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Sudden increase in Clear Airway apneas?
#1
Sudden increase in Clear Airway apneas?
So the last few days, while I'm awake, I've been having a feeling of shortness of breath. I just assume that it's anxiety, or maybe being out of shape, since I have both of those. When I went to check my data today after sleeping all night though, I discovered something weird. I have never had central apneas (other than one or two, here or there, over the entire night), but that I had a ton of them the previous night according to sleepyhead. I didn't sleep very well either and woke up a lot too. Can the machine read me being awake and breathing slowly or shallowy as having a central apnea. I have no idea otherwise why this would have happened. Pictures are below.

https://imgur.com/a/ehHwk


Not sure what is happening, or if my machine is glitching, as most central apneas look like that. Could that just be me being awake and breathing slowly, or something?
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#2
RE: Sudden increase in Clear Airway apneas?
If you find yourself short of breath while awake or other symptoms, I would get to ER/A&E. A sudden increase would mean a trip to the doctor to me. Something has changed. Yes, you ignore events while you are awake and only count while asleep in sleepyhead. In saying ignore, it's only little things, not shortness of breath etc.

you could repost sleepyhead with the side bar with all the stats, but i doubt it would change my thoughts to ring for medical advice and an appointment.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#3
RE: Sudden increase in Clear Airway apneas?
The machine has no way of detecting sleep vs awake.  If you are tossing and turning that can cause the CAs. Is this a one off or is it occurring most nights?


The onset of shortness of breath may indicate a number of issues that should be checked out by your Doctor.  My wife had something similar about a year ago.  Turned out her pulse was 26.  (Pacemaker before they would let her go home.)
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#4
RE: Sudden increase in Clear Airway apneas?
Shortness of breath is not something to take lightly, it could be as previously stated, an acute scenario and it could be brought on by certain medications.

You didn't mention how long you've been on CPAP and from your join date, I would speculate that you have recently started CPAP.  If so, it isn't unheard of to have CPAP induced central apnea, as the body is adjusting to constant flow of air 'washing out' the carbon dioxide.  You may find it helpful to reduce the EPR settings as low as you can tolerate (1 or 0) and see if that helps reduce the number of CA events.
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#5
RE: Sudden increase in Clear Airway apneas?
Back in December, you were struggling with extreme fatigue, and even ended up in the emergency room where nothing was diagnosed.  Your early results on APAP were done using low starting pressures and the last I recall was recommending that you use a minimum pressure of 6.0 and maximum of 10 with EPR set at 2.  Your tidal volume then was low, and that continues to be the case.  Here is last December, and obviously far fewer CA events.

[Image: b0eQTxE.png]

In your most recent results, we see that you really have not changed settings.  Your pressure starts low, and is quickly powered to 14 cm by flow limitations. Most of the rest of the night the pressure is near 10 cm. The large number of CA events is new.

[Image: DsE4huN.png]

You zoomed into the flow rate at about 16:00 and her we see an extremely low respiratory flow with frequent recovery spikes. This appears as persistent hypopnea, even though nothing is flagged.  It is not flagged as a hypopnea because the background flow is so persistently low that any reduction is seen as an apnea. 

I wanted to suggest getting EPR into your therapy to try and improve your respiratory volume a bit.  That may work, but the risk is that it makes CA worse.  At this point, I don't think you belong in an ER, but you should discuss this problem with your sleep specialist.  If you have any pulmonary issues (COPD, asthma)  or are significantly over-weight causing hypoventilation, you may need a different form of therapy.  It is very difficult to make a specific recommendation from the available information, but a doctor might have some ideas on using bilevel or bilevel PAP with a backup rate to improve your respiration and prevent apnea.  The last graph is an especially bad one.  We see persistent CA events interspersed with a single flow limited recovery breath.  The problem is much greater than the number of apnea being flagged. There are at least a dozen apena events here where only 3 are flagged. This may need professional attention from a sleep / pulmonary specialist. Please get an appointment soon if this persists through the weekend.


[Image: 0neT3uQ.png]

[Image: INRIYoQ.png]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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#6
RE: Sudden increase in Clear Airway apneas?
Thank you for all of your amazing replies, I really appreciate all the help you all are offering. The shortness of breath has resolved and I no longer feel as if I don't have enough air, and with that it seems like my central apneas are no longer there, it just seems like the machine went crazy for one day, or something, as there's nothing like that this time around. I will be making an appointment with a sleep specialist come monday, though, because I believe that something is not fully working with my therapy, as I do not feel any better. I am also very skinny and do not have any other known respiratory issues, so I am not even sure why I would have sleep apnea in the first place. I appreciate all of your help though more than I could ever type out. This has been a very hard period in my life.

Edit: Something I just noticed while looking over my data, is it possible to have "sleep apneas" while awake? I just put the mask on to try to go to sleep, and I have my ramp set to Auto, and it started blowing very hard almost immediately. I noticed the pressure was around 13.5, and that my SD card said the machine detected multiple obstructive sleep apneas (obstructive, not central, no central ones this time.) But I know for certain that I did not fall asleep. Is my machine possibly faulty? I also have a pulse oximeter I bought from walmart and checked my air over those 15 minutes I was laying down and noticed it stayed around 99% almost all of the time. I intend to talk about this with my sleep doctor, as I am making an appointment on monday, I was just wondering if it's possible to have "sleep apneas" while awake.
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#7
RE: Sudden increase in Clear Airway apneas?
yes everyone makes the machine go nuts with awake breathing. Also as you fall asleep, it's called sleep wake junk SWJ here, and can do the same thing.

seeing the major stuff is over, I would put my min pressure on 7 or 8, I think that will help a lot.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#8
RE: Sudden increase in Clear Airway apneas?
Though Sleeprider may be right I am a bit concerned about you being short of breath during the day.
I would get yourself checked out, I don't think you need to rush to A&E yet, but get your doctor to check out your heart and your lungs.
I am NOT a doctor.  I try to help, but do not take what I say as medical advice.


Every journey, however large or small starts with the first step.

Sleep-well
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