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Clear airway events - fractalice - 02-14-2015

I just had my fourth night on cpap and I imported my data into Sleepyhead. Of the events I'm having, most of them are "Clear airway events." I have looked that up and I understand that those could be central apnea. What I don't understand is why during my sleep study and titration study I had no central apnea whatsoever, only obstructive. Is there something else it could be?


RE: Clear airway events - Sleeprider - 02-14-2015

CA events can occur during sleep onset or waking. Unless they are occurring in clusters or as a component of periodic breathing, we tend to ignore them, at least in relatively small numbers. We don't treat CA with higher pressure, and we'd need more information to make any judgements.

It would help if you'd complete your equipment profile as different equipment detects and flags CA a bit differently. You're welcome to post some graphs from Sleepyhead showing your concerns.


RE: Clear airway events - DeepBreathing - 02-14-2015

Hi fractalice. Yes, clear airway events could be central apneas, but they could also be false positives. Can you post the details of the total number of events (central, obstructive and hypopneas)? And from the charts, are these CA events occurring at any particular time, are they clustered together or scattered through the night?

If you had no centrals in your sleep study, then these are likely to be one of two things: 1. Actual centrals brought on by your body and brain adapting to the pressure and changed oxygen / CO2 balance in your body. These usually occur in patients with fairly high pressures, and they usually go away with time. 2. False positives, which can occur while you're transitioning in and out of sleep, or due to temporary breathing pauses eg while you're changing position in your sleep.

In either case they are probably not of great concern unless there is a large number or if they are very persistent.



RE: Clear airway events - fractalice - 02-14-2015

Right, thank you, I have updated my profile. My machine is set right now to be a cpap, not an apap, though I have requested that it be changed. I was having lung discomfort, though last night went a lot better. So, four nights:
Night 1 (7 hours):
Clear Airway: 7
Hypopnea: 3
Obstructive: 3

Night 2 (8.4 hours):
Clear Airway: 9
Hypopnea: 2
Obstructive: 3
RERA: 1

Night 3, (4.4 hours):
Clear Airway: 6
Hypopnea: 2
Obstructive: 0

Night 4, last night, first time I thought I might survive this (7 hours):
Clear Airway: 1
Hypopnea: 1
Obstructive: 2
RERA: 1

I like the theory that the clear airway events could have been part of my brain getting used to the cpap. I feel like last night I turned a corner and even though I was wide awake after 4 hours I was able to get back to sleep while wearing the mask. And obviously the numbers look good especially since on my sleep study I was having 40 events an hour during REM sleep. What do the numbers mean in the parentheses:


RE: Clear airway events - Sleeprider - 02-14-2015

You can request a copy of the Clinician Manual for your machine here: http://www.apneaboard.com/adjust-cpap-pressure/change-cpap-pressure-settings-adjusting-your-machine-with-a-clinician-setup-manual

By getting the manual, you can easily enter the clinical manual and change your setting yourself to Auto mode. You may choose to keep your minimum pressure at 8, or reduce minimum pressure slightly, and let the machine titrate you.

To learn how to share your Sleepyhead data on the forum, check out this tutorial http://www.apneaboard.com/wiki/index.php?title=Attaching_Images_and_Files_on_Apnea_Board


RE: Clear airway events - fractalice - 02-14-2015

I got the Clinician Manual but since last night I seemed to do ok with the cpap mode I'll wait and talk to the doctor's office. Do the numbers in parentheses mean that's the total amount of time in seconds I spent not breathing? The 72 seems a little alarming. I'll study the imgr instructions when I'm a little more awake, thanks!


RE: Clear airway events - Sleeprider - 02-14-2015

The number in parenthesis is time in seconds, but on a CA event, there may be breathing there. In sleepyhead, go to the Daily tab and click on Events (same place you got the table). Click on the event and it will zoom in on the flag and you can see in the wave form data what happened. Do you see a flat line, or is there respiration indicated. CA events can be a bit different from an OA.


RE: Clear airway events - fractalice - 02-14-2015

Sorry for using clip again. The second CA is the "72":


RE: Clear airway events - archangle - 02-14-2015

(02-14-2015, 11:24 AM)fractalice Wrote: Sorry for using clip again. The second CA is the "72":

You're still breathing a bit during that apnea, so it's not as bad as a "complete" apnea. You might look at what your minute vent and tidal volume are during that apnea. A screenshot of all 3 waveforms zoomed out a bit from your last screenshot might help.


RE: Clear airway events - fractalice - 02-14-2015

I'll try to figure out imgr later so I can do this right...