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[Treatment] Clear Airway Episodes Creeping Up
#1
Surprised 
Clear Airway Episodes Creeping Up
   
Not to be too alarmist, but as of recent weeks I've noticed the number of Clear Airway episodes (AKA Central Apnea events), as reported by SleepyHead, has been creeping up. Apneas and hypopneas have remained rather steady and my AHI is always well below 5. So why this gradual increase in central apnea events? Nothing to worry about, eh?
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#2
RE: Clear Airway Episodes Creeping Up
Are you noticing this as a trend? Or did you notice this one night and other nights don't have this pattern? I don't think I would freak out like the videos suggest :-)

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#3
RE: Clear Airway Episodes Creeping Up
Anything changed during the time period in question that could account for CA addition? IMO unless it's a long trend, it's probably only a flesh wound. Smile

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Clear Airway Episodes Creeping Up
Is it possible there may be a glitch with your machine? I noticed that a few of your reported CA events are less than 10 seconds - five 8's and two 9's - why are they being reported as "events" at all?
Coffee

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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. 
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#5
RE: Clear Airway Episodes Creeping Up
(03-25-2018, 08:04 PM)sonicboom Wrote: Is it possible there may be a glitch with your machine?  I noticed that a few of your reported CA events are less than 10 seconds - five 8's and two 9's -  why are they being reported as "events" at all?

Good point. I, too, was under the impression that events under 10 seconds "don't count." I had a quick look in SleepyHead under Preferences, but I didn't find where this parameter might be tweakable. Perhaps something in my machine, as you suggest? I did look at my data back over a couple of months, and SleepyHead does regularly indicate Clear Airway events shorter than 10 seconds, as well as Obstructive apneas and even the occasional Hypopnea shorter than 10 seconds. Perhaps while it indicates the latter two, its algorithm disregards events shorter than 10 seconds in calculating the AHI, in accordance with the classic definition. Dont-know

Still, it does appear to be a slight trend of sorts, with gradually increasing Clear Airway events over the past months, even when discarding the ones shorter than 10 seconds. Is my brain slowly but surreptitiously trying to rub me out by preventing my lungs from breathing while I'm fast asleep? Unsure crygreen Tongue
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#6
RE: Clear Airway Episodes Creeping Up
The other thing that stands out on the image you posted are that the CAs are all in the last 3 hours. It would be helpful to know if that is a pattern or are they usually more spread out during the night. If the former maybe just light sleep “wake junk”.
Coffee

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Never Give In, Never Give Up




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. 
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#7
RE: Clear Airway Episodes Creeping Up
(03-25-2018, 10:23 PM)sonicboom Wrote: The other thing that stands out on the image you posted are that the CAs are all in the last 3 hours.  It would be helpful to know if that is a pattern or are they usually more spread out during the night.  If the former maybe just light sleep “wake junk”.

Good eye, Thanks .

I went and looked back at previous data and though there's a general spread of CAs throughout the night, more often than not they tend to be in the second half of the night. I didn't know "sleep/wake/junk" could could be spread over a few hours, though; I thought it was more or less during however-long the snoozing process of waking up (or dozing process of falling asleep) takes. In my case I usually fall asleep within minutes of my head hitting the pillow, and I hardly ever snooze at all. Wake up, get up.
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#8
RE: Clear Airway Episodes Creeping Up
Sheepish,
What is your mean respiration rate? Mine is quite low sleepyhead chart shows my RR dropping from about 12 to less than 10 during periods of sleep/wake junk. It is no surprise to see clusters of short duration (all 10 - 15 second, never under 10 second) centrals scored during these periods. My sleep doc has told me that these are nothing to worry about. Unlike your results I believe almost all my reported centrals fall into this category. The number of theses centrals varies widely and seems to correlate with small adjustments I make to my fixed pressure (due to periods of sinus congestion) and switching the size of my nasal pillows.
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#9
RE: Clear Airway Episodes Creeping Up
Here's a screenshot of that same day (yesterday), with the respiratory rate. Eat-popcorn

[attachment=5100]
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#10
RE: Clear Airway Episodes Creeping Up
(03-25-2018, 09:23 AM)Sheepish Wrote: Not to be too alarmist, but as of recent weeks I've noticed the number of Clear Airway episodes (AKA Central Apnea events), as reported by SleepyHead, has been creeping up. Apneas and hypopneas have remained rather steady and my AHI is always well below 5. So why this gradual increase in central apnea events? Nothing to worry about, eh?

I am a newbie and while have been using a CPAP on trial for about a week now, I just looked at my first night of SleepyHead results. My trial machine does not talk to SleepyHead, so I borrowed my wife's S9 for a night. The results were a bit surprising to me and are not unlike yours. I was suprised by the number of CA events I was getting. My sleep test results showed an CA Index of 0.4. Now with the CPAP I am getting 1.5. The OA's of course have gone way down, but the CA's up. 

With some very quick research, I have found that this is not all that unusual with CA events. When OA events go down with a CPAP, CA events can go up. There is a condition which I have seen described as Complex Sleep Apnea Syndrome (CSAS) which seems to describe it quite well. However, I, nor you based on your just posted data, technically meet the diagnostic criterea as our CA Index is less than 5. But it sure sounds like what I have. There is a link at the bottom of this post to a very technical article on the issue. I have not slogged all the way through it yet, but I am hoping it will give some assistance in understanding and dealing with it. The first thought that has popped into my head is that I take a beta blocker blood pressure med, that slows your heart rate down, and it may be contributing to it. I use Bisoprolol, and Metaprolol is another common one from the same class. If I figure out anything more I will post back. Once I understand a bit more about it, I will start my own thread. Don't want to hijack yours. 

In any case I like your references about not worrying. My favourite is this one by Hans Solo from the original Star Wars:

Han Solo[flustered] Uh, had a slight weapons malfunction. But, uh, everything's perfectly all right now. We're fine. We're all fine here, now, thank you. How are you?"

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3945285/
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