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Where do I find my Central Apneas? I have many Cheyne Stokes?
#1
I'm confused about where I should be looking to see if I have any CENTRAL apnea events......and I'm confused as to why I spend so much time in Cheyne Stokes Respirations? Does this Sleepyhead look like something I should contact my doctor about?
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#2
(02-15-2016, 06:58 PM)Daisylouu Wrote: I'm confused about where I should be looking to see if I have any CENTRAL apnea events
They are called "clear airway" events.

greetings
Hermann
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#3
They are also called "clear airway events."
You had 7.
Click the Details Tab and look at their duration.
Also, look along the Event Flags -- do you see "CA" -- those would be them.

You are dominated by Obstructive apneas and hypoapneas. (38 + 18 events)

You slept roughly 7 hours. Your AHI would be approximately (38+18+7)/7 = 63/7 = 9
A bit higher than is considered adequate treatment.

So, I would advise a consult with your doc. It's more the Obstructive apneas and hypoapneas that are running up the numbers.
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#4
The periods flagged as "CSR" are during relatively high obstructive apnea clusters. That is inconsistent with CSR, and while it may be periodic breathing of some kind, I think it is something else. We would need to look at the flow rate waveform close up to even begin to interpret it. I'm going to say you have pretty classic OSA and while Sleepyhead labels periodic breathing events as CSR, that is in error in your case. You do not have CSR.

You are having a couple intense clusters of OA, and I have usually seen this in people whose apnea is strongly positional. Your minimum pressure is not preventing airway collapse and we see the first OA cluster at 23:15 at around 6.0 cm pressure. This is followed by a number of vibratory snores which raise pressure over 11.0, then the onset of the biggest OA cluster of the night which is unbroken with pressures to 15 cm. The OA seems to resolve, but is replaced by very uneven breathing patterns and a smaller cluster of OA at 01:30. From 1:30 to 3:00 you have some hypopnea and uneven breathing, but no OA, and the machine reduces pressure until you have another cluster of OA. There is an arousal and break in therapy, then a completely different picture where pressure stays low and no events from 3:45 to 4:45 where another obstructive cluster of hypopnea and RERA occur.

I think you need to increase minimum pressure to around 8.0 for now, but find a way to stay off your back. It's possible the OA is related to REM sleep, but it looks like sleeping position from here. It's interesting that you don't have enough flow limitation or snores to increase pressure ahead of the OA clusters, and this again points to a sudden onset like with a change in sleep position. That's my best guess for now.
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#5
Thank you so much! I sleep in a recliner, am unable to sleep on my side because of joint/shoulder issues. So it's either my back or a recliner. The time from 3:45-4:45 I was awake
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#6
A wedge pillow may help, or it's possible that opening the machine up a bit you will be able to prevent obstructive events, even on your back. Your peak pressure is less than 16, and you have up to 20. The trick will be increasing minimum pressure enough to prevent the obstructions from getting started. So your tolerance of that pressure is key. Another alternative is bilevel which is capable of higher pressures, but gives you pressure relief on exhale that can be very comfortable overall. I use an auto bilevel machine, but not at the pressures you may require. If you're working with a doctor and insurance, you might want to share our results with him or her. Your treatment is not working at the expected level and while we're glad to help here, your doctor should be in the conversation in case you need to upgrade the machine.
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