Sudden increase in Clear Airway Apnea

[Tcahull87]

My Clear Airway Apnea events suddenly have spiked and is progressively getting worse. My overall AHI has went from an average of under 5 for about the past year, to worsening two-fold every day for the past 4 days. The events are specifically clear Airway events , as the OSCAR program shows me. The exact date is started corresponds to me going back to work, where I do physical labor. I was off work for two weeks prior, the longest break I've had from work in about 3 years. I'm hoping it's related to work and not other worrying underlying conditions such as neurological problems. Has ANYONE had a similar situation or can shed some light on this for me. Thanks in advance!

[Miss Emerita]

Welcome to the forum. It'd be very helpful if you could post your most recent Oscar chart. Be sure to include these graphs, if your machine enables them:

Events
Flow rate
Pressure
Leaks
Snores
Flow limitations.

Don't include any other graphs for now.

Please also include the left panel with the calendar turned off. (Just click the triangle to the left of today's date.)

[Julie]

Are you taking any (new) meds? Is the work very physical?

[ChicagoGranny]

My Clear Airway Apnea events suddenly have spiked and is progressively getting worse.

Are you aware that CPAP machines often falsely flag events as central apneas? The machines can't tell whether you are awake or asleep. If you are awake and reflexively stop breathing for ten seconds or more, the machine will falsely flag this as a central apnea. But these events are nothing to be concerned about.

It's possible that your return to work at physical labor is causing you to sleep restlessly. You might be reflexively holding your breath when you change positions in the bed. You have to be awake, but possibly not aware of the awakening, to change positions.

These false centrals can be identified by zooming in on them in OSCAR (SleepyHead). This video, starting at about 3:13, shows how to identify false centrals - https://youtu.be/1OQFESwNXm0?t=193

[Tcahull87]

Welcome to the forum. It'd be very helpful if you could post your most recent Oscar chart. Be sure to include these graphs, if your machine enables them:

Events
Flow rate
Pressure
Leaks
Snores
Flow limitations.

Don't include any other graphs for now.

Please also include the left panel with the calendar turned off. (Just click the triangle to the left of today's date.)

[Tcahull87]

Are you taking any (new) meds? Is the work very physical?

No new meds, work beats me up, but then I adjust.

[Tcahull87]

My Clear Airway Apnea events suