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Duration of Clear Airway Events
#1
Duration of Clear Airway Events
Hello,

I've recently been diagnosed with mild sleep apnea.  I've been provided with a Philips Dreamstation machine set in APAP mode.  The minimum pressure is set to 5 and the max to 20.  The highest it's actually gone so far is 9.5.  My 90% score after 5 nights is 7.  I downloaded Sleepyhead after 5 nights to look at my data and noticed that on some nights I'm getting a couple of Clear Airway Events each night.  I understand that this indicates possible central sleep apnea.  The data shows that these CA events have been 26 to 27 seconds long each.  They are all at least an hour apart in the middle of the night.  But the duration of the events seems like an awfully long time (at least to the new guy.)  I understand from reading several other threads that a) two CA events a night is a tiny number compared to what many people are dealing with, b) that it's possible to have false positives, especially when the duration is shorter, and c) that new PAP users can get these CA events for a period of time while they adjust to the therapy.  What I'm wondering is whether the duration of the CA events that I'm seeing is concerning, particularly from a heart health standpoint.  My sleep doc only told me that I have "mild sleep apnea with 10 events an hour."  Beyond that, I'm not sure what they saw during the sleep study (I've asked for the info but don't have it yet.)  

Thanks!
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#2
RE: Duration of Clear Airway Events
Clear airway events when beginning CPAP is quite common. Your machine does not treat them. So if you are having so few, there's nothing to be concerned about. Just keep an eye on them. Should they ever consistently go over a CI of 5 regularly, then it is time to consult with your sleep doc.

I think all of us have CA events here and there or even nightly. It's just part of the game.
PaulaO2


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#3
RE: Duration of Clear Airway Events
Is the duration normal too?
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#4
RE: Duration of Clear Airway Events
You should post some sleepyhead graphs, zoomed in on one of those CAs.
One thing to look for a a large breath just before and/or just after.

I know approaching 30 seconds sounds long; but many Obstructive Apneas are 30+ seconds.
Keep in mind that although these machines are good, they can misclassify an event as CA when in fact it's OA.
Have to look at flow limitation, hypopneas, and snoring just prior to the event.

I wouldn't worry about it; but let's drill down and see what we can discover.

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#5
RE: Duration of Clear Airway Events
One question, when you start, do you feel like you get enough air? some find 5cm a bit low and need 6 as a minimum.

I too wouldn't worry about CA at this stage, as they will probably settle down.
How are the OA and H? It will be interesting to see your sleepyhead chart.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap from machine data, or software. Set the min pressure at 'med' median pressure or 90% OR 2cm below 95% pressure. max pressure at 20cm for now. Forum will help you fine tune settings
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#6
RE: Duration of Clear Airway Events
The first three nights I started at 5, but the last couple of nights I've tried the ramp feature which starts at 4 for 20 minutes. It's so new to me that I didn't really think too much of it, but now that you mention it, I did notice that it seemed like I was pulling a bit hard to get air at first.  I'll go with 5 tonight and see if I'm getting the same thing.

I'll also post some SleepyHead graphs when I get home later.

Thanks!
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#7
RE: Duration of Clear Airway Events
Hi Unison,
WELCOME! to the forum.!
Good luck to you with CPAP therapy.
trish6hundred
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#8
RE: Duration of Clear Airway Events
Here's one example zoomed in.

http://imgur.com/a/PriOU

I had to add a couple spaces between http: and //imgur

Here's another

http://imgur.com/a/YctEz

Again, I had to add a couple spaces between http: and //imgur
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#9
RE: Duration of Clear Airway Events
In general it's looking good and you don't need to do anything, your doctor will be happy with under 5 AHI.

However, I would raise the minimum to 6.5 for the FL/H and the odd OA and see how it goes. (you may get away with 6, but since we are talking very low pressures you could even set 7, I doubt you will notice the difference and you can adjust as you go.) I think the rest of it is par for the course for a new and even an old user. A bit of messy breathing here and there.

Put the cpap on while you watch TV and breathe funny for a while. Hold your breath till it starts to feel uncomfortable, close your throat and not breathe for 10 seconds, open your throat without breathing for 10 seconds, have a few snores. Breathe fast and slow, shallow and deep. Then have a look at it in sleepyhead and scare yourself, it is going to be much worse than you are seeing now. Smile
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap from machine data, or software. Set the min pressure at 'med' median pressure or 90% OR 2cm below 95% pressure. max pressure at 20cm for now. Forum will help you fine tune settings
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#10
RE: Duration of Clear Airway Events
the CA events you zoomed in on did not result in distress based on flow - no large recovery, no hyperventilating before the event.  these are not an issue, just blips even that long.  I do think you were sleeping before the 6:39 event and was alerted.  In the 2:35 event I think you had transitioned to awake before and were awake after.  both could be classified as SWJ sleep wake junk - stuff that happens at transitional points.

he he.

have a good sleep!

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
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