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High "Clear Airway" events
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zzzzk Offline

Members

Posts: 19
Joined: Aug 2012

Machine: System One RemStar Auto with A-Flex (550P)
Mask Type: Full face mask
Mask Make & Model:
Humidifier: System One Remstar
CPAP Pressure: 8
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #1
High "Clear Airway" events
Hello,

I have a Philips Respironics System One 550P RemStar Auto with A-Flex. I have a full face mask. Do I have central sleep apnea, too? Here are my stats in sleepyhead last night:

AHI 14.88
Hypopnea 2.23
Obstructive Apnea 0.70
Clear Airway Apnea 11.95
Resp. Effort Related Arousal 0.70
Flow Limitation 0.00
Vibratory Snore 0.35
PB/CSRPeriodic Breathing 4.49%

Statistics
Channel Min Med 95% Max
PressurePressure (cmH20)
W-Avg: 9.71 9.50 9.80 11.00 11.50
Minute Vent.Minute Ventilation (L/min)
W-Avg: 9.33 0.12 8.62 19.50 36.91
Resp. RateRespiratory Rate (breaths/min)
W-Avg: 16.22 6.89 16.60 21.00 24.80
Total LeaksTotal Leak Rate (L/min)
W-Avg: 29.77 0.00 29.00 32.71 34.00
SnoreSnore (unknown)
W-Avg: 0.18 0.00 0.00 1.00 3.00
Insp TimeInspiratory Time (seconds)
W-Avg: 2.47 0.32 2.20 4.06 6.50
Exp TimeExpiratory Time (seconds)
W-Avg: 1.34 0.06 1.20 2.20 2.66
Tidal VolumeTidal Volume (ml)
W-Avg: 576.02 13.33 500.00 1200.00 2280.00

Machine Settings
Pr. ReliefPressure Relief A-Flex x2
HumidifierHumidifier Setting x5

Session Information
SessionID On Date Start End
CPAP Sessions
00000370PRS1 CPAP 1h, 50m, 23s 9/11/2012 02:09 03:59
00000371PRS1 CPAP 0h, 44m, 58s 9/11/2012 04:05 04:50
00000372PRS1 CPAP 2h, 53m, 20s 9/11/2012 04:53 07:46
00000373PRS1 CPAP 3h, 3m, 20s 9/11/2012 07:47 10:50

Pressure setting is auto; 9.5min and 15 max.

I was able to get my obstructive down, but now my clear airway keeps going up. Many people say don't worry so much about it, but when it is lower, along with hypopnea and obstructive being lower, I feel much better. Any suggestions? If I lower the pressure, my obstrutives go up.

I attached a pdf with more details.
.pdf  zzzzk01.pdf (Size: 171.65 KB / Downloads: 208)

Thank you.
09-11-2012 10:43 PM
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trish6hundred Offline

Advisory Members

Posts: 6,446
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #2
RE: High "Clear Airway" events
Hi zzzzk, First, WELCOME! to the forum.! I don't know the answer to your question but hang in there and someone will have suggestions to help you.

trish6hundred
09-11-2012 10:56 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #3
RE: High "Clear Airway" events
Does your sleep study reports mention anything about central apnea?
Whats makes you waking up? The machine don,t know if you were awake or asleep so we cannot tell for sure
I wouldn't worry if its only one night but if its a typical night than you need to show those charts to your doctor
09-12-2012 12:16 AM
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zzzzk Offline

Members

Posts: 19
Joined: Aug 2012

Machine: System One RemStar Auto with A-Flex (550P)
Mask Type: Full face mask
Mask Make & Model:
Humidifier: System One Remstar
CPAP Pressure: 8
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #4
RE: High "Clear Airway" events
(09-12-2012 12:16 AM)zonk Wrote:  Does your sleep study reports mention anything about central apnea?
Whats makes you waking up? The machine don,t know if you were awake or asleep so we cannot tell for sure
I wouldn't worry if its only one night but if its a typical night than you need to show those charts to your doctor

Hi zonk, the stats are basically the same over 2 months. Only 2 good nights, no idea why. I don't have insurance right now. The latest sleep study I had was about 8 years ago. Did they know about central, then? I don't remember them saying anything about central, then. Also, I don't know what is waking me up. Obstructions, back pain, not sure, both?

Thank you.
09-12-2012 12:34 AM
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Moriarty Offline

Advisory Members

Posts: 270
Joined: Jul 2012

Machine: Respironics REMStar 50 Series Auto
Mask Type: Nasal pillows
Mask Make & Model: Fisher & Pakel Pilairo Q
Humidifier: Respironics System One
CPAP Pressure: 8.5-20 (average 9.4)
CPAP Software: SleepyHead

Other Comments: Image above is my CPAP machine...

Sex: Male
Location: Toowoomba - Qld - Australia

Post: #5
RE: High "Clear Airway" events
Hi zzzzk

I have no special knowledge and can only speak from my experience but I have found a bit of a connection between the A-Flex / C-Flex / EPR and the reports of CA's. For me I notice that the CA's are more when I have A-Flex turned on - although not as high as your's.

