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CA while "awake" or "restless" - Printable Version

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CA while "awake" or "restless" - Wcwilson - 09-11-2019

Hello everyone,
I've been using an ResMed AirSense 10 Autoset, DreamAir Nasal mask for almost two weeks now, and behind the scenes have been reading a ton of posts, tweaked a few things here and there, but not yet finding consistency.  It is great that there are so many folks here to support each other.  

My prescription was 5/14 with EPR 3. I'm running manual humidity at 5 after experiencing dry mouth.  I'm no longer using the ramp feature.

Last night I went to bed at 10, the power went out at 12:30 approx. and back on a little before 1:00.  I woke up at 5, and went to the bathroom.  At that point I felt good, even thought it was later in the morning, but after seeing the time went back to bed.  From 5 to 6 I alternated between being on my back and being on my left side.  What I find curious is that I have a cluster of CA's during this period where I don't feel like I'm asleep at all.  Additionally, looking at the pressure, the ResMed doesn't increase the pressure to give me more flow (at least that's my interpretation).  

Most nights my AHI runs 5 or 6.  Approx. 3.5 are CAs.  Last night seems to be an anonomaly so looking for some real interpretation of the data if possible. The only slight tweak I had last night was I loosened the strap on the back of my head slightly because I was experiencing some discomfort under my nose (which I understand is common for the first few weeks of therapy).

I have tried to attach the Ocscar generated screenshot but its 878 kb, which exceeds the 700kb limit.  I've reviewed the Attachments wiki but not seeing what I need to do to correct this.  If someone can help me with that I will post the image right away.

Thanks so much!


RE: CA while "awake" or "restless" - DeepBreathing - 09-11-2019

G'day Wcwilson. Welcome to Apnea Board.

The centrals you describe are commonly known as sleep-wake junk. During the transition from sleep to wakefulness (and vice versa) our breathing gets quite erratic, often with long pauses, especially if we move around during this period. If a pause exceeds 10 seconds, it's flagged as an apnea. It's really a false positive and can generally be ignored.

The Autoset doesn't respond to central apneas. It diagnoses the type of apnea while it's happening - if it's obstructive, it will raise the pressure to prevent another one occurring in the next little while. However increasing static pressure is contra-indicated for central apneas.

If your screenshot is that size my guess is that you're using a Mac with a retina screen. There is a known problem with the way Macs capture screen shots which will be remedied in the next release of Oscar. Is it possible to reduce your screen resolution?


RE: CA while "awake" or "restless" - slowriter - 09-11-2019

I've experienced this myself, such that I don't trust the CA reporting of the machine.

I have taken, though, to making sure I turn off the machine if I wake up, so that I can easily correlate where those clusters are in relation to that awakening. Almost always, it's on either side of them, and there are a handful outside of that.

Others with more experience can give you more details though.


RE: CA while "awake" or "restless" - SarcasticDave94 - 09-11-2019

I don't know if this helps on the screenshot size, but on my Android phone I'll resize the image via a resize edit action to 25%. That gets my images under the pixel limit.

As for sleep wake junk, if it's applicable, I'd disregard that segment.


RE: CA while "awake" or "restless" - alexp - 09-11-2019

(09-11-2019, 09:17 AM)Wcwilson Wrote: Hello everyone,
I've been using an ResMed AirSense 10 Autoset, DreamAir Nasal mask for almost two weeks now, and behind the scenes have been reading a ton of posts, tweaked a few things here and there, but not yet finding consistency.  It is great that there are so many folks here to support each other.  

My prescription was 5/14 with EPR 3. I'm running manual humidity at 5 after experiencing dry mouth.  I'm no longer using the ramp feature.

Last night I went to bed at 10, the power went out at 12:30 approx. and back on a little before 1:00.  I woke up at 5, and went to the bathroom.  At that point I felt good, even thought it was later in the morning, but after seeing the time went back to bed.  From 5 to 6 I alternated between being on my back and being on my left side.  What I find curious is that I have a cluster of CA's during this period where I don't feel like I'm asleep at all.  Additionally, looking at the pressure, the ResMed doesn't increase the pressure to give me more flow (at least that's my interpretation).  

Most nights my AHI runs 5 or 6.  Approx. 3.5 are CAs.  Last night seems to be an anonomaly so looking for some real interpretation of the data if possible. The only slight tweak I had last night was I loosened the strap on the back of my head slightly because I was experiencing some discomfort under my nose (which I understand is common for the first few weeks of therapy).

I have tried to attach the Ocscar generated screenshot but its 878 kb, which exceeds the 700kb limit.  I've reviewed the Attachments wiki but not seeing what I need to do to correct this.  If someone can help me with that I will post the image right away.

Thanks so much!

The best way to know if a central is real or not is to look at your tidal volume. This is not an absolute rule but in general, if you see a big jump in tidal volume right before the CA event, it usually means you were awake or you woke up.


RE: CA while "awake" or "restless" - Wcwilson - 09-11-2019

[attachment=15390]

Got it reduced via Mac Preview.


RE: CA while "awake" or "restless" - SarcasticDave94 - 09-11-2019

OK great on the getting the screenshot. Can you do a 2 minute or so zoom in where one of the CA events are on this?


RE: CA while "awake" or "restless" - Wcwilson - 09-11-2019

Thanks Dave.  See attached.  I chose approx. 3:40 because all was pretty good up until that point.  I don't remember waking up then.

and here is about 5:12 when I know I was awake trying to go back to sleep.


RE: CA while "awake" or "restless" - mesenteria - 09-11-2019

After we have had a fairly good blast of decent quality sleep, and we awaken close to our usual time, we may feel the need to turn over and attempt to get another 40 winks.  Often this works out uneventfully.  But at least as often we'll drift off, our brain thinks of something or a noise brings us back (car passing in the street?), and we will fall into a steady drift/wake cycle until our alarm goes off or we get annoyed and throw off the covers for the day.  During this cycling, many of us will stop breathing for a few seconds.  Longer than 10 seconds and the machine detects and notes it.

All that to say I agree with the others: they are innocuous and you should ignore them.  If they were in the range of 20+ seconds (as an example of longer and possibly deleterious pauses), and clustered, they could be a problem worth rectifying by adjustments to your treatment.


RE: CA while "awake" or "restless" - alexp - 09-11-2019

(09-11-2019, 10:00 AM)Wcwilson Wrote: Thanks Dave.  See attached.  I chose approx. 3:40 because all was pretty good up until that point.  I don't remember waking up then.

and here is about 5:12 when I know I was awake trying to go back to sleep.

Add your tidal volume chart please.