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Waking up with headaches, have S9 data
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zonk Offline

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Post: #11
RE: Waking up with headaches, have S9 data
(10-16-2012 04:28 PM)bryank1 Wrote:  I seem to have several clear airway (central) apneas usually patterned together. When would it be appropriate to use a bi-pap instead of apap?
bi-pap don,t correct central apnea
for some it might help if needing high pressure to splint the airways open or having problem exhaling against high pressure
the machine cannot tell if you,re awake or asleep
the machine cannot guarantee accuracy of the data if unintentional leak above the acceptable threshold 24L/min
finding the right mask is the key to successful PAP therapy
few of us fortunate enough finding the right mask at first try ... others have to try several masks before find the right one
the best mask is the one works best for YOU
10-16-2012 05:15 PM
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bryank1 Offline

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Post: #12
RE: Waking up with headaches, have S9 data
(10-16-2012 04:44 PM)PaulaO2 Wrote:  BiPAP is not for central apnea. BiPAP (or bilevel PAP) can have an inhale and exhale pressure difference of more than 3 points.

Central events are common when first starting therapy. I'm too lazy today to go back and see how long you have been using the APAP.

However, clear airway events and central events are not necessarily the same thing. This is a topic of much discussion here and elsewhere. Some people say they are, some people say they are not.

If these clear airway events continue or worsen, you really need to discuss this with your doc. But, if you are just starting, my bet is that they will slowly subside, especially if none were seen during the sleep study.

I am confused, as I got this info from the respiratory clinician at ResMed. She said the clear airway events are central apneas. In that case they recommend a Vpap(their branded name) or industry name bi-pap. Thanks for the post, just trying to understand.
10-16-2012 10:19 PM
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PaulaO2 Offline
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Post: #13
RE: Waking up with headaches, have S9 data
The machines are fairly accurate but they are still just machines. It can tell if you are having an obstructive event, yes. But a 'clear airway' event means the machine knows you aren't breathing but can't detect an obstruction (hence the clear airway part). It doesn't know if you woke up and are thinking of something. Or if you are having a bad dream. Or if you are yawning.

Bilevel CPAPs are for those who have difficulty breathing out against the pressure. Normal PAPs can variable in the exhale relief by 1-3 points. A bilevel PAP, however, can go more than that.

BiPAP is Respironics brand name for their bilevel machines but it has become so common place just like Xerox is for copiers.

A bilevel machine, whatever the name, is not generally for those with central sleep apnea. But if none showed up in your sleep test, I'd not be worrying about it just yet. Some people can use a bilevel PAP to treat their central apnea IF the CSA is related to hypoventilation.
http://emedicine.medscape.com/article/304967-treatment

Central apnea is treated with a machine that continually changes the pressure in order to trick the mind into continuing breathing. From what I understand, they are a PITA to adjust to. Resmed's device is called the ASV which is derived from Adaptive servo ventilation.

To help with the alphabet soup of all this:
http://www.apneaboard.com/wiki/index.php?title=Acronyms

PaulaO2
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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. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-16-2012 11:23 PM
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Denial Dave Offline

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Post: #14
RE: Waking up with headaches, have S9 data
I have a tendency to hold my breath when rolling over during sleep. which the machine then thinks is a clear airway obstruction

Plus with a deviated septum or when I have post nasal drip, I'll stop breathing slightly as I try to inhale & clear my sinus's.

none of which are Central's
10-17-2012 05:25 AM
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PaulaO2 Offline
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Post: #15
RE: Waking up with headaches, have S9 data
Yes, if you hold your breath for more than ten seconds and do it by simply holding it vs moving your tongue to block it, the machine will register a 'clear airway event'.

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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. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-17-2012 11:15 AM
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Sleepster Offline
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Post: #16
RE: Waking up with headaches, have S9 data
(10-16-2012 04:28 PM)bryank1 Wrote:  Headaches have subsides (not gone entirely)

That's good. Experiment with different pain relievers, and drink plenty of water.

Quote:The sleepyhead software from the S9 shows different readings like clear airway clustered pretty close together every night. like last night 9 of those events , 2 of which were 16 seconds long each spaced within about 1 1/2 minutes from each other. I seem to have several clear airway (central) apneas usually patterned together.

This is called CPAP-induced central apnea.

Quote:When would it be appropriate to use a bi-pap instead of apap?

