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How many CA's are acceptable
#1
How many CA's are acceptable
[attachment=12137]This seems to be my new normal. I have virtually eliminated all Obstructive apneas, and reduced my Hypopneas and RERA's to almost nothing. I am feel I am getting enough sleep even though I do wake up 3 or 4 times a night. I don't get up or remove the mask, just wake up. 

What I have learned from this forum is that CA's tend to disappear (unless there is other problems). 
Having said that, I am aware of wake/asleep junk, positional clusters and pressure related CA's. I feel that my CA's might fall in this category, however, I still wonder. 

How many CA's can be considered normal and not correctable?
CPAP is a journey like “The Wizard of Oz”. It’s a long slow journey. You will face many problems and pick up many friends along the way. Just because you reach the poppies, it doesn’t mean you are in Kansas. 
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#2
RE: How many CA's are acceptable
if you've been using cpap since 2016 as your profile suggests, centrals are not likely to be treatment induced. any and all events are concerning to me in my treatment, at least until I am confident I am no longer feeling the ill effects of apnea, but I suspect the system would say if your central apnea index is 5+, it should raise an eyebrow. looks like yours are nothing to worry about. watch for a while to see if they get worse.
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#3
RE: How many CA's are acceptable
Honestly, it will vary.  

Medicare gives this:

  • Titrate to minimize OSA, that is the obstructive AHI to less than 5 per hour. This typically is raising EPAP or pressure until obstructive AHI is less than 5 per hour, we expect this to make the Central and Complex Apnea worse thus failing the current treatment

  • Record the central apnea-central hypopnea index (CAHI) (looking for greater than or equal to 5 per hour and greater than 50% of total AHI)
Different people respond differently, what are the associated desats (not measured by your CPAP machine, how sensitive you are.
The goal is to either optimize your therapy with your current machine (balance your Obstructive apnea with your central apnea in a manner that best optimizes your therapy) or to qualify you to get a machine that manages central apnea (ASV).

That said we always watch central events but typically ignore values 2 and under CAI.
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#4
RE: How many CA's are acceptable
I sometimes end up with a higher CA event rate of 2.5, and the next day it will be 0.5. Sometimes I'm not even aware that a night was higher than normal for events. I think if your AHI is under 3.0 it's fine. If you mange to keep it under 1, that's impressive. Everyone's a little different, and all we can do is try to solve any problems, especially with obstructive events. Don't worry about the abnormal night that has higher than usual events, focus on the normal night that you sleep better.
Sleeprider
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www.ApneaBoard.com

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