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AHI all over the place this month, mostly CA
#1
AHI all over the place this month, mostly CA
(40F) I'm approaching one full year of being on cpap. Lots of ups and downs, but I have some clear non-AHI victories that keep me in the mask at night. I have mild sleep appnea, that was about 1:1 CA:OA for my home sleep test. I'm using a resmed autoset 10 with dreamwear nasal pillows mask.

While on vacation the first week of the month, my AHI was mostly below 1.0. Coming home, it was between 1.0 and 2.0, but last week, it went above 2.0 most nights, and last night, it was nearly 5. I really, really feel it. I don't even know what questions to ask. Any insight? Thank you for your time.

Details: I don't have problems with leaks or snoring (only snore when I have a respiratory illness)

Screenshots: sleepyhead data for a few nights this month, with a closeup of last night's worst clustering of events. I haven't posted in a long time, and I can't find the specific requested layout for sleepyhead data. I can repost if someone can point me to that information again.
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#2
RE: AHI all over the place this month, mostly CA
Results look good except for the night with the periodic breathing and CA events above normal. You are using the Autoset in fixed mode at 7.0 cm pressure. As I recall, you had more central events with pressure fluctuation and EPR. There are no changes I would recommend based on these results, but you are right to keep an eye on it. How are you feeling?

For future charts, please include Flow Limitation instead of Inspiratory Time.
Sleeprider
Apnea Board Moderator
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#3
RE: AHI all over the place this month, mostly CA
It would help to know the duration of the CA events.  If they range from 10-15 seconds, I would ignore them.  I know, they seem to come in clusters, but that might be a temporary restlessness that makes you toss and turn, and when you settle and begin to slip back down into a deeper sleep, you hold your breath.  I have had days like yours with unexplained and persistent CAs, but when I place my cursor over them, they are all of short duration; I forget about them as my AHI is always excellent.

My father just had a really bad night, the worst since commencing PAP about six months ago.  His AHI was 7.9 (YIKES!!).  I hadn't bothered to take his SD and read it on my PC to date, but that started the ball rolling.  I found immediately that he had plenty of large leaks (you don't, so we must look elsewhere for an answer for you). He was unaware, but has since taken positive steps to correct it.

If your CAs are longer than 15 seconds typically, now we're getting into some iffy territory where we need to address them.  This is especially true when they come nose-to-tail, in clusters.  You'll get serious desaturation episodes which will completely undo any good PAP benefit.  Hence, you don't feel like you're doing well...at all.

CAs come and go, and do so seemingly at will.  If these persist, you may need a revisit of your therapy type (assuming there isn't a new correctable disorder or condition that we don't know of).
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#4
RE: AHI all over the place this month, mostly CA
a 10 second pause in breathing is a 10 second pause in breathing whether it is obstructive or central. a 10 second ca is every bit as damaging as a 10 second oa. ca has been a second class citizen in the cpap industry for too long. notice the increase in members with central and mixed apnea over the last year or so.
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#5
RE: AHI all over the place this month, mostly CA
I get a lot of CA myself. Can someone tell me how I find out how long they are?
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#6
RE: AHI all over the place this month, mostly CA
in sleepyhead and oscar, look under the daily tab for the events tab. events are listed individually followed by a number in parens. this is said to be the duration of the event in seconds. to be flagged as apnea, they have to be at least 10 seconds long.
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#7
RE: AHI all over the place this month, mostly CA
If all the CAs are (10) as on ResMed ignore the "duration" SH got them wrong and we are working on correcting that.

You can look at a detailed Flow Rate and actually measure them.
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#8
RE: AHI all over the place this month, mostly CA
bonjour, my resmed apap ca's came in different durations listed in parens. this with SH 1.0.0 beta 2 and with oscar. are you saying ignore if every one shows 10 seconds or ignore each one that's 10 seconds? I haven't seen any ca for the last year since starting asv. did whatever this problem is stem from a SH 1.1.0 problem (and therefore I don't see it)? but if that's the case, I should see it in oscar and I don't.
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#9
RE: AHI all over the place this month, mostly CA
I feel fine (not good =/) when my AHI is below 1.0, maybe 1.2. Today, I really feel the 4.8- no motivation, no energy, and that is after a week well over 2. There were 48 clear airway events; the shortest were 10s, all between 10 and 16 seconds.There are 8-ish times with a lot of clustered events like in the last image in my original post. 

I've attached the overview for July here. I'm just not sure what I can do to improve things, and if this is the best there is, it just isn't worth the cpap frustrations when my appnea is mild.
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#10
RE: AHI all over the place this month, mostly CA
The issue of 10 seconds is not with CA’s but with hypopnoeas these do not have a duration in the Resmed data, but Oscar assumes 10 seconds long
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