Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Q_TeaPie · Post by **Q_TeaPie** » Wed May 15, 2019 2:29 pm

I am only new to 'all of this'- I was diagnosed with OSA (they said my AHI was 29) only early April this year (I am a month into my CPAP trial). I downloaded the DreamMapper app (to sync via Bluetooth with the Philips Dreamstation Auto-Cpap machine that I'm currently using for my trial).
I know the info the DreamMapper app provides, is extremely limited compared to the info I've seen Oscar software provide on the forums- however, for now its the best I've got until I can get a chance to download it, & set it up. I will attach my DreamMapper results from several nights ago, with the results on it.
*I pointed these results out to the people who are doing my trial, and they said I was having 'central apneas' (which they then said they weren't familiar with, so they were going to talk to someone more senior, and get back to me the following day- no one rang me back, so should I assume there is nothing to be concerned about/ or should I contact them and ask them if they found out any information, in regards to what I should do. Thanks

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palerider · Post by **palerider** » Wed May 15, 2019 2:40 pm

Yes, but not that many.

Pugsy · Post by **Pugsy** » Wed May 15, 2019 2:41 pm

If you slept solidly for those 8 hours...yes that number of centrals is concerning.
If you struggled to sleep and had a lot of awake time with the mask and machine being on then a lot of them might be the machine flagging awake breathing by mistake and in that case...no concern.

Watch to see if it happens again especially if you know you were asleep.
While it's normal to have a few centrals here and there...not normal and not good to have so many.

D.H. · Post by **D.H.** » Wed May 15, 2019 6:22 pm

This is awful! You cannot be getting good sleep (though with the machine might be even worse).
I suggest that you download Sleepyhead (or OSCAR), and see what you can do.

Miss Emerita · Post by **Miss Emerita** » Wed May 15, 2019 8:02 pm

Your treated AHI seems to be higher than your untreated AHI, so something is amiss, and not just with centrals. The experts here can help you figure this out after you post an Oscar chart, so you might want to move that to the top of your list.

Before you post a chart, be sure to turn off the calendar and pie chart on the left so that the other information will be visible. Include your graphs for events, flow rate, pressure, leaks, and snores. I think for your machine, flow limitations show up as flagged events, but if there’s a FL graph, include that too.

Q_TeaPie · Post by **Q_TeaPie** » Wed May 15, 2019 10:46 pm

Thank you to all that respond, I'll see if I can organise Oscar sometime today.

CelesteMcC · Post by **CelesteMcC** » Thu May 16, 2019 8:42 am

For what it's worth, my sleep study showed zero Open Airway Apneas, but Dreammapper says I have them. My doctor (not my DME) says Dreammapper isn't accurate about those... better by far to get OSCAR for this, as people suggest.

Pugsy · Post by **Pugsy** » Thu May 16, 2019 9:05 am

DreamMapper is accurate in the sense that it reports what the machine gathers in terms of data.
OSCAR or SleepyHead is going to show essentially the same thing...too many centrals.
The fact that you didn't have centrals prior to cpap doesn't mean those aren't real now. There's about 10 to 15% of the people who start cpap without a problem with centrals who find that cpap triggers centrals.
Sometimes with a bit of time those centrals will go away...sometimes not and a different machine is needed.

Here's a video that explains why people get complex sleep apnea (both central apnea and obstructive apnea) with the starting of cpap therapy.
https://www.youtube.com/watch?v=CU-XTcf ... e=youtu.be

If you were asleep when all those centrals/CAs were flagged...you have a problem.
Now if you weren't asleep much and the machine flagged awake breathing pauses by mistake...probably no problem as long as they go away when you are actually asleep.

But until you know for sure...you can't ignore it. Way too many centrals to ignore.

ajack · Post by **ajack** » Thu May 16, 2019 9:08 am

Well aren't you pressure sensitive. Did you have large CA is the first sleep study? If you didn't, It's new user and most people resolve in 12 weeks.After that, it's back to the doctor for another machine to treat it.

Pugsy · Post by **Pugsy** » Thu May 16, 2019 9:11 am

Sometimes treatment emergent centrals will go away with time...but not always.

