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Breathing Stops When First Falling Asleep
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Tommy C Offline

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Machine: ResMed S9 AutoSet
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Post: #1
Breathing Stops When First Falling Asleep
I tried the new S9 AutoSet last night. Beautiful machine!

However I had a minor problem. I started to fall asleep after about 10 minutes as SleepyHead showed the breathing getting slower and more shallow. Suddenly at 11 minutes the breathing stopped for about 40 seconds. I woke up and ripped the mask off thinking I was suffocating. I could not fall asleep with the mask on after that and slept without the APAP for the rest of the night.

Sleephead called it a "CA" event for clear airway. It acts like central apnea. My sleep study showed many of these but called them OSA events. I see there were no leaks, and everything else confirmed the ceased breathing on the charts.

I simulated some test OSA, CA and snoring to see how the software acted as a reference, so getting familiar with SleepyHead.

I realize this is not much data this early in the game, but I'm wondering how many of you have these "central apnea" events at the beginning of falling asleep and do you regularly see them on the chart as "clear airway" events. They certainly can make it hard to get past the waking to sleeping transistion.

Geezz... hope it doesn't mean a VPAP later on.

Right now I am sitting here with the mask on practicing - getting used to it for another go tonight...Smile I realize I need a few weeks of data first, but this initial problem puzzled me.

Tom
(This post was last modified: 08-15-2012 01:03 PM by Tommy C.)
08-15-2012 01:01 PM
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trish6hundred Offline

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Machine: Resmed S9 AutoSet for Her
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Post: #2
RE: Breathing Stops When First Falling Asleep
Hi Tommy C, CONGRATULATIONS on your new "beautiful machine," and yes, I agree, (ha.) While it is true that you need more than one night's worth of data, you might want to post last night's report so that others can give you suggestions although, it sounds like you've got it figured out.. Best of luck getting used to your new mask and machine.

trish6hundred
08-15-2012 01:25 PM
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PaulaO2 Offline
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Post: #3
RE: Breathing Stops When First Falling Asleep
Yes, one night's worth of data isn't much. If it really is a central apnea event, then a VPAP is indeed in your future.

The major difference between an obstructive event and a central event is the lack of struggle. This is something the machines cannot detect and why sleep studies are so important. In an obstructive event, the brain is panicking and trying to get you to wake up enough to breathe. In a central event, the brain is cool with the not breathing so it does nothing to wake us up.

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
08-15-2012 01:30 PM
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Tommy C Offline

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Machine: ResMed S9 AutoSet
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Post: #4
RE: Breathing Stops When First Falling Asleep
(08-15-2012 01:30 PM)PaulaO2 Wrote:  The major difference between an obstructive event and a central event is the lack of struggle. This is something the machines cannot detect and why sleep studies are so important. In an obstructive event, the brain is panicking and trying to get you to wake up enough to breathe. In a central event, the brain is cool with the not breathing so it does nothing to wake us up.

I read that only about 5% of apnea cases are central apnea, so that is encouraging.

The HOME sleep study showed no CA's, only OSA - and they said their test would have picked it up.

I'm hoping it was just one of these common CA events that some people get in the sleep transisition.

Though, I DID wake up in a panic, evidently because of lack of O2.

I'm still not sure what a SleepyHead "clear airway" designation means when the breathing stops for 40 seconds. If the airway is clear, then what else can it be but central? SH did not indicate any central in that event.

I can't post these overall results because they are contaminated with many waking tests filled with simulated apneas and snoring to get the software to respond.

I'll see if I can get a clean set of real night data soon.

Tom
(This post was last modified: 08-15-2012 01:57 PM by Tommy C.)
08-15-2012 01:55 PM
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mjbearit Offline

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Post: #5
RE: Breathing Stops When First Falling Asleep
Tom, I get CA events every night, they compliment my OA events. A couple of CA events that last a short time are no more dangerous than a couple of OA event that last a short time. What matters is your oxygen saturation. if you are getting severe desat then you have issues. If you are having hundreds of CAs then you have issues. I got a lot more CAs while I was zeroing in on my pressure and now that I have my pressure set, over time they have settled down even more so that I get maybe 3-5 a night now and they don't last any significant period of time. Sounds to me like you may have had an event of some sort followed by a panic event! Smile It really sounds like you just need time to get used to the equipment and the new sleeping arrangements. Before you know it you will be wondering what all the hub-bub was about! Smile Once you are doing well on the equipment and sleeping well with it, then start worrying about CAs and OAs and such. Just take it one step at a time and learn to relax into the machine for now. You'll get there!

As always, YMMV! You do not have to agree or disagree, I am not a professional so my mental meanderings are simply recollections of things from my own life.

PRS1 - Auto - A-Flex x2 - 12.50 - 20 - Humid x2 - Swift FX
08-15-2012 02:12 PM
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Sleepster Offline
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Post: #6
RE: Breathing Stops When First Falling Asleep
(08-15-2012 01:55 PM)Tommy C Wrote:  I'm still not sure what a SleepyHead "clear airway" designation means when the breathing stops for 40 seconds.

