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[Diagnosis] 2 Weeks in Data - Thank you! and Questions
#1
First I wanted to thank everyone who replied to my 2 previous posts you have been really helpful in getting started and getting me used to using a pressure device forcing air down my throat! A little tongue and cheek but seriously thank you for the help!

Looking at the data for the past 2 weeks from my prs1 the machine has almost eliminated the OSA but the AHI is averaging around 7 to 10 most nights with a few nights below 5. The bulk of the events are "CA" Clear Airway events and Hypopnea events.

Wondering how accurate these machines are at detecting "CSA" or "CA" as the machine calls them. Per Philips website they are 95% accurate. (Looking for opinion and experience.)

Has any else experienced this? If so what was the solution?

My diagnosis from the split study was for severe OSA 58 per hour nothing about CSA.

I figure the answer is another sleep study with my machine but would love to hear the wisdom of the board.

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#2
Hi Apnea_GM,
Your body is probably still getting used to the machine. I think the CAs usually settle down over time as you get used to it.
Hang in there for more answers to your questions and best of luck to you with your CPAP therapy.
trish6hundred
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#3
You say the AHI is around 7 - 10. How does that break down? As in, how much of that is AI, HI, and CI?

It's probably just you, your body, and your brain adjusting to the air from the machine. Our brain tells our body when to breathe based on the CO2 content. We breathe in O2 and breathe out the CO2 in exchange. For some people, when they start using the CPAP, the air coming in confuses the brain. It can't figure out whether or not the body needs to breathe or not. So it doesn't. With time, the brain gets it figured out and it will all settle down.
PaulaO2
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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.




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#4
(01-23-2014, 01:44 AM)PaulaO2 Wrote: You say the AHI is around 7 - 10. How does that break down? As in, how much of that is AI, HI, and CI?

It's probably just you, your body, and your brain adjusting to the air from the machine. Our brain tells our body when to breathe based on the CO2 content. We breathe in O2 and breathe out the CO2 in exchange. For some people, when they start using the CPAP, the air coming in confuses the brain. It can't figure out whether or not the body needs to breathe or not. So it doesn't. With time, the brain gets it figured out and it will all settle down.

Eyeballing the data, pasted below should be close to an average night.

AHIApnea / Hypopnea Index 7.31
HypopneaHypopnea 2.69
ObstructiveObstructive Apnea 0.38
Clear AirwayClear Airway Apnea 4.23
RERAResp. Effort Related Arousal 0.19
VSnore2Vibratory Snore #2 0.19
PB/CSRPeriodic Breathing 1.53%

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#5
I'd agree with the comments above - a lot of people get centrals when they start on therapy and it usually resolves itself over time. You might also see centrals during the transition in and out of sleep, which are not usually a problem. However for some people, the centrals induced by the pressure don't resolve, and you then need to consider further consultations and possibly a more specialised machine.

I'd give it a couple of weeks and see if it settles down.

DeepBreathing
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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.
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#6
Howdy,

I am new to cpap too. I check my sleepyhead data every morning and love it. CA events as I understand it are when the machine sends a puff of air and gets nothing back. This could be many things like re-adjusting your mask or yawning, but can also be a central apnea! I think it's why sleepyhead calls it a clear airway event and not a central apnea because it "could" be many things.

Great thing about sleepyhead is you can zoom in and investigate each event in detail. It shows you your exhale and inhale wave form, typically a ca event will be 10 seconds or longer of not breathing, sleepyhead is very sensitive in marking events where under further investigation it was fine.

This video helped me a lot to interprete the sh data:

http://m.youtube.com/watch?v=bmhXkmeJDIM

I think the machines are very accurate, but it can't factor in everything (like knowing if you are actually sleeping or watching tv in bed). It's best to get a good average over time and try to bring your ahi down below 5 by experimenting and seeing what helps the ahi and what does not.





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#7
If you are actually asleep, the machine's accuracy is pretty good. But the machine cannot tell when you are awake and when you are asleep. And normal wake breathing is much more irregular than normal sleep breathing, and this in turn, can lead the machine to score false events if you are extremely restless during the night with lots and lots of wake periods. Some centrals while drifting off to sleep are also normal---and would not ordinarily be scored on an in-lab PSG, but they get scored by a PAP machine.

My advice: Watch the CAI for now. If it doesn't start to come down in the next couple of weeks AND you don't think you're lying in bed awake during the times the CAs are being scored, then it's time to call the sleep doc's office and let them know what the data is showing. The reason is simple: If you're still having an excess number of CAs after a month or so of PAPing, that's evidence that may point to you being in the unlucky 10% of PAPers who develop complex sleep apnea after being put on PAP. The solution to complex sleep apnea is usually a change of machine, but the ASV machines that are used to treat complex sleep apnea are significantly harder to adjust to; hence most docs want to wait for at least a month or two to see if the problem resolves itself rather than making a premature switch to a much more expensive machine. And for many (most) PAPers, the problem with CAs does resolve after a few weeks, and there's no real need for moving the patient to an ASV machine.
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