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Clear Airway on Sleepyhead Software (info needed)
#1
Question 
Hi:

Wondering if anyone has information on the Clear Airway number
shown in Sleepyhead Software? and any info on how to reduce that number
so the AHI number can be lower?

Also does anyone have information of what the various numbers mean
for all the variables in Sleepyhead software and what is condered to be good numbers for each variable? Examples: Clear Airway, RERA Index, Tidal Volume, Minute Vent, VSnore, CSR, etc....

Thanks!

Jake
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#2
Can't help you on the numbers for the other things but may have some advice for the clear airway.

There's a lot of debate as to if clear airway is a central event or just you pausing in your dream. Clear airway means the machine detected you stopped breathing. It sends a pulse of air and then, through magical means (sarcasm), it can tell if your throat is closed or open. If open, it considers it a clear airway event.

Either way, clear airway events should be treated as if they are central just because it is safer to assume the worse and hope for the best. They count toward your total AHI and that total should remain below 5.

AHI is the apnea count (central or obstructive events lasting longer than 10 sec) and the hypopnea count (shallow breathing) added together then divided by the number of hours of use. So 40 total events over an 8hr night would give you an AHI of 5.

If your clear airway events are rising or are more numerous than the obstructive events, it is time to see your doctor. Central events can indicate there's something serious going on.
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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#3
The AHI is the sum of the OA, CA, and hypopnea indices. Were you diagnosed with simple OSA, or do you also have central apnea? For how long have you been collecting data? If you have simple OSA and you've been collecting for at least two or three weeks and your AHI is dominated by CA's then you might want to try lowering the pressure a bit to see if it lowers your AHI.

Look for clusters of CA's and see if they are accompanied by high pressure. Sometimes the APAP sets the pressure too high so you have to set the upper pressure limit (yours is 17) to a lower number. Sometimes the APAP algorithm just doesn't work and you have to put the machine in CPAP mode. The problem, though, is that if you lower the pressure it may increase your OA index, which is not good, either.

This is something you should discuss with your doctor and your equipment provider before you consider changing the pressure on your own.

The other thing you want to pay attention to is your leak rate. Part of the leak is the unintentional leak. You want to keep that below about 35 L/min because if it's too high the machine can't maintain the pressure needed to keep your airway from collapsing. Which is the whole point of CPAP therapy.

If your leaks are too high you should try wearing a chin strap to see if it cures the problem. You may have to switch to a different mask or adjust the mask you have. Discuss with your equipment (DME) provider.

The AHI reported by the machine is an unreliable number if your leaks are too high. You have to get the leaks under control first before you you worry about anything else.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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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#4
Sometimes CA's occurr during CPAP while you are still awake, before falling asleep or after you awaken. These recorded CA's are of no significance when they only occur at those times. I believe it has to do with our being awake and being conscious of that we are breathing in an unnatural way, as we breath out with more effor againsta pressure. As a result, we then tend to hyperventillate for a while, and then follow that with rest by pausing our breathing. If the pause is for 10 second, the machine records a CA. In most cases, it isn't a true CA, since it is doubtful there would be a drop in your oxygen saturation of any significance during wakefullness during those few seconds that you choose not to breath.

So if you are having a lot of CA's, try to remember if you struggled to fall asleep and whether the CA's occurred early during the time before sleep. Look for CA's in the morning, too, when you know you are just laying in bed hoping you might fall back asleep again. If those are the only times you have these CA's, you can subtract these machine events from the more real OS and hypopneic events to figure out a more meaningful AHI.
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#5
The event definitions can be found in the manual...The manual is available via Email (scroll down to section three)
http://www.apneaboard.com/adjust-cpap-pr...tup-manual




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#6
Thumbsup 
[quote='Sleepster' pid='17711' dateline='1346345643']
The AHI is the sum of the OA, CA, and hypopnea indices. Were you diagnosed with simple OSA, or do you also have central apnea? For how long have you been collecting data? If you have simple OSA and you've been collecting for at least two or three weeks and your AHI is dominated by CA's then you might want to try lowering the pressure a bit to see if it lowers your AHI.quote]

Thanks to everyone for the information. I did extensive research on the Respironics website this weekend and used a combination of lowering my minimum Auto pressure from 12 to 10 and changing my white fine air filter and black sponge filters. Respironics recommends changing the white filters every 2 weeks to 30 days max. The result, my AHI dropped from an average of 11 down to 3.26 last night. Granted, that is just one night but it looks promising.

Current settings:
Respironics System One Remstar Auto with A-flex.
Resmed Activa Lt nasal mask with Softgel cushion.
Pressure settings Min=10 Max=17
Mode APAP A-Flex setting-3 Resistance=0
Heated Humidification setting 4
Results:
AHI: 3.26 RERA: 3.00
Hypoapnea: 0.52 Flow Limit: 0.26
Obst. Apnea 0.91 Vsnore: 0.39
Clear Airway 1.83 PB/CSR: 0.00%



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#7
"AHI dropped from an average of 11 down to 3.26 last night"

That sounds great & I hope it stays that way for you.

There is so much to learn & I have found that we aren't going to learn much from the sleep Doctor's or DME's because they would have a lot less revenue if we were not in the dark.

I have found much more help here but

My sleep Doctor does not say much & only gives 1 word answers mostly No! but he hast left so hopefully the new one is better.

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