effects of stopping prednisone.
Amazing drug, but the body learns to like it a little too well.
Excellent point. Too bad we cannot stay on low dose steroids! They do solve so many issues!
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scf
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Re: "False" CA's but isn't it still Apnea?

Post by scf » Mon Jan 24, 2022 2:28 pm

Miss Emerita wrote:
Mon Jan 24, 2022 12:18 pm
In the snippet you provided, the CAs come as you pause after exhaling; you're not holding your breath. You're right that there's arousal breathing at the start of this interval, though whether that disruption accounts for the later CAs is hard to say.

But I'm intrigued that with pain relief your CAs dropped. That really does suggest that the CAs in general are arousal-related.

Have you talked to your rheumatologist (or other doctor) about ways to minimize pain at night? E.g., as Zonker suggests, by using a different sleep position? Or using pillow to prop one part of you or another? I have chronic hip tendon pain at night and side-sleep. I find it useful to use a pillow that runs from my knees to my ankles -- that's just an example.

I really hope you can have a long-lasting remission from pain.
Thank you for your kind words. Unfortunately there is not much that can be done right now except for some extreme measures that I am not ready to do. It was pretty well controlled with anti-inflammatories and then I developed a fib and cannot take them. I do have some pain meds, but try to not take them unless absolutely necessary. I still have a great quality of life and can deal with the pain. It just would be nice to sleep as well as I did on prednisone. I will consider your suggestions.
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