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Help ! Clear airway apnea 27.68
#1
Hi. I just received my bipap machine's data today and imported it on Sleepyhead. It looks bad. The AHI is 29.97 on the machine. Most of those are clear airway apneas, 27.68. What is a clear airway apnea? It sounds bad like not obstructive apnea. I think I should call my doctor. I had a headache this morning as usual. It felt as if the new machine (that I got yesterday) is not working but the respiratory therapist came by today and he measured the air pressure on the machine and it was correct at 12/07. But I could tell last night when I used it something wasn't right.

What do you all think?

Kimberly from HonoluluSleep-well
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#2
The people who are going to be able to help you are going to want to see the sleepyhead data (from my experience) so take a moment now and post the picture of it so they can help you faster.
If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
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#3
While you're waiting for someone that knows more than I (anyone actually) about bipap boxes, tell me how they measured the pressure, I mean did they use an actual instrument such as a water column or mechanical manometer?

Also describe better why you think it didn't seem right. Did you get any sleep...if so, how much/ Did most of the events occur in clusters while you were still awake or just after waking up? Anything else you can supply will help you get a faster opinion.

EDIT: And yeah, what Galactus said..
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#4
Hi. I have my Sleepyhead software open and I am trying to export graphs so I can upload the here. Should I save as a cvs file or what?
Kimberly from HonoluluSleep-well
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#5
(09-13-2014, 08:30 PM)kfujioka Wrote: Hi. I have my Sleepyhead software open and I am trying to export graphs so I can upload the here. Should I save as a cvs file or what?

You can just do a "print screen" of the data then using a site like http://www.tinypic.com just upload the image and copy the [img] [/img] link in your post so everyone can see it.
If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
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#6
(09-13-2014, 08:30 PM)kfujioka Wrote: Hi. I have my Sleepyhead software open and I am trying to export graphs so I can upload the here. Should I save as a cvs file or what?

Just give us a screen dump of the summary area (around the pie chart) and the graphs - events, pressure, leaks, flow rate and flow limitation.

Clear airway apneas are also called central apneas and are quite different from the more common obstructive apnea. Part of the brain is devoted to automatic muscle functions including breathing. Every few seconds the brain sends a message to the diaphragm and other muscles around the lungs saying "breathe now". In a central apnea either this message doesn't get generated or for some reason doesn't get through.

This can occur when people first go on PAP therapy as the brain is fooled by the increased oxygen levels / decreased CO2 in the blood. However it can also be a built-in feature of your particular physiology. The PAP machine has to be capable of detecting a clear airway apnea and distinguishing it from an obstructive, then giving your lungs an extra blast of air to get them breathing again. I suspect that a max pressure of 12 isn't high enough to give you the kick you need. I'm not familiar with your machine, but it should have a whole range of settings to get it doing what it's supposed to.

You may heard it said that your don't need to worry about central apneas - this is not true. They deprive your body of oxygen and interrupt your sleep just as much as obstructive apneas. You'll get some good advice hear, but I suggest you talk to yur doctor and get this reviewed sooner rather than later.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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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#7
(09-13-2014, 09:01 PM)DeepBreathing Wrote: The PAP machine has to be capable of detecting a clear airway apnea and distinguishing it from an obstructive, then giving your lungs an extra blast of air to get them breathing again. I suspect that a max pressure of 12 isn't high enough to give you the kick you need. I'm not familiar with your machine, but it should have a whole range of settings to get it doing what it's supposed to.

Hi DeepBreathing - kfujioka's machine does not have a backup respiration rate and is not an ASV machine. If operated in AutoB (Auto BiPAP) mode, the machine can slowly adjust EPAP to minimize obstructive events and can slowly vary Pressure Support to further lower Flow Limitation.

Hi kfujioka - What therapeutic mode is your machine set in?

The settings 12/7 in your profile seem like settings for BiPAP mode, which is the fixed BiPAP mode where IPAP (the pressure when inhaling) is always 12 and EPAP (the pressure when exhaling) is always 7. If you doctor or therapist has put the machine in fixed BiPAP mode, I do not suggest changing the therapy mode. They may have some good reason for doing so.

By the way, to update the settings in your profile, you can use the "My Profile" link members see at the top right of all forum pages.

How long have you been using the machine at these settings?

Lowering PS (Pressure Support, which is the difference between IPAP and EPAP) often tends to lower the number of CA events.

Also, lowering IPAP (preferably by lowering PS) often tends to lower the number of CA events.

Lowering EPAP tends to increase the number of obstructive events, so I do not suggest doing that.

I suggest you talk to your doctor or respiratory therapist about lowering PS, at least temporarily, until your body gets accustomed to breathing under pressure and the number of CA events decreases.

Take care,
--- Vaughn

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.
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#8
(09-13-2014, 07:09 PM)kfujioka Wrote: Hi. I just received my bipap machine's data today and imported it on Sleepyhead. It looks bad. The AHI is 29.97 on the machine. Most of those are clear airway apneas, 27.68. What is a clear airway apnea?

Apnea (you stopped breathing) with an airway that was not obstructed. This happens to new users fairly often. Tell your doctor about it. If it lasts for more than a week or two they may want to lower your pressure to something like 10/7. At least for a while until you adapt.
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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#9
Duration of events is also a factor in the degree of concern.
I get an occasional clear airway apnea flagged; but the duration is 10 to 12 seconds.

Still, at ~28 per hour, I would get the doctor involved. At least notified.

FYI folks: I use a digital manometer to check my machine pressure.
It measures in inches of water; the conversion is: multiply by 2.54
I usually can only catch the EPAP pressure as the display is still slewing during IPAP.
That's why an analog manometer -- even a u-tube with water in it is better.
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#10
(09-14-2014, 10:56 AM)justMongo Wrote: FYI folks: I use a digital manometer to check my machine pressure.
It measures in inches of water; the conversion is: multiply by 2.54
I usually can only catch the EPAP pressure as the display is still slewing during IPAP.
That's why an analog manometer -- even a u-tube with water in it is better.

Thanks for that, it confirms what I suspected, that the old U-tube wc is still alive and well (sometimes a little messy though). If you have the time to wait for a well calibrated digital instrument to make up its mind, it no doubt will give the most accurate reading with the highest degree of granularity.

I have a scope that would be great for this type of thing but I suspect a transducer might cost more than I could justify. My wc is close enough for government work.
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