I have known people giving it a year and they still have way too many centrals. They ended up giving it a year or more because they didn't know any better.

JDS74 · Post by **JDS74** » Fri May 17, 2019 7:13 pm

Although the reported AHI is greater treated than in the untreated sleep study, it really isn't
The sleep study didn't report any CSA events but the DreamMapper software is including them in the calculation.
Excluding the Central count, the AHI now becomes 16.3 or so. That's an improvement over the 29 you started with (but not good enough.)

So either get a copy of Encore or OSCAR so that you can look at the real data.
To distinguish between "real" central events and "sleep-wake" central events you have to look at the length of the events and the "look" of the breathing waveform immediately surrounding one.
If it's real, then the breathing will be nice and regular right up to the event (for most people who don't have Cheyne-Stokes breathing a whole other topic) and then it just stops somewhat abruptly.
If it's not real, the the breathing will be all raggedy and irregular. That happens when you either wake up or almost wake up.
In a sleep study, all of those apnea events that occur during one of those (partial) wake cycles are ignored. The machine doesn't make that same judgement and reports them all.
To get the OSA and HYP events under control it my be that your exhale pressure is not sufficient. You'll need a ton more data to figure that out though.

So, as Pugsy says, keep on and watch to see if you are really asleep when this is going on or in disturbed sleep.
It's possible that the osa an hyp events are disturbing your sleep enough to generat the CSA events that are getting recorded.
Get some more data, talk to your doctor and/or RT to see what can be done to get the OSA and HYP events under control, then, if centrals still exist, start working on the CSA issue.

Q_TeaPie · Post by **Q_TeaPie** » Thu May 23, 2019 1:59 pm

I have finally worked Oscar out, and have managed to transport data from the CPAP machine's SD card (haven't done any screenshot images, to post here yet-: I'm not sure which graphs I should focus on, for the screenshot/ in other words, I have to scroll down the page to see all of the available daily data... so, I'm not sure if I'm meant to do a screenshot, then scroll further down & do another screenshot? Any suggestions?). Anyway, after looking through the data, It looks like I seem to be having multiple nights where I am having a high number of Central apneas (200+ some nights) -which is concerning. I rang the respiratory physician that is treating me, and asked her to take a look at the data, which she did- and she then said she is going to have to refer me to a specialist, with more experience dealing with something called complex breathing disorder (I think that's what she called it).
Before I started the CPAP, I knew I was having some weird breathing issues (as well as obstructive sleep apneas) as there were times I woke up knowing I was severely oxygen deprived. Many times, as I was drifting off to sleep, I would suddenly have the realisation that I simply wasn't breathing. My husband, many times has observed me breathing nice & regular (no snoring etc) and slowly get shallower and shallower, and then he couldn't see or hear me breathing at all, and end up frantically shaking me awake. I'm wondering if the Cpap therapy has maybe, therefore just highlighted an issue that was already there?? (not sure, just thinking out loud really).
Oh, and I almost forgot to add, that I have just found out that I am changing over to a Bipap machine, soon (as my respiratory physician thinks bipap would be a better option for me).

palerider · Post by **palerider** » Thu May 23, 2019 7:24 pm

Q_TeaPie wrote: ↑
Thu May 23, 2019 1:59 pm
I have finally worked Oscar out, and have managed to transport data from the CPAP machine's SD card (haven't done any screenshot images, to post here yet-: I'm not sure which graphs I should focus on, for the screenshot/ in other words, I have to scroll down the page to see all of the available daily data... so, I'm not sure if I'm meant to do a screenshot, then scroll further down & do another screenshot? Any suggestions?).

wiki/index.php/Sleepyhead:Organize

The instructions for Oscar are the same.

Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Re: Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Re: Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Re: Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Re: Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Re: Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Re: Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Re: Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Re: Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Re: Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Re: Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Re: Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Re: Do 'open airway apneas' regularly happen to all who've been diagnosed with OSA?

Machine	Mask

Additional Comments: Auto PAP; 13.5 cmH2O min - 20 cmH2O max