Treatment going well, but a lot of "clear airway" events

[jajvirta]

I've been a little over two weeks on CPAP and it's been great so far. No more slogging through the day feeling dead-tired all the time.

Today I finally got my SD card out of the machine and started using Sleepyhead software. The only curious thing is that there are relatively many "Clear Airway" events, at least compared to OA and other events. I read a couple of comments about the CA events, but I'm not quite sure what they are. I interpreted them as having breathing stopped but without there being any obstructions. Like Central Apnea? Should I be worried about CAs frequency as they seem to have increased during the two weeks?

(As a sidenote, Jan 30 was my failed attempt to return back to our normal bed, where my wife and I, and our two children on a typical night, slept before treatment.)

Anyhow, here's the graph for AHI.

https://www.dropbox.com/s/dy0opkulk8t9w ... s.png?dl=0

Edit: direct embedding doesn't work for dropbox, so I changed to a link to the image.

[palerider]

clear airway=central apnea=ca different words, same thing.

[jajvirta]

clear airway=central apnea=ca different words, same thing.

OK. Nothing much I can do about it, then?

[palerider]

clear airway=central apnea=ca different words, same thing.

OK. Nothing much I can do about it, then?

"relatively many" is meaningless.

you could have 1 oa and 2 ca and that would be "twice as many!" relatively speaking.

unless I missed it, you didn't say how many.

[Pugsy]

Not much we can do about centrals/Clear airway events nor do we really need to do anything about them unless they are present in large numbers and from what I see from the one image you posted......not enough centrals to worry about even if every single one of them were the real deal.

The machine can sometimes flag awake breathing irregularities as some sort of apnea event and often as a central. The machine doesn't know if we are awake or asleep and just calls things like it senses them. If you are seeing centrals very close to known awake times (like early on in the night or right close to where you woke up) then it might not even be a real central.
Also...it's not unusual to have a few centrals get recorded that are real because having a few centrals might be a normal thing since it isn't unusual to have what we call sleep onset centrals as we transition into the sleep stage. It's normal and not usually a problem unless present in large numbers and you were for sure not awake when they happened.

Since from what I saw on the one graph for AHI that you listed, your AHI is still below 5.0...your central count isn't horribly high at this point even if they were all real centrals and not caused by awake breathing irregularities.

[archangle]

Look at your airflow waveforms and see how long and how complete the CA's are. They're a lot more meaningful if they last a long time and you completely stop breathing.

Realize that CA's aren't necessarily more harmful than OA's, just harder to eliminate.

[jajvirta]

clear airway=central apnea=ca different words, same thing.

OK. Nothing much I can do about it, then?

"relatively many" is meaningless.

you could have 1 oa and 2 ca and that would be "twice as many!" relatively speaking.

unless I missed it, you didn't say how many.

Sorry, it was only in the diagram, which was linked in the bottom of the post.

But yeah, I've had few nights now when the CA index is around 3-4 and very little other events.

[LSAT]

If you are a restless sleeper and toss and turn a lot you will notice more CAs

[Sircadian]

If you are a restless sleeper and toss and turn a lot you will notice more CAs

Therapy seems to have stopped the majority of that restlessness for me. I would have thought that 'real' sleep wouldn't allow that to happen. Referring to getting into the deeper stages of sleep, thinking that tossing at the end of a cycle is possible through the night.

I toss a lot less than pretreatment nights, probably alter my position (side sleeper) 4-6 times. Includes the 2 breaks for a whiz but that is 100% better than before.

[Pugsy]

There are any number of other reasons for "restless" sleep that aren't necessarily related to sleep itself.
Example..pain. I have some spinal issues that sometimes are pretty significant and when I have a "bad" night in terms of pain management and end up doing a lot of tossing and turning trying to relieve the pain I will see a substantial increase in centrals (clear airway) along with sometimes the other events. In my case I am pretty sure that the bulk of the extra centrals are likely post arousal centrals or sleep onset centrals because my sleep is so fragmented I have a lot of sleep onset cycles which increase the chance of having sleep onset centrals (which are normally not anything to worry about unless we have a truck load of them).

Most docs won't do anything about centrals unless the central index is over 5 on a consistent basis or someone is having significant problems with desats or getting bounced out of sleep (with those sleep onset centrals) making it so a person simply can't get to sleep and stay asleep.

[Sircadian]

Example..pain. I have some spinal issues that sometimes are pretty significant and when I have a "bad" night in terms of pain management and end up doing a lot of tossing and turning trying to relieve the pain

Heart goes out to you, 'pain' how soon we forget, when the pains go away or an illness passes, how they can rattle our comfort level. Takes a strong person to deal with that on a daily basis. On that level, kudos to you.

[JimP]

If centrals were an issue during your sleep study, then they would have put you on a type of machine that would initiate a breath if you didn't breathe.

Might be worth mentioning to your sleep doctor when you see him.