Please help define "Clear Airway apnea"

The Latinist · Post by **The Latinist** » Wed Aug 06, 2014 3:09 pm

archangle wrote:Central vs. obstructive mostly matters in terms of figuring out how to eliminate the apneas.

Um…exactly?

palerider · Post by **palerider** » Wed Aug 06, 2014 3:10 pm

archangle wrote:
The Latinist wrote: The real issue is, in my opinion, exactly the opposite of the one you seem to be addressing. It's not that centrals are being missed, but that things are being falsely flagged as centrals when they may in fact be pauses in breathing due to arousals, movement, etc rather than central nervous system issues. If one assumes that all clear airway events are centrals, he may falsely believe that he has a complex apnea problem or pressure-induced centrals when the real issue is sleep hygiene or medication or any of a number of things that can affect sleep and cause CA's that are not CNS-related.
If you have an apnea, and no respiratory effort, it's a "central apnea," by definition, no matter what the cause. Presumably, if your airway is clear, and you're not breathing there is no respiratory effort.

us agreeing on something is midly disturbing

palerider · Post by **palerider** » Wed Aug 06, 2014 3:11 pm

The Latinist wrote:
archangle wrote:Central vs. obstructive mostly matters in terms of figuring out how to eliminate the apneas.
Um…exactly?

so, now you agree, and will drop this 'I wanna call it something other than a central' distraction?

archangle · Post by **archangle** » Wed Aug 06, 2014 3:31 pm

The Latinist wrote:
archangle wrote:Central vs. obstructive mostly matters in terms of figuring out how to eliminate the apneas.
Um…exactly?

As in "don't worry about central vs. obstructive unless your AHI is too high." Everyone around here wigs out when the word "central" is mentioned.

The Latinist · Post by **The Latinist** » Wed Aug 06, 2014 4:46 pm

palerider wrote:
The Latinist wrote:
archangle wrote:Central vs. obstructive mostly matters in terms of figuring out how to eliminate the apneas.
Um…exactly?
so, now you agree, and will drop this 'I wanna call it something other than a central' distraction?

No, because how to eliminate the apneas is the entire point of knowing what kind of apneas they are. Calling them centrals when they might not be could lead to incorrect assumptions about the way to fix them. And, in the absence of actual PSG to tell whether you are having centrals or SWJ or something else entirely, it is NOT safe to assume that all CAs are centrals and adjust therapy accordingly. That is, I'm sure, why ResMed doesn't call them centralized.

palerider · Post by **palerider** » Wed Aug 06, 2014 5:56 pm

The Latinist wrote:
palerider wrote:
The Latinist wrote:
archangle wrote:Central vs. obstructive mostly matters in terms of figuring out how to eliminate the apneas.
Um…exactly?
so, now you agree, and will drop this 'I wanna call it something other than a central' distraction?
No, because how to eliminate the apneas is the entire point of knowing what kind of apneas they are. Calling them centrals when they might not be could lead to incorrect assumptions about the way to fix them. And, in the absence of actual PSG to tell whether you are having centrals or SWJ or something else entirely, it is NOT safe to assume that all CAs are centrals and adjust therapy accordingly. That is, I'm sure, why ResMed doesn't call them centralized.

well, I started to make a snarky response about bowing to your years of experience using cpap and your expert grasp about every aspect of it, and then though no, I'd be more civil.

and just say that you're welcome to your opinion no matter it's accuracy.

as to what Resmed has to say on the subject, a *quick* googling brings up a few things.... I'll only paste a couple:

http://www.resmed.com/fr/assets/documen ... -paper.pdf
http://www.resmed.com/assets/documents/ ... ow_eng.pdf
http://www.resmed.com/us/en/healthcare- ... ology.html
http://www.resmed.com/ap/products/s9_vp ... html?h=s#s

and if you want to HEAR them say it:
https://www.youtube.com/watch?v=fDhGpyeYb0c
https://www.youtube.com/watch?v=WltM71AURf8

it actually seems they DO call 'em centrals.

ChicagoGranny · Post by **ChicagoGranny** » Wed Aug 06, 2014 6:31 pm

Day_Dreamer wrote:Hi,

What is a clear airway (apnea?)

Day_Dreamer wrote:As always

thanks everyone!!!

You can't just say thanks and then not hang around for the fun.

palerider · Post by **palerider** » Wed Aug 06, 2014 6:38 pm

ChicagoFanny wrote:
Day_Dreamer wrote:Hi,
What is a clear airway (apnea?)

Day_Dreamer wrote:As always
thanks everyone!!!
You can't just say thanks and then not hang around for the fun.

poke it with a stick and run for cover...

archangle · Post by **archangle** » Wed Aug 06, 2014 7:23 pm

The Latinist wrote:No, because how to eliminate the apneas is the entire point of knowing what kind of apneas they are. Calling them centrals when they might not be could lead to incorrect assumptions about the way to fix them. And, in the absence of actual PSG to tell whether you are having centrals or SWJ or something else entirely, it is NOT safe to assume that all CAs are centrals and adjust therapy accordingly. That is, I'm sure, why ResMed doesn't call them centralized.

Well then, shall we go down the path of "efficiency data from a CPAP machine is useless because the patient might be awake, and we don't count apneas while awake."?

You could also say "It's not safe to assume a "OA" event from a CPAP machine is an obstructive apnea and adjust therapy accordingly."

It's all potentially useful data, but it's not absolute gospel, not even an in-lab PSG.

Most importantly, the CPAP machines probably don't miss any apneas, even if their determination of OA vs. CA is suspect.

Day_Dreamer · Post by **Day_Dreamer** » Wed Aug 06, 2014 7:29 pm

ChicagoGranny wrote:
Day_Dreamer wrote:Hi,

What is a clear airway (apnea?)

Day_Dreamer wrote:As always

thanks everyone!!!
You can't just say thanks and then not hang around for the fun.

I am always lurking

ChicagoGranny · Post by **ChicagoGranny** » Wed Aug 06, 2014 8:24 pm

palerider · Post by **palerider** » Wed Aug 06, 2014 8:56 pm

WindyFanny wrote:

who's whom?

ChicagoGranny · Post by **ChicagoGranny** » Thu Aug 07, 2014 7:07 am

palerider wrote:
who's whom?

Uh PailRider, you have a subject complement there. So a subject pronoun is required.

Who's who?

WindyGranny

palerider · Post by **palerider** » Thu Aug 07, 2014 8:04 am

ChicagoGranny wrote:
palerider wrote:
who's whom?
Uh PailRider, you have a subject complement there. So a subject pronoun is required.
Who's who?

WindyGranny

sez you! I like to mix things up for amoozements sake.

Please help define "Clear Airway apnea"

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