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Distinguishing Between "True" Centrals and SWJ
#1
Distinguishing Between "True" Centrals and SWJ
I've searched and can't seem to find definitive info on this question. I'm trying to determine whether the events my machine is reporting as CA/central apneas are actually centrals, or whether they're post-arousal events that are being recorded as centrals. 

I have two questions/requests:
  • Can anyone who definitely knows they have/had central apnea post a SH chart that shows what a central looks like on the relevant data points? I'd love to see flow rate, flow limit, and any other relevant screenshots.
  • Can someone take a look at these zoomed in screenshots from me to see if these look like true centrals or artifacts of being awake/rolling over/etc? And can you tell me what you're looking at that pointed you in that direction? In other words, regardless of whether they look like true centrals or sleep/wake junk, can you walk me through your thinking so I understand for myself what you saw in my charts? Thanks!  Big Grin
This is a random set of screenshots from the last few nights. All the recorded CAs look the same on the flow rate chart-- the small squiggly line before the flagged event. What does that tell us about the flow? If this were a true central, would it look like this? If not, what would a true central look like? 

[attachment=8462]


[attachment=8463]

[attachment=8464]
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#2
RE: Distinguishing Between "True" Centrals and SWJ
I know its not really the answer you are looking for, but unfortunately, everyone is different.
One easy to identify is sleep onset apnea (one of the only "ok" apneas to have).  When you begin your night, you can watch your transition for active breathing to sleep breathing; in the center, you will see the breathing change pretty noisily as you transition.  I notice apneas here from time to time, more so when I am stressed/anxious.  Now, I will see this same kind of pattern if I wake up and go back to sleep (the joys of a 5 year old, no?)
   


I also do notice one other readily false apnea, as you asked about, the roll over.  I have discovered mine seem to have a pretty defined batter, where I will take a larger inhale, then hold my breath (confirmed by somebody watching me).
   

Now, the micro squiggles you see when the breathing stops, is your machine pulsing trying to see if there is an obstruction or if it is clear(central). Looking at your charts, its hard for me to tell for sure, but I would argue that some of that could be SWJ.
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#3
RE: Distinguishing Between "True" Centrals and SWJ
(09-25-2018, 06:49 PM)Madcat207 Wrote: I know its not really the answer you are looking for, but unfortunately, everyone is different.
One easy to identify is sleep onset apnea (one of the only "ok" apneas to have).  When you begin your night, you can watch your transition for active breathing to sleep breathing; in the center, you will see the breathing change pretty noisily as you transition.  I notice apneas here from time to time, more so when I am stressed/anxious.  Now, I will see this same kind of pattern if I wake up and go back to sleep (the joys of a 5 year old, no?)



I also do notice one other readily false apnea, as you asked about, the roll over.  I have discovered mine seem to have a pretty defined batter, where I will take a larger inhale, then hold my breath (confirmed by somebody watching me).


Now, the micro squiggles you see when the breathing stops, is your machine pulsing trying to see if there is an obstruction or if it is clear(central). Looking at your charts, its hard for me to tell for sure, but I would argue that some of that could be SWJ.


Thanks, that's all helpful. I'm finding this all quite difficult to wrap my head around. I have a different thread with info about my situation, and I wanted to keep this thread purely about the charts and not about my specifics. If you're feeling up for a read, check it out!  Big Grin
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#4
RE: Distinguishing Between "True" Centrals and SWJ
eyeheartny,
I am now almost three years into my apnea experience. From the beginning I soon realized virtually all my central events were not true central apneas. I initially kept a detailed sleep log and soon recognized that almost all my "central" events occurred during periods that I was trying to get back to sleep after an arousal (sleep/wake junk). I was able to note times I was awakened and estimate the time needed to get back to sleep and this correlated with clusters of central apneas. Also almost all these events had a duration of 10 - 13 seconds, just over the arbitrary 10 second threshold. After 6 months a second sleep clinic study on a BiPAP machine pretty much confirmed my suspicions with the Doc simply saying I wasn't asleep thus no sleep apnea when on the machine. I did however have many times when the time between breaths was more than 10 seconds, but pulse oximetry results were ok.

That being said my graphs did not look like yours. My clear-air events were usually scored late in my sleep (only after 4 hours) and usually appeared in groups (clusters) and my respiration showed a dip (from above 12 to less than 10).
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#5
RE: Distinguishing Between "True" Centrals and SWJ
If you look at some of the links at the bottom you'll see charts with centrals. Also you can do a search at the top of the page. There's tons of charts with centrals on them and discussions about them. I'd post a chart myself but I don't have central events.
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#6
RE: Distinguishing Between "True" Centrals and SWJ
I mentally discount any events that occur in the beginning of a sleep session. I don't get many of those and usually attribute them to rolling over. usually I'm awake when rolling over (awakened by apnea, disordered breathing or periodic limb movements I believe) and I've learned most of the time to make the effort to breathe through the change of position to avoid those potential false flags. otherwise I do not get SWJ because I'm either asleep or awake and when awake for more than about a minute or two, I stop the machine until I feel ready to go back to sleep. these gaps in sleep may be 2 minutes or up to about an hour and a half. as a rule I fall back to sleep within a minute or two or else I stop the machine again. while there's some justification for leaving machine on while awake in order to 'train' ourselves to wake less often, in the absence of a clear understanding of why I frequently wake up and because of the frequency and duration of my wakeful periods, I believe my method returns more accurate sleep data unadulterated and undiluted by wakefulness. I might feel and do differently if I didn't come fully awake least 6+ times per night but given my typical sleep efficiency of 75% (25% awake time) this works best for me. I honestly see no reason to lie awake for more than a few minutes and sleep hygiene proponents tell us to get out of bed rather than do so. my approach might not suit your situation but it's one way to avoid SWJ.
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