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CA started after using CPAP
#1
CA started after using CPAP
Hello. I did an at home sleep study about 5 months ago that indicated I have an AHI of 7.2. My apnea score was actually less than 1 overall, but I had several hypopneas per hour. I do realize that this is a pretty mild score, but I've been living with fatigue for years that has really ruined my life and so I hoped that using a CPAP would help. 

I just downloaded Oscar yesterday and realized that almost all of my events are now CA. I thought this was pretty strange because on my at home study it indicated like .2 CA or something really low. I seem to be averaging around 3 AHI with almost all of those coming from CA over the past couple of months. I've tried lowering my settings to the lowest I can go without bringing hypopneas back, but this seems to have no effect on my CA score. I do notice that my respiratory rate seems to fluctuate between 8 and 50 throughout the night, with an average of around 10.5. Again, I realize 3 AHI is still pretty low, but I still feel more tired than I should throughout the day and would like to resolve my issue as thoroughly as possible.

Does anyone have any insight regarding this?


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#2
RE: CA started after using CPAP
Welcome to the forum. Wow that must be an amazing monitor you have. Great resolution and size.

Have you heard of treatment-emergent CAs?
Instead of repeating the information... as a first step...take a look at the link in my sig.
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#3
RE: CA started after using CPAP
Welcome to the forum,

The nutshell version is that a home study is performed without a CPAP. This means that the use of CPAP has increased the efficiency of your breathing. Because your breathing efficiency has increased your body is doing a better job of removing CO2 from your blood. Sounds good but a 'high' level of CO2 is what provides the main drive to breathe. In fact the CO2 level has dropped below the apneic threshold causing a Central Apnea. These apneas are called Treatment-Emergent Central Apneas. Typically they go away in 2-3 months.

This can be validated by increasing your breathing efficiency even more and set EPR to Full Time with EPR=2. This should raise your CA index noticeably.

I'm sure that your respiration rate was nowhere near 50, instead, you had some ragged where your flow was bouncing around zero and zero crossings are counted incorrectly as a breath. Look at a 2-minute view during the high respiration rate, first adjust the vertical scale on flow rate to +/- 70 and expand thr vertical height of that graph.
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#4
RE: CA started after using CPAP
Ah, this makes so much sense now after reading the link on it. I've heard a little about treatment emergent CA, but from what I've read I thought it was very rare and might not describe my situation. I'll take the advice you've given and give it some time. Thank you!!
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#5
RE: CA started after using CPAP
Welcome to Apnea Board. Home sleep study or in the lab, if your CA was low like that and now it jumps while on CPAP, yes I certainly agree with bonjour. You don't have pre-existing CA like I do definitely. Your numbers would probably have been skewed similar to my 124 CA to 24 OA in that sleep study. You do not follow that pattern.

These CA events you have will start dropping off, as bonjour said in about 2-3 months. I think in about 1 month timeframe you'll see a reduced CA number.

Best to your success. Coffee
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