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Many Clear Airways when falling asleep. Sleep wake Junk?
#1
Many Clear Airways when falling asleep. Sleep wake Junk?
Hi,
I started on CPAP about three months ago. It seems to be working well for the most part, but I've noticed that I usually have quite a lot of clear airway events at the start of my sleep when I am first falling asleep. It sounds like this might be sleep wake junk, but it seems like I'm holding my breath quite a bit. Just curious if this looks like something I should be worried about. I've done searches, but haven't been able to find a similar situation. Any thoughts? Thanks!


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#2
RE: Many Clear Airways when falling asleep. Sleep wake Junk?
If this is just a one time thing, then I wouldn't worry about it.
It does look to be SWJ, being it occurred at the beginning of the night. Maybe you were trying to get comfortable, or holding your breath?

It bears watching if this occurs often.
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#3
RE: Many Clear Airways when falling asleep. Sleep wake Junk?
Sleep transition central apneas.

Often times people prone to them will have one or two each time they fall back to sleep but in some cases they appear in larger numbers. The pattern you are seeing is a central apnea, then large amplitude arousal breathing, this momentarily washes out CO2 so then you have another apnea. Seems like you are mostly prone to this when first falling asleep (if this is your typical night) which may be due to the light sleep stage or a bit of SWJ mixed in and trigger apneas as well.

You have some other centrals and hypopneas throughout the night and it appears you may have periodic breathing at times when apnea and hypopnea aren't present. If this is your average night then this would be indicative of being prone to central apnea which could be part of your original pre cpap breathing issue or it could be treatment emergent central apnea. How long have you been on CPAP? Do you have sleep study results you can post (post redacted version)?

Your current settings look decent, you could try EPR of 0 which may help reduce the CAs.
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#4
RE: Many Clear Airways when falling asleep. Sleep wake Junk?
Thanks for the feedback, this does seem to be a typical night for the most part. Sometimes it's a bit better with a bit less clear airways. I've been on CPAP for about 3 months now. I don't have the sleep study results, but I'll see if I can get them.

Thanks for the suggestion, I'll try EPR 0 and see if that helps!
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#5
RE: Many Clear Airways when falling asleep. Sleep wake Junk?
You might try setting the ramp feature for 30 minutes with the starting pressure equal to your minimum pressure. It’s my understanding no events will be recorded during this time and no adjustments to pressure will occur.
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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#6
RE: Many Clear Airways when falling asleep. Sleep wake Junk?
After using Brevida mask, I'm now sure that pillows arn't for me. I've had a night with a cluster of centrals starting out like yours, and my CA went up. Centrals do not come up nearly as much as when I wear nasal, but also I seem to wake more with pillows (during when many centrals shows up).

When I wear a nasal mask like Resperonics Wisp, DreamWisp, or ResMed N20, I do not have such severe level of arousals throughout the night. I recommend giving nasal mask a try if you haven't done so yet.

My number of central isn't as high as yours. With a good nasal mask, it's usually less than .5, but with other mask, it varies in a wider range up to 2. The range of inconsistencies has reduced with a particular type of mask.
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