A Bi-PAP could just make it worse. It'll go away on its own in a week or two. If not, you will have to talk to your doctor. He may lower your pressure a bit, or put your APAP in CPAP mode at a fixed pressure. These CA events could be the cause of your headache. It's good that they're subsiding but if you have concerns you really should contact your doctor.

Are these clusters of CA's occurring at times when your APAP pressure is near the high end of its range? If so, this would be further evidence that you're experiencing CPAP-induced central apnea. If it doesn't subside on its own in a week or two I'd contact the doctor and see if he thinks you should lower your pressure a bit.

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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. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-17-2012 01:09 PM
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zonk Offline

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Post: #17
RE: Waking up with headaches, have S9 data
(10-17-2012 01:09 PM)Sleepster Wrote:  This is called CPAP-induced central apnea.
the S9 autoset distinguish between obstructive and central sleep apnea (older machines did not)
it uses Forced Oscillation Technique (FOT) to determine whether the airways are open or closed
if open airways detected ... no action is taken
http://www.s9morecomfort.com/s9morecomfo...toset.html

I've been using S9 autoset for nearly two years and never seen this pressure induced central apnea phenomena
not at low pressure or high pressure
machine cannot tell if we,re awake or asleep ... real apnea when we,re asleep Not while awake
only sleep study can determine and diagnose central sleep apnea
10-17-2012 02:48 PM
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Sleepster Offline
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Post: #18
RE: Waking up with headaches, have S9 data
(10-17-2012 02:48 PM)zonk Wrote:  if open airways detected ... no action is taken

Right. APAP's respond only to obstructive apneas. Response to clear-airway apneas is required by the user. The usual remedy is to reduce the pressure, but if that strategy is not effective a more sophisticated machine, such as a ASV is required. Of course all of this requires the assistance of a doctor.

Quote:I've been using S9 autoset for nearly two years and never seen this pressure induced central apnea phenomena

You're lucky. It's a well-documented effect among some patients.

Quote:machine cannot tell if we,re awake or asleep ... real apnea when we,re asleep Not while awake
only sleep study can determine and diagnose central sleep apnea

If you're awake you'd have to stop breathing on purpose for at least 10 seconds for your machine to score a CA. A cluster of CA's while awake is really hard to do. You'd have to be concentrating really hard on some task, or something like that.

I've looked at my clusters of CA's and I don't think they happen while I'm awake. At one point I was getting an average of 15 per hour during an eight hour night of sleeping. I can't imagine any scenario where I'd have been awake that much during that eight hour night!

The thing is, a small reduction in pressure can cause them to go away, as can a few nights of getting used to CPAP therapy.

Sleepster
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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. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-17-2012 05:52 PM
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bryank1 Offline

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Post: #19
RE: Waking up with headaches, have S9 data
(10-16-2012 04:44 PM)PaulaO2 Wrote:  BiPAP is not for central apnea. BiPAP (or bilevel PAP) can have an inhale and exhale pressure difference of more than 3 points.

Central events are common when first starting therapy. I'm too lazy today to go back and see how long you have been using the APAP.

However, clear airway events and central events are not necessarily the same thing. This is a topic of much discussion here and elsewhere. Some people say they are, some people say they are not.

If these clear airway events continue or worsen, you really need to discuss this with your doc. But, if you are just starting, my bet is that they will slowly subside, especially if none were seen during the sleep study.

My understanding is that bi-pap has the added function of exhaling with the cpap (positive pressure) to the user for the purpose of sort of jump starting a central apnea event.
If the machine works this way, then it should resolve the patients central apnea issues. Isn't it in a sense an automated breathing machine?

I had one night with a cluster of centrals with the longest being 25 seconds. That seems like a long time to stop breathing.
10-18-2012 11:45 PM
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bryank1 Offline

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Post: #20
RE: Waking up with headaches, have S9 data
There are no leaks during these times. In the flow chart its a straight line for those seconds. The respiratory rate has an odd signature. The mask pressure during that time is a straight line. The selection ahi on one event was about 72.

So I guess I was thinking that a bi-pap did what you described as a ASV. So possibly the ASV may be the ticket if this problem doesn't go away. If these do go away, when do they start to go away. Im at the 2 week point. Obstructive events are low, but central events are the majority.
10-19-2012 12:22 AM
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