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[Diagnosis] High CA breakdowns.. What should I do?
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hs8738 Offline

Members

Posts: 13
Joined: Feb 2016

Machine: Philips Dreamstation Auto CPAP
Mask Type: Nasal mask
Mask Make & Model: Wisp/Dreamwear
Humidifier: Philips Dreamstation
CPAP Pressure: 10
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #1
High CA breakdowns.. What should I do?
This is my 6th night on CPAP..
I do not feel I am getting better, although I have become acquainted to wearking masks in my sleep..

All 6 nights, there is a high CA (Clean Air) breakdown in my chart.

What change should I make to my setting?

My current setting is.

CPAP fixed 10 pressure
RAMP 20min (starting at 5)
EPR 2 (only during RAMP)
Humidity 7 (out of 8)

Thank you in advance for your support!
You guys rock! (more than my sleep doctor..:likeSmile
02-26-2016 12:29 AM
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hs8738 Offline

Members

Posts: 13
Joined: Feb 2016

Machine: Philips Dreamstation Auto CPAP
Mask Type: Nasal mask
Mask Make & Model: Wisp/Dreamwear
Humidifier: Philips Dreamstation
CPAP Pressure: 10
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #2
RE: High CA breakdowns.. What should I do?
FYI, Here is a capture of my Sleepyhead..
02-26-2016 01:43 AM
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eseedhouse Online

Advisory Members

Posts: 878
Joined: Dec 2014

Machine: ResMed Airsense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: SimPlus
Humidifier: ResMed
CPAP Pressure: 7-10
CPAP Software: SleepyHead

Other Comments: Also on supplemental O2 at 3L/min. while sleeping.

Sex: Male
Location: Victoria, British Columbia

Post: #3
RE: High CA breakdowns.. What should I do?
You have a leak problem, which you need to get fixed. Since you have a nasal mask I assume your mouth is opening, causing the leak. You need to fix this either by learning how to keep your mouth closed or possibly using a chin strap.

You AHI, while a bit high, is not too bad for the first week. Your fixed pressure might be a bit high because it seems to be controlling our OA's and Hypopneas well. Clear air apneas are fairly normal when you begin therapy and usually go down after a few weeks. But you might benefit from changing to a variable pressure which your machine can do - maybe run it from 8 to 12 and see if that helps.

Some people do do better on a fixed pressure, though. You might also try lowering that by a cm or so and see if the CA's fade away. Or you might want to wait a couple of weeks to see if they go away spontaneously as they often do.

For some reason your CA's aren't showing on your screenshots except on the pie chart, so we can't tell when they are starting or stopping. We need to see this plus your flow limitations and snores to make a proper judgement. On steady pressure the machine can't respond to these by seeing them might tell us what might be initiating your events.

Ed Seedhouse
VA7SDH

I am neither a Doctor, nor any other kind of medical professional.

Actually you know, it is what it isn't.
02-26-2016 05:58 PM
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OpalRose Offline

Monitors

Posts: 3,159
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #4
RE: High CA breakdowns.. What should I do?
(02-26-2016 01:43 AM)hs8738 Wrote:  FYI, Here is a capture of my Sleepyhead..


Hi hs8738,
It would be helpful if we could see the clear airways, snores, and flow limitations on the event graph.

To turn those on, go to the bottom of the sleepyhead screen, to the right, and you will see the Event Flags. Click on arrow, and choose the above to be included in your graph.

OpalRose
02-26-2016 06:12 PM
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hs8738 Offline

Members

Posts: 13
Joined: Feb 2016

Machine: Philips Dreamstation Auto CPAP
Mask Type: Nasal mask
Mask Make & Model: Wisp/Dreamwear
Humidifier: Philips Dreamstation
CPAP Pressure: 10
CPAP Software: Not using software

Other Comments:

Sex: Male
Location:

Post: #5
RE: High CA breakdowns.. What should I do?
Thank you both for your reply.

I did not know how to provide sleepyhead information on the forum.

I will get back to you with detailed info.

Thank you again.
(This post was last modified: 02-28-2016 01:04 AM by hs8738.)
02-28-2016 01:03 AM
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vsheline Offline

Advisory Members

Posts: 1,907
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #6
RE: High CA breakdowns.. What should I do?
Hi hs8738,

As eseedhouse noted, it is not unusual for new users to have central apneas and for the central apneas to mostly go away within the first weeks or months of treatment. Higher pressures often tend to make central apneas more frequent, so you might want to consider lowering the pressure slightly, like to 9.

A pressure of 10 was probably prescribed to prevent obstructive events when sleeping on your back, which is usually the worst sleep position for obstructive sleep apnea. If you can totally avoid sleeping on your back, you might not need the pressure to be as high as 10.

Your leaks were not so bad that the machine was unable to maintain treatment pressure, but when unintended leaks are greater than around 30 L/minute, the machine will not any longer be able to reliably distinguish between central apnea (CA) versus obstructive apnea (OA), and any apneas will be marked unknown type apnea (UA).

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 02-28-2016 02:08 AM by vsheline.)
02-28-2016 02:00 AM
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