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First Night on Therapy -- CA worries
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SleepyWabbit Offline

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Post: #21
RE: First Night on Therapy -- CA worries
(06-20-2015 06:23 AM)quiescence at last Wrote:  @SleepyWabbit - the machines score CA if they interpret the breathing pause to be non-obstructive, so probably caused by something else. The two phrases usually used in place of CA are "CLEAR airway" or "central apnea".

A CA generally is detected by forcing a small pulse of air down your upper airway, and scores if there is no resistance.

Thanks all, I meant "Clear Airway", not closed Airway. That's what I get for replying on my phone when I wake up a 4am instead of trying to go back to sleep. Not very sleep inducing.
06-20-2015 02:12 PM
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eseedhouse Offline

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Post: #22
RE: First Night on Therapy -- CA worries
(06-20-2015 03:07 AM)SleepyWabbit Wrote:  Question for the smart people here the OP in this thread refered to CAs as "Closed Airway". I thought CA'S were Central Apneas. Is this the same thing? I had a bunch of CA'S show up on my titration which were not on my untreated study which worried me initially. After reading different threads here I'm glad to know it's normal.

The "CA" machines report stands for "Clear Airway", not "Closed Airway" the latter is an obstructive apnea.

If you stop breathing but your airway is open, it is likely to be caused by your brain not telling your lungs to take a breath. But while this is likely, the common CPAP/APAP/XXPAP machines can't tell for sure. The only way to be sure a "Clear Airway" apnea event is a "Central Apnea" is to have electrodes on your skull reading your brainwaves.

So out of caution they report the only thing they can actually detect, which is that you had an apnea while your airway was not blocked. So the "CA" report means only "Clear Airway".

They detect this by sending short pulses into your airway and seeing if they are reflected back - if they are not then that means your airway is open and the pulses are absorbed in your lungs. If they are reflected it means your airway is closed and so your lungs can't absorb these pulses.

You can reasonably assume that a CA event while you were sleeping was some kind of "central" apnea, but the machines can't know that for sure, so they really have no business claiming that a clear airway event is a "central apnea".

Ed Seedhouse
VA7SDH

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

Actually you know, it is what it isn't.
06-20-2015 06:01 PM
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trish6hundred Offline

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Post: #23
RE: First Night on Therapy -- CA worries
Hi Andy,
If you are using EPR, you might try turning it off and see if your CAs go away.
EPR can cause this problem.

trish6hundred
06-20-2015 06:20 PM
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AndyB Offline

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Post: #24
RE: First Night on Therapy -- CA worries
Here is my SleepyHead report from last night, for what it's worth. This was my eighth night of therapy, but my first using a full face mask (F&P Simplus). The mask greatly reduced my large leaks and my overall leak rate, so from that perspective the switch was a success.

Unfortunately, my AHI rate increased to 10.48, of which 6.98 were CA events. Oddly, my OA, Hypopnea and RERA events were higher than on any of the preceding 7 nights. I'm mystified, but I'm also starting to understand that getting used to CPAP therapy may take longer than I had hoped at the outset.

I appreciate the EPR reduction suggestions -- the technician who did my sleep study used an EPR of 2cmH2O, so that's what my doctor prescribed and the DME set on my CPAP. I'm going to turn EPR off tonight to see what effect, if any, that has.

Continued thanks to all,
Andy

[attachment=1549]
(This post was last modified: 06-20-2015 06:57 PM by AndyB.)
06-20-2015 06:56 PM
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AndyB Offline

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Post: #25
RE: First Night on Therapy -- CA worries
Here's my SleepyHead overview for the 8 nights I've been on CPAP therapy (my last image used up my allocation for forum attachments, so I am posting a Screencast link instead):

http://screencast.com/t/d7d3c8GEwX6
06-20-2015 07:07 PM
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DariaVader Offline
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Post: #26
RE: First Night on Therapy -- CA worries
fwiw - i looked at one or two of my (rare) CA events, and the flow limitation leading up to it looked exactly like an OA, except the machine didnt detect obstruction anymore when it checked and scored it as a CA. None of the events I have had while on treatment is longer than 10 to 15 sec, tho.

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
06-20-2015 07:24 PM
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SleepyWabbit Offline

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Post: #27
RE: First Night on Therapy -- CA worries
(06-20-2015 06:01 PM)eseedhouse Wrote:  The "CA" machines report stands for "Clear Airway", not "Closed Airway" the latter is an obstructive apnea.

Thanks, got that from the above posts. Smile
I would have edited mine, but I guess we can only edit for a short amount of time on this board. Probably for the better.

Quote:So out of caution they report the only thing they can actually detect, which is that you had an apnea while your airway was not blocked. So the "CA" report means only "Clear Airway".

That makes a lot of sense. Good explanation!
Thanks
06-20-2015 07:30 PM
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AlanE Offline

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Post: #28
RE: First Night on Therapy -- CA worries
(06-20-2015 07:24 PM)DariaVader Wrote:  fwiw - i looked at one or two of my (rare) CA events, and the flow limitation leading up to it looked exactly like an OA, except the machine didnt detect obstruction anymore when it checked and scored it as a CA.

Looking over some of my flagged CA and OA for last night, I also found some where some waveforms look identical. Pretty much flat line with the oscillations. I can only guess that in those instances when it flagged it as a CA that maybe the airway opened at the end (stopped being an OA) for just enough time for it to reclassify it?

Here is a snapshot of the events from last night.
[Image: TripleCA.PNG]
[Image: TripleOA.PNG]

Dont-know


Sorry Andy, not trying to hijack your thread. Your graphs from the 19th are very busy. If it were me, I would raise my Max pressure a bit. There is some risk that CA will worsen but to me it looks like you are spending 50% of your time close to max.



Using FlashAir W-03 SD card in machine. Access through wifi with FlashPAP or Sleep Master utilities.

I wanted to learn Binary so I enrolled in Binary 101. I seemed to have missed the first four courses. Big Grinnie
(This post was last modified: 06-21-2015 05:53 AM by AlanE.)
06-21-2015 05:41 AM
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AlanE Offline

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Post: #29
RE: First Night on Therapy -- CA worries
(06-20-2015 07:07 PM)AndyB Wrote:  Here's my SleepyHead overview for the 8 nights I've been on CPAP therapy

Good job on getting the leak controlled. At least on the 19th. Leaks are going to effect your results.



Using FlashAir W-03 SD card in machine. Access through wifi with FlashPAP or Sleep Master utilities.

I wanted to learn Binary so I enrolled in Binary 101. I seemed to have missed the first four courses. Big Grinnie
06-21-2015 05:52 AM
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quiescence at last Offline

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Post: #30
RE: First Night on Therapy -- CA worries
Andy,

While you are getting a high percentage and a high count of CAs, your machine is also obviously adjusting pressure upward for some other reason - it would not increase pressure when a CA appears. Top contenders for having pressure adjustment are flow limitations, and snores. As Alan points out, your machine gets you to your upper limit many times and sort of stays up there, evidence that these other occurrences continue at that pressure.

Since you had clusters of CA at lower pressures and at upper pressures, you are probably just adjusting to the treatment. The sleep respiration feedback loop can initially get confused by the excess oxygen the lungs are getting.

I would think reducing the EPR setting to 0 or 1 would help, so we await the results from your adjustments.

QAL


[updated - ps: you might try assigning user flags like Mark did in this thread: http://www.apneaboard.com/forums/Thread-...s-the-bomb to show some of those things that are causing the climbing pressure.]

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.
(This post was last modified: 06-21-2015 11:49 AM by quiescence at last.)
06-21-2015 10:14 AM
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