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Clear airway events after waking and going back to sleep - Printable Version

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Clear airway events after waking and going back to sleep - Mpadgett714 - 11-01-2019

I have been on apap therapy for 6 weeks.  In the last two weeks, I have clear airway events that occur primarily after I wake up to use bathroom and trying to fall back to sleep.  Virtually no CA events until that.  My AHI’s for entire session is usually 5 or less, but having 12-15 CA’s just in the 2 hours after waking and falling back to sleep.  I can feel this, as I am rousing during event and confirmed via OSCAR.  I have an APAP machine, so I’m assuming it’s not due too much pressure.  THoughts?


RE: Clear airway events after waking and going back to sleep - SarcasticDave94 - 11-01-2019

OK, you take your bathroom break and then get back in bed, mask up and switch the xPAP back on while moving around to get comfortable to fall back asleep, possibly holding breath while moving. About right? If so then breath holding is probably the CA flag reason and I'd just disregard if my description is accurate. You can classify this as SWJ or sleep wake junk.


RE: Clear airway events after waking and going back to sleep - bonjour - 11-01-2019

It is best if you post an OSCAR daily chart, see my signature for the organization.
Best guess is that at least some of the CA you are seeing is SWJ, holding your breath as you are waking up or settling back in falling asleep.


RE: Clear airway events after waking and going back to sleep - Mpadgett714 - 11-01-2019

I would agree, but the events persist for a couple of hours.


RE: Clear airway events after waking and going back to sleep - bonjour - 11-01-2019

(11-01-2019, 12:59 PM)Mpadgett714 Wrote: I would agree, but the events persist for a couple of hours.

Thus the request to see the charts.


RE: Clear airway events after waking and going back to sleep - Mpadgett714 - 11-01-2019

[attachment=16679 Wrote:bonjour pid='317579' dateline='1572629375']It is best if you post an #OSACR daily chart,  see my signature for the organization.
Best guess is that at least some of the CA you are seeing is SWJ, holding your breath as you are waking up or settling back in falling asleep.

[attachment=16679][attachment=16679]

(11-01-2019, 01:01 PM)bonjour Wrote:
(11-01-2019, 12:59 PM)Mpadgett714 Wrote: I would agree, but the events persist for a couple of hours.

Thus the request to see the charts.
Thanks, new to this.  Chart posted.  I will also post a different day.  If there are any important graphs to show, please advise.


RE: Clear airway events after waking and going back to sleep - Mpadgett714 - 11-01-2019

(11-01-2019, 01:02 PM)Mpadgett714 Wrote:
(11-01-2019, 12:29 PM)bonjour Wrote: It is best if you post an #OSACR daily chart,  see my signature for the organization.
Best guess is that at least some of the CA you are seeing is SWJ, holding your breath as you are waking up or settling back in falling asleep.



(11-01-2019, 01:01 PM)bonjour Wrote:
(11-01-2019, 12:59 PM)Mpadgett714 Wrote: I would agree, but the events persist for a couple of hours.

Thus the request to see the charts.
Thanks, new to this.  Chart posted.  I will also post a different day.  If there are any important graphs to show, please advise.



RE: Clear airway events after waking and going back to sleep - bonjour - 11-01-2019

The irregularity of the flow rate tends to say that you were likely awake for the bulk of your central apneas.
That's not what caught my eye.
RERAs, which mean Flow Limitations far in excess of the FL events reported, RERAs being significant because they are a series of Flow Limitations ending with arousal.

Please raise your min pressure to 8.  Then another look at your chart,  then maybe another boost.  There is a decent chance that you will need a biLevel with its pressure support to treat this.


RE: Clear airway events after waking and going back to sleep - Mpadgett714 - 11-01-2019

[attachment=16685]What is bilevel therapy.  I use a dream station apap with min of 7.5 and a flex of 3.   Also, could you expand on the RERA comment.


RE: Clear airway events after waking and going back to sleep - bonjour - 11-01-2019

Flex should work nut never does.  I can manipulate a ResMed into providing 2 cmw worth of pressure support but cannot.  BiLevel in the next level of machine above the APAP and allows a significant difference between inhale and exhale pressures called Pressure Support.  This is effective for treating Hypopneas, Flow, Limitations, RERAs, and snores, and is also useful for treating UARS.  

The first step is to increase pressure to see if you need to, or not get a more capable machine.

RERAs are always bad because by definition they all end in arousal, one of the big things we try to avoid or eliminate.