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UNCLASSIFIED APNEA
#1
Gross 
Hi Folks, last nights data showed I had an unclassified apnea and it was a long one. I have seen many different types of situations with me but most of my OA's and Hypopneas have been about 12 seconds long and I also get an occasional central as well but again only about 10-12 seconds. last nights unclassified apnea lasted .40 seconds with a large recovery breath and me waking fully. At that point I took the mask off for the rest of the night, not sure why I didn't put it back on. How does one go about figuring out whether it was an OA or CA? If these long events happen more often I may need an ASV machine instead of an Autoset.
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#2
I would try fix the leak, if the numbers too high. Large can spring out any time and fool the machine
Usually obstructive apnea have flow limitation component, the Autoset increase pressure to deal with FL but not during an apnea event, it wait until the event is over and increase pressure if the events is obstructive (not central) providing the pressure haven't reached the maximum already. Also an apnea can occur out of the blue, without the usual signs of snoring and FL and no machine can prevent that


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#3
Yea, the pressure of the machine was at max set pressure and I had a large recovery breath after so I am not thinking it was a large leak.
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#4
(09-13-2015, 12:42 PM)Adoniscmj Wrote: Hi Folks, last nights data showed I had an unclassified apnea and it was a long one. I have seen many different types of situations with me but most of my OA's and Hypopneas have been about 12 seconds long and I also get an occasional central as well but again only about 10-12 seconds. last nights unclassified apnea lasted .40 seconds with a large recovery breath and me waking fully. At that point I took the mask off for the rest of the night, not sure why I didn't put it back on. How does one go about figuring out whether it was an OA or CA? If these long events happen more often I may need an ASV machine instead of an Autoset.

Recovery breaths are most often associated with obstructive events rather than central events.

If an apnea occurs when the unintended Leak is 30 Liter/minute or higher then the machine will not attempt to classify it as central or as obstructive and names it an unclassified apnea.

If the large Leak was fairly steady, then in the Flow waveform you should still be able to see the breathing pattern, the inhales and exhales. If these stop and the Flow waveform stays centered on the horizontal axis (not blown off the axis by varying large Leak) while the machine is scoring an apnea, then I think the machine probably has accurately scored the apnea. Perhaps the Leak was large enough that the pressure was lower than it should have been at the mask, and that may have allowed an obstructive apnea to occur.

I think lots of patients (most) will have an elevated number of obstructive apneas during large unintended Leak,especially if during REM sleep. The machine simply does not work as well when the unintentional Leak is larger than about 30.

We are supposed to keep unintended Leak below 24 L/m.




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#5
(09-14-2015, 01:00 AM)vsheline Wrote:
(09-13-2015, 12:42 PM)Adoniscmj Wrote: Hi Folks, last nights data showed I had an unclassified apnea and it was a long one. I have seen many different types of situations with me but most of my OA's and Hypopneas have been about 12 seconds long and I also get an occasional central as well but again only about 10-12 seconds. last nights unclassified apnea lasted .40 seconds with a large recovery breath and me waking fully. At that point I took the mask off for the rest of the night, not sure why I didn't put it back on. How does one go about figuring out whether it was an OA or CA? If these long events happen more often I may need an ASV machine instead of an Autoset.

Recovery breaths are most often associated with obstructive events rather than central events.

If an apnea occurs when the unintended Leak is 30 Liter/minute or higher then the machine will not attempt to classify it as central or as obstructive and names it an unclassified apnea.

If the large Leak was fairly steady, then in the Flow waveform you should still be able to see the breathing pattern, the inhales and exhales. If these stop and the Flow waveform stays centered on the horizontal axis (not blown off the axis by varying large Leak) while the machine is scoring an apnea, then I think the machine probably has accurately scored the apnea. Perhaps the Leak was large enough that the pressure was lower than it should have been at the mask, and that may have allowed an obstructive apnea to occur.

I think lots of patients (most) will have an elevated number of obstructive apneas during large unintended Leak,especially if during REM sleep. The machine simply does not work as well when the unintentional Leak is larger than about 30.

We are supposed to keep unintended Leak below 24 L/m.
Thank you I believe you are probably correct as there was a leak as well, however not sure how the leak happened because I had a great seal and no leak most of the night. I must have rolled over and dislogded the mask some. Then with out the full support of the machine I had a bad apnea, this was the longest I have recorded me having. If I am having apneas lasting as long as .40 seconds it just reminds me as to why I need to be on this machine all through the night.
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