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home study for centrals
#11
(08-23-2017, 06:22 PM)richb Wrote: I did some "sleep study" experimentation using one of the CPAP machines that I had before getting my ASV machine.  At what would have been therapeutic settings (pressures above 8cm H2O I had very high AHI (above 40) consisting of CAs and Cheyne Stokes Respiration.  Below 5 cm H20 I had primarily Hypopneas and Periodic Breathing.  The Hypopneas had the waveform characteristic of Central Hypopnea (normal breaths in miniature).  I had no Obstructive events at either setting.

Rich

In your case there was never much doubt.  One of the most arrogant posts I have ever made: http://www.apneaboard.com/forums/Thread-...#pid133690
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#12
Yup! But right on target. I have since made a recommendation to the hospital with that "sleep center" as to how to fix their "problem". They have an award winning CHF center whose Docs could point out the diagnostic value in recognizing Central Apnea and checking for CHF in those exhibiting Central Apnea prior to prescribing ASV machines.

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
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#13
(08-23-2017, 03:22 PM)jerry1967 Wrote: So are clear airways the same as central or not?

The answer is: Maybe.

Clear Airway is the term the CPAP machine world uses because these machines cannot detect that you had or are having a central apnea. It requires monitoring signals from your brain. A Central Apnea is your brain failing to tell your body to breath. The signal just doesn't get sent. There is no way a CPAP machine can detect that the 'signal' is missing. The machine will guess, often by sending pulses of air at a certain frequency into the tube. Depending on the resistance measured by the machine it will guess "that signal went further than my algorithm was set for so it probably is not an obstruction and we will just call it a Clear Airway." It is possible that it was a central apnea. After all, what other reason could it be? If there is not a large leak, and very little resistance, the odds are it is but they can't say it is medically and therefore legally. What they should have just done was call it an unknown. But then they would miss out on the industry dollars.


Using FlashAir W-03 SD card in machine. Access through wifi with FlashPAP or Sleep Master utilities.

I wanted to learn Binary so I enrolled in Binary 101. I seemed to have missed the first four courses. Big Grinnie

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#14
A complete pause in breathing is just one of many forms of Central apnea. Periodic Breathing, Central Hypopnea and Cheyne Stokes Respiration have characteristic wave patterns that can be recognized and used for diagnosis. The medical community is not always able to figure out the exact cause of a disease or condition. They use alternate pathways (differential diagnosis for example) to come up with a best guess as to the probable cause and eventual treatment for a condition. Think of how many conditions are named by referring to their symptoms. Also think of the people helped with ASV technology when the diagnosis is based on a best guess. Also much of the scholarly literature on the subject concludes with "more research is needed".

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
Post from Imgur


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#15
I'm by no means a pro at this CPAP stuff, I'm trying to play catch up and figure out what is going on.  I did watch a video last night that helped to explain how to look at Clear Airway vs Central Apnea, using Sleepyhead.  

Please correct me if I'm wrong, but it basically it came down to looking at the breathing pattern to see what took place JUST prior to the "CA" report given on Sleepyhead.  Often, when someone takes a big sigh, they will have a pause (sometimes long pause) after the sigh, the pulse is generated and determines there is a Clear Airway, and so it is reported as such.  If teh breathing pattern stays constant and then a long pause between breaths, a pulse is generated and it too will show Clear Airway (if there is one), and if there is no sigh breath before the long pause in breathing, then it is Central Apnea.  Does this sound correct???

With my sleep study, they told me I had mainly Central Apnea (I actually felt I had a good night and my AHI was only 6.7 and I know I normally have worse nights), but they still put me on  CPAP.  Now that I'm learning more  thanks to everyone here, I'm starting to think I need ASV and plan on doing a few more nights and calling Monday.
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#16
I forgot to mention that it was also stated that a new CPAP user with Obstructive Airway may experience some Central Apnea when first starting to use CPAP, as their body adjusts to the new ventilation.
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#17
As far as the machine is concerned, what is happening during the apnea is what it concerns itself with to determine CA versus OA. The machine waits for a few seconds after one has quit breathing and then sends air pulse(s) to determine if the airway is clear.

Clear Airway vs Central Apnea. My question is; If the airway is clear, what would cause one to not take a breath other than there being no breathe signal from the brain? To me that would make it reasonably certain that a clear airway event is truly a central apnea event.

Best Regards,

PaytonA

Admin Note:
PaytonA passed away in September 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#18
I think it is worth pointing out the O.P. is using some powerful anti-seizure medications including Dilantin and Phenobarbital that are known to contribute to central apnea events. Epilepsy and the medications used to treat it, greatly complicate issues of sleep disordered breathing, and anyone dealing with a combination of complex and central apnea in combination with epilepsy needs to get high level assistance in order to be safely and effectively treated. Being aware of this complication discussed on another thread, there is little doubt that the centrals in question here are real, and require special consideration apart from the normal sleep apnea evaluation. What is relevant for this thread is that a home study is extremely unlikely to be appropriate, and beyond that, even a clinical study should be conducted by someone with expertise in these matters.

https://www.uspharmacist.com/article/cen...inhibitors
https://epilepsytalk.com/2013/06/10/epil...erous-duo/
http://www.goldbamboo.com/relate-tl9380-tr4466.html
http://onlinelibrary.wiley.com/doi/10.11...12478/full
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#19
(09-01-2017, 01:43 PM)Sleeprider Wrote: I think it is worth pointing out the O.P. is using some powerful anti-seizure medications including Dilantin and Phenobarbital that are known to contribute to central apnea events.  Epilepsy and the medications used to treat it, greatly complicate issues of sleep disordered breathing, and anyone dealing with a combination of complex and central apnea in combination with epilepsy needs to get high level assistance in order to be safely and effectively treated.  Being aware of this complication discussed on another thread, there is little doubt that the centrals in question here are real, and require special consideration apart from the normal sleep apnea evaluation.  What is relevant for this thread is that a home study is extremely unlikely to be appropriate, and beyond that, even a clinical study should be conducted by someone with expertise in these matters.

https://www.uspharmacist.com/article/cen...inhibitors
https://epilepsytalk.com/2013/06/10/epil...erous-duo/
http://www.goldbamboo.com/relate-tl9380-tr4466.html
http://onlinelibrary.wiley.com/doi/10.11...12478/full
Very interesting articles Sleeprider
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#20
I just had a home sleep study done on a Philips device, and it did indeed test for centrals.  I have a different issue and that I am clearly one of the mythical subset that have centrals caused by therapy.  In my first week I'm seeing 100+ centrals per night, and in sleep transition I am subconsciously "confused" as the whether I am supposed to breathe or let the machine do it.

I went from a handful of hypopnea to basically no apneas and hypopnea but ahi of 15-25 nightly from Clear Airway Apneas.

Central = Clear Airway in Dreamstation/Mapper
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