High "Clear Airway" events

[zonk]

Why are you taking antihistamines?
The pressure hardly increased above 11 and for most of the night lower.
I would to try to lower both (max and min) and especially the minimum. Keep monitoring and see how it work out

Edit: you need a new sleep and if its central apnea we,re talking about than you need different machine ..... PRS1 doesn't treat central apnea

[PaulaO2]

When the events happen, look to see what the pressure was at those times.

OK, thank you. Have you heard if taking naproxin or antihistimines can raise CA's?

I don't think they do because neither of them are strong enough.

With central events, it is completely a brain thing. For a wide variety of reasons, the brain thinks you don't need to breathe. There's no struggling, no anything, just you aren't breathing. This is why sleep tests are a good thing.

I did a Google search for medications and sleep apnea. The NIH says that some medications, particularly narcotic pain medications, can contribute to central events. A Mayo Clinic article explains this further. These types of medications (and others) cause your breathing to become irregular and that irregularity can confuse the brain.

http://www.nlm.nih.gov/medlineplus/ency/...003997.htm
http://www.mayoclinic.com/health/central...ION=causes

[zzzzk]

Zzz,

Welcome!

Modern xPAP machines try to differentiate between Central and Obstructive events, but they can only guess. There are various methods, like Resmed's Forced Oscillation Technique (FOT). If you have an apnea event, the machine pulses the pressure. If the flow reacts in one way, it shows the throat is closed and you're having an obstructive event (obstructed airway). If the flow reacts in a different way, it shows that the throat is open and you're having a central event (clear aiway). It's just the best the machines can do. It's not 100% accurate. To really tell if you're having a central event, you've got to be hooked up to wires that monitor your brain, a chest ring to tell if you're actually trying to breath, etc. This is the fully instrumented sleep study.

Now an event is an event. Regardless if the machine is correct that it is OSA or CSA, they are very accurate in saying you've quite breathing for 10 seconds (or more). Your AHI is higher than optimal target (<5), so don't ignore this.

Many people have reported a correlation between higher pressures and machine reports of increased CSAs. I wouldn't ignore it, but I wouldn't take it as "fact."

You said you are currently without insurance, so you're in a tough spot. You've got Sleepyhead figured out. Read the forum Widi article on changing your pressures. If at that point you are comfortable, follow the guidelines and monitor the results. Never take one night as results, you should allow 7-14 days with each change to really see how the change is affecting you. Pay attention to both the high and low APAP pressures. Look at your 95% pressure and, general rule of thumb, about 2 cmH2O above that and about 4 cmH2O below that should get you in the right area. If you're bouncing against the high limit frequently, you may need to push it up. Just keep working at it.

All that said, if and when you can get to a doctor, take the graphs and information you've shown us. We're not professionals, just trying to help.

Thank you. Is there no "home" tester for oxygen levels, central apneas, etc.? As much as sleep labs help if you have insurance, I think it would be more useful to test over a period of time, not just one or two nights... Thank you everyone for the suggestions. If anyone has anymore, please let me know...

[PaulaO2]

Yes, you can get an oximeter capable of data collection. Several of us have the CMS 50D Plus. Supplier #19 has it and others. Check out the reviews here.

There are some home sleep apnea tests. Most of them use a band across the user's chest. It detects not just breath movements, but also struggling. It will know if you stop breathing and if there is any body movement at the same time. If there is none, it's a central event.

[zzzzk]

Thank you everyone, going to a sleep study tonight! We'll see..

[zzzzk]

Hi zzzzk

I have no special knowledge and can only speak from my experience but I have found a bit of a connection between the A-Flex / C-Flex / EPR and the reports of CA's. For me I notice that the CA's are more when I have A-Flex turned on - although not as high as your's.

I turned mine off.

Your mileage may vary

Hi Moriarty,

I tried what you said, but only one night, and my CA's went way down. Thank you for the suggestion! Strange, though. I guess it's because the air doesn't come in as fast? Doesn't seem like a logical tech to add for sleep apnea victims. Have you tried it with the C-flex? That's only on exhales, I think. Thank you.

[givememoresleep]

I have also found my CA's are lower when on C-Flex as opposed to A-Flex.

[PaulaO2]

Actually, the x-Flex depends on which machine you have. Regular CPAPs have the C-flex, APAP has the A-flex, and Bilevel has the Bi-Flex. That's for Respironics machines. Resmed machines, such as the S9, have the EPR.

It's all alphabet soup - http://www.apneaboard.com/wiki/index.php?title=Acronyms

[Sleepster]

I have also found my CA's are lower when on C-Flex as opposed to A-Flex.

C-Flex is the same thing as A-Flex. They lower the pressure a few centimeters upon exhling. It's called exhalation pressure relief (EPR).

BiPAP's induce CA apneas, so it's not surprising that EPR does too. It's probably an effect that subsides with time.

This is one reason why just a night or two of therapy shouldn't be used to establish an effect. It can take the human body weeks to adjust to changes in therapy pressures.

[givememoresleep]

I have also found my CA's are lower when on C-Flex as opposed to A-Flex.

C-Flex is the same thing as A-Flex. They lower the pressure a few centimeters upon exhling. It's called exhalation pressure relief (EPR).

BiPAP's induce CA apneas, so it's not surprising that EPR does too. It's probably an effect that subsides with time.

This is one reason why just a night or two of therapy shouldn't be used to establish an effect. It can take the human body weeks to adjust to changes in therapy pressures.

There are subtle differences between the two. On my PR-S1 550 I can set the machine in auto and still have the choice of A-Flex or C-Flex. Yes they are both comfort settings but they are not the same. Four different 30 day trials and the numbers were better both times on C-Flex vs A-Flex for me at the same pressure range.