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Central Apneas - common
#1
How common are central apnea's in a sleep study when a majority of the results are Obstructive or hypopnia?

I just posted another thread, but this was one of my main questions...

in my first study I showed 17 centrals and about 80 obstructive/hypopnia over the course of the evening. Are the centrals of concern? The results say obstructive apnea and nothing about central.

On the second with cpap, I had about 0 obstructvie and about 40 hypopnia but 11 centrals over the course of the night.

This scares me....uhhhhh

thanks

-JOE
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#2
If you are talking about the data your Philips machine collects, it is not to worry. Smile
I just checked some of the source documents on Onkor software.
The program is not able to collect data on actual centrals it really looks at clear airway apneas. (CA)
A formal sleep lab has all the equipment right there to detect and log central events when they occur.
A clear airway apnea means that your airway is open and not obstructed but you are not producing much airflow
from your lungs for *at least 10 seconds*
Your machine is not a ventilator so it just logs the event. Indeed it lacks the brute power needed to breathe for you.
Even though it might be blowing your brains out at times, it can't even blow up a balloon. But it can keep your airway tissues from collapsing. So...
If you can check the time series on that event and see how long the events are lasting then you might have some suspicion.
If the event lasts 15-30 seconds and only occurs a few times a night, it's most likely no big deal.
If it lasts a minute or more it may be of concern. (how long can you hold your breath?)
In order to detect a *true central event* more data is needed, oximetry and additional equipment to detect your chest expansion.
(are you straining to breathe? or not? Is oxygen saturation caving in to danger levels? or not?)

What can you do? If you have a logging pulse oximeter you can collect any desaturation events and see if they tie in with any long duration CA events. (30+ seconds or more)
Are these isolated events or in tight clusters one right after another.
Once you know these things you can THEN start to think about taking the data printouts to a Dr, or Pulmonary specialist.
The O2 is the biggie. No desats, no centrals. ok? Smile

Since you are just starting out therapy you are mostly going to see all kinds of stuff coming and going
and your poor body is wondering what in hell is going on.
Why are you sending all this pressurized air down here??
Smile

Do not fear, but be vigilent instead.

Cheers!


"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#3
Thanks for the reply....those were actually the results from the formal sleep study in the lab. I Should have never read the study!
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#4
Shastzi, I could not answer it better - I appoint you honorary doctor....
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#5
(03-21-2013, 01:29 PM)Shastzi Wrote: If you are talking about the data your Philips machine collects, it is not to worry. Smile
I just checked some of the source documents on Onkor software.
The program is not able to collect data on actual centrals it really looks at clear airway apneas. (CA)

I'm going to have to disagree with you on this.

If anything, the Philips Respironics and ResMed machines will under report central apneas. If it says "clear airway," it's almost certainly a true central apnea. The problem is that it will sometimes classify a true central apnea as an obstructive.

i.e. If anything, the true situation will be worse than reported.

The problem is that you can have a central apnea, even if your airway is not open.

However, even true central apneas aren't necessarily any more harmful than obstructive apneas. They're simply harder to eliminate.

Look at your apnea count, and look at the airflow waveform to see how long, and how total the apneas are.

Central apneas mostly indicate you can't simply increase pressure to reduce your apnea. If you have too many apneas, and too many of them are central, you may need some more sophisticated treatment such as bilevel, ASV, or at least very careful monitoring of pressure adjustments.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#6
(03-21-2013, 01:45 PM)wojowojo16 Wrote: Thanks for the reply....those were actually the results from the formal sleep study in the lab. I Should have never read the study!
Normally at the sleep study if obstructive apnea or hypopnea observed ... pressure is increased
If central apnea observed ... pressure is decreased
If central apnea/hypopnea persist ... retitration with asv is considered

What your sleep specialist recommend?
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#7
Think of it this way: you had 11 the entire night. The AHI is the apnea events (both central and obstructive) plus the hypopneas divided by the number of hours. So if you slept 8 hrs, the 11 events is an CI of just 1.4. Way good number.

Central events are common. You know about the bits of breathing because of your work. The oxygen and CO2 in our systems as we hold our breath is horribly out of balance. So a central event here and there is to be expected.

Keep using your machine, keep track of how you are doing, then evaluate after at least two weeks.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.




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#8
Another thing to do is get a pulse oximeter and see if you have significant blood O2 saturation drops during the flagged central events. If they are not disturbing your sleep, and your O2 saturation is not dropping below, say, 85%. No worries. If your O2 saturation is getting down to 70%, you might want to discuss this more with your doctor.

There are tons of threads and reviews on finger tip pulse oximeters on the forum. Look at them, they cost around $100 so its not a cheap decision. It is another piece of information for your treatment.

Good Luck!Sleep-well
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#9
On my phone so short answer but doctor said nothing about central sleep apnea, only obstructive. Only reason central came up is because of the events on my sleep study that I read.
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#10
Then don't worry about it. Seriously. Keep using your machine and observe the data. After time, you'll see trends.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.




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