I turned mine off.

Your mileage may vary
09-12-2012 06:14 AM
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Sleepster Offline
Wiki Editor
Moderators

Posts: 4,994
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #6
RE: High "Clear Airway" events
In your profile you list your CPAP pressure at 8, yet you have your APAP set at 9.5 to 15?

CPAP-induced CSA is a known effect. The usual cure is to lower the pressure and hope it doesn't raise the hypopnea or OA indices. Try setting the APAP range to 9.5 - 12 and see what happens to the three indices. You may need to lower it even further.

Have you discussed this with your doctor or DME?

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.
09-12-2012 08:14 AM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,065
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #7
RE: High "Clear Airway" events
When the events happen, look to see what the pressure was at those times.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
09-12-2012 11:13 AM
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zzzzk Offline

Members

Posts: 19
Joined: Aug 2012

Machine: System One RemStar Auto with A-Flex (550P)
Mask Type: Full face mask
Mask Make & Model:
Humidifier: System One Remstar
CPAP Pressure: 8
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #8
RE: High "Clear Airway" events
(09-12-2012 06:14 AM)Moriarty Wrote:  Hi zzzzk

I have no special knowledge and can only speak from my experience but I have found a bit of a connection between the A-Flex / C-Flex / EPR and the reports of CA's. For me I notice that the CA's are more when I have A-Flex turned on - although not as high as your's.

I turned mine off.

Your mileage may vary

Thank you Moriarty, I'll look into that...
(09-12-2012 08:14 AM)Sleepster Wrote:  In your profile you list your CPAP pressure at 8, yet you have your APAP set at 9.5 to 15?

CPAP-induced CSA is a known effect. The usual cure is to lower the pressure and hope it doesn't raise the hypopnea or OA indices. Try setting the APAP range to 9.5 - 12 and see what happens to the three indices. You may need to lower it even further.

Have you discussed this with your doctor or DME?

Hi Sleepster,

I am testing, that is why it's different in my profile. I can't lower it more because my OA's go up. Or maybe a few more OA's is better if it drops my CA's more?
(This post was last modified: 09-12-2012 12:50 PM by zzzzk.)
09-12-2012 12:49 PM
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zzzzk Offline

Members

Posts: 19
Joined: Aug 2012

Machine: System One RemStar Auto with A-Flex (550P)
Mask Type: Full face mask
Mask Make & Model:
Humidifier: System One Remstar
CPAP Pressure: 8
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #9
RE: High "Clear Airway" events
(09-12-2012 11:13 AM)PaulaO2 Wrote:  When the events happen, look to see what the pressure was at those times.

OK, thank you. Have you heard if taking naproxin or antihistimines can raise CA's?
09-12-2012 12:52 PM
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jdireton Offline

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Posts: 149
Joined: Feb 2012

Machine: Resmed S9 Elite
Mask Type: Nasal mask
Mask Make & Model: Resmed Mirage FX
Humidifier: Resmed H5i
CPAP Pressure: 12
CPAP Software: ResScan

Other Comments: ClimateLine Hose

Sex: Male
Location: Florida

Post: #10
RE: High "Clear Airway" events
Zzz,

Welcome!

Modern xPAP machines try to differentiate between Central and Obstructive events, but they can only guess. There are various methods, like Resmed's Forced Oscillation Technique (FOT). If you have an apnea event, the machine pulses the pressure. If the flow reacts in one way, it shows the throat is closed and you're having an obstructive event (obstructed airway). If the flow reacts in a different way, it shows that the throat is open and you're having a central event (clear aiway). It's just the best the machines can do. It's not 100% accurate. To really tell if you're having a central event, you've got to be hooked up to wires that monitor your brain, a chest ring to tell if you're actually trying to breath, etc. This is the fully instrumented sleep study.

Now an event is an event. Regardless if the machine is correct that it is OSA or CSA, they are very accurate in saying you've quite breathing for 10 seconds (or more). Your AHI is higher than optimal target (<5), so don't ignore this.

Many people have reported a correlation between higher pressures and machine reports of increased CSAs. I wouldn't ignore it, but I wouldn't take it as "fact."

You said you are currently without insurance, so you're in a tough spot. You've got Sleepyhead figured out. Read the forum Widi article on changing your pressures. If at that point you are comfortable, follow the guidelines and monitor the results. Never take one night as results, you should allow 7-14 days with each change to really see how the change is affecting you. Pay attention to both the high and low APAP pressures. Look at your 95% pressure and, general rule of thumb, about 2 cmH2O above that and about 4 cmH2O below that should get you in the right area. If you're bouncing against the high limit frequently, you may need to push it up. Just keep working at it.

All that said, if and when you can get to a doctor, take the graphs and information you've shown us. We're not professionals, just trying to help.

Sleep-well
09-12-2012 01:02 PM
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