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Difference between central and clear airway apnea
#11
(05-16-2016, 03:58 PM)eseedhouse Wrote:
(05-16-2016, 02:54 PM)palerider Wrote: > Difference between central and clear airway apnea

if you do a fair amount of searching on the net, you'll find that "clear airway" is a phrase that respironics coined for the condition of not breathing and not having your airway blocked.

everybody else in the industry calls that condition "central apnea".

Well I think that in this particular case it's Respironics that's right and "everybody else" is wrong. No machine that doesn't have electrodes pasted to your scalp can definitively say your apnea is "central", which means caused by the central nervous system and (IIRR) in particular your brain stem.
well, you're certainly entitled to your opinion... I'll stick with the common usage, because it causes less confusion. Smile

though I'll point out that the EEG isn't there to see whether you're trying to breath or not, (that's what the chest/abdomen bands are for) but rather simply to try and determine whether you're asleep, and look for signs of arousal...

"Central sleep apnea (CSA) occurs when the brain temporarily fails to signal the muscles responsible for controlling breathing."

since there's not really any definition of exactly what a central apena is, other than 'not trying to breath'... and it's not an obstructive apnea... *shrugs* and all 'apnea' is, is "temporary cessation of breathing, especially during sleep." so, technically you can have a central (no signals sent to breath) apnea (cessation of breathing) while awake. calling it something else just leads to confusion... as witnessed by all the people asking "what's the difference in a "clear airway" and "central" apneas?...
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#12
(05-16-2016, 03:58 PM)eseedhouse Wrote: So good medical practice is to not lable events "central" unless it is certain that they are.

That's a good point. Unfortunately, a lot of people who practice medicine for a living don't follow that convention. So, if you want to communicate effectively with them, you can either follow their practice or argue with them about it. Arguing over which convention is better is, as you know, is not a very productive way to engage someone. In fact, in many cases, it's downright counterproductive.

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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#13
I think that one needs to ask the following question: If you have stopped breathing (apnea) and your airway is clear, what could have caused the stoppage other than there being no signal to breathe? (If I am missing something here, please speak up) Ergo, a clear airway apnea would have to be a central apnea.

Best Regards,

PaytonA
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#14
(05-16-2016, 08:42 PM)PaytonA Wrote: I think that one needs to ask the following question: If you have stopped breathing (apnea) and your airway is clear, what could have caused the stoppage other than there being no signal to breathe? (If I am missing something here, please speak up) Ergo, a clear airway apnea would have to be a central apnea.
Yes, but ....

It's also possible for there to be no signal to breathe and then the airway collapses and so the machine classifies the apnea as an OA, when it would be classified as either a central apnea or a mixed apnea on an in-lab sleep test.

In other words, a machine scored CA is likely to be central in nature if it occurs when you are asleep.

But some real central apneas can be misclassified as OAs by the machine, particularly at higher pressures. It doesn't happen often, but it can happen often enough to be a problem for some people.

And real mixed apneas are very likely to be misclassified as OAs by CPAP machines.
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#15
(05-16-2016, 05:22 PM)Sleepster Wrote:
(05-16-2016, 03:58 PM)eseedhouse Wrote: So good medical practice is to not lable events "central" unless it is certain that they are.

That's a good point. Unfortunately, a lot of people who practice medicine for a living don't follow that convention. So, if you want to communicate effectively with them, you can either follow their practice or argue with them about it. Arguing over which convention is better is, as you know, is not a very productive way to engage someone. In fact, in many cases, it's downright counterproductive.

I suppose that may be true, but if so it does not say much in favour of Doctors. Medicine is not always practised by the rational, and when it isn't we need to keep our skeptical glasses clear.

Still, I prefer to take my chances with M.D.s practising Allopathic medicine than with Homeopaths or Naturopaths to name only two.

Ed Seedhouse
VA7SDH

The above is my opinion.  It is just possible that I may, occasionally, be mistaken.

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

Everything put together sooner or later falls apart.
Your brain is not the boss.
Our forefathers took drugs.
He's no fun he fell right over.
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#16
(05-16-2016, 09:30 PM)robysue Wrote: But some real central apneas can be misclassified as OAs by the machine, particularly at higher pressures. It doesn't happen often, but it can happen often enough to be a problem for some people.

And real mixed apneas are very likely to be misclassified as OAs by CPAP machines.

the time when I've seen this most definitely is when the pressure is too low.

I was helping a guy in iceland who's now on an asv, but before he got on that, he was playing around with settings, and set the minimum pressure lower than I recommended.

his long string of centrals turned into a long string of mixed centrals and obstructives... confused the heck out of him till I explained it.
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#17
Wasn't the subject clear airway versus central apnea?
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#18
(05-17-2016, 10:25 AM)PaytonA Wrote: Wasn't the subject clear airway versus central apnea?

Yeah, but that is boring and not worth arguing over Smile
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
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#19
(05-16-2016, 09:40 PM)eseedhouse Wrote: I suppose that may be true, but if so it does not say much in favour of Doctors.

People in all fields use jargon to communicate.


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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#20
(05-16-2016, 08:42 PM)PaytonA Wrote: I think that one needs to ask the following question: If you have stopped breathing (apnea) and your airway is clear, what could have caused the stoppage other than there being no signal to breathe?

Yes, I agree that if the airway is not obstructed then it's not an obstructive apnea. The problem is in the making of that determination. CPAP machines use pressure pulses in an attempt to determine if the airway is obstructed. The reason the determination is important is that you don't want an auto-adjusting machine to raise the pressure in response to a non-obstructive event.

Perhaps a more relevant question is this: What would cause an obstructive apnea to be classified as a central apnea? In a sleep study a chest belt is used to confirm that there's no effort to breathe so the determination is more reliable.

By the way, over 10 hours of sleep last night with a AHI of 0.0 reported on the machine, but 0.1 reported by SleepyHead. One central apnea that lasted 10 seconds. Closer examination of the data shows pressure increases in response to flow limitations, sometimes reaching the maximum, but apparently always successfully preventing obstructive events. Also, significant stretches of time at the minimum pressure with no obstructions or flow limitations. Seems I've got things successfully tweaked. Something I never could have done without SleepyHead and the knowledge gained in forums, especially this one.


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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