It means that you stopped breathing for 40 seconds, but your airway was not obstructed. It's a clear-airway apnea, or CA. Sometimes referred to as a central apnea.

It's common for these to be induced by the CPAP therapy itself. The remedy is to lower the pressure. Is your APAP pressure range currently set to wide open, that is, 4 - 20?

What you'll want to do is see how high the pressure is when you have these CA events. If indeed they are always accompanied by a high pressure, you may want to discuss with your doctor the possibility of lowering the upper end of that pressure range. Sometimes APAP's will do this, they "run away" and set the pressure too high.

Wear the mask while you're awake, watching TV, reading or listening to music. Get used to it so you can sleep with it and get some data. Let us know how things go tonight.

Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
08-15-2012 03:19 PM
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Tommy C Offline

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Post: #7
RE: Breathing Stops When First Falling Asleep
(08-15-2012 03:19 PM)Sleepster Wrote:  It means that you stopped breathing for 40 seconds, but your airway was not obstructed. It's a clear-airway apnea, or CA. Sometimes referred to as a central apnea.

It's common for these to be induced by the CPAP therapy itself. The remedy is to lower the pressure. Is your APAP pressure range currently set to wide open, that is, 4 - 20?

Thanks for the info, Sleepster. Well, that's what I kinda thought.... central apnea since the airway was open. CA = Clear airway = cental apnea.

The S9 was set to 4-20 as per the doc's instructions. I got into the clinical settings and put the max at 16 for now. Anything more than 12 feels like my ears want to blow out.

When running normally when awake it averages around 4cm and peaks to 6 on the chart. When falling asleep, it is also about the same.

I had a thought - tell me what you think - I experimented and tried to simulate the worst OSA apneas I could. I snorted, snored, stopped breathing and choked. I was able to get the cm to rise up to about 15-16. But it took about 1.5 minutes to even get above 8. After a bad bout of simulated apneas, it settled down at about 11 for normal breathing. It starts out at 4 on each start up.

My concern is that let's say I have my first OSA apnea event when the cm is at 4 and it takes 15 to clear the airway. It would take a LONG time for the machine to ramp up there. Maybe I should start the range at a higher minimum.

I realize that for CA the lower the pressure the better, so 4 is a plus. This does not bode well for me if I DO have CA and I am getting CA at only a 4 cm setting, as happened last night.

I did notice that after the simulated apnea test, the machine stayed up at 11cm for a long time, even though I was breathing easily during my waking test. I guess the algorithm is a compromise for the average sleep apnea case.

Yes, I will try to get a full night's data. It may very well tell a different story once the body gets used to it and the data averages out over time.

MJ, OK on your short CA events. That's a good thang. Mine lasted 45-60 seconds during the sleep study and the O2 dropped to 83%, so I'm concerned to get it corrected. I even see a touch of CA when working during the day. I had the mask on for two hours while working at the desk and could see several CA instances on the charts when I concentrated on something.

BTW, a VPAP - does it actually create a NEGATIVE exhale pressure to make the lungs contract when needed for CA? That sounds like the only way it could work for me if needed...

Tom
(This post was last modified: 08-15-2012 03:47 PM by Tommy C.)
08-15-2012 03:42 PM
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
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Post: #8
RE: Breathing Stops When First Falling Asleep
What was the pressure during the long CA event that woke you up?

Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
08-15-2012 03:56 PM
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Tommy C Offline

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Post: #9
RE: Breathing Stops When First Falling Asleep
(08-15-2012 03:56 PM)Sleepster Wrote:  What was the pressure during the long CA event that woke you up?

During the whole CA event it was solid at about 4cm, peaking at about 4.2 according to the SleepyHead Mask Pressure chart. Basically noise.

That's what concerns me. I can't really I go lower for better CA treatment at this point, right?

The tidal volume dropped to zero during this time. Leaks were zero.

Looking at the overall lead-up to the CA event, I see the classic syndrome deep breathing, followed by progressively shallower breathing - repeating this pattern until the shallow turns in a full stop for 40 seconds. No obstructions, no OSA, for the entire 11 minutes.

T
(This post was last modified: 08-15-2012 04:36 PM by Tommy C.)
08-15-2012 04:35 PM
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
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CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

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Post: #10
RE: Breathing Stops When First Falling Asleep
(08-15-2012 04:35 PM)Tommy C Wrote:  During the whole CA event it was solid at about 4cm, peaking at about 4.2 according to the SleepyHead Mask Pressure chart. Basically noise.

Then it's not due to high pressure. Your machine should be left at the same 4-20 pressure range prescribed by the doctor. You need to try to get used to the mask by wearing it while you're awake.

I think your problem is anxiety. If you can't get used to sleeping with the mask tonight I'd advise you to make an appointment with your doctor and see if he can prescribe a sedative for you. Something that will get you over this hump.

Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
08-15-2012 05:13 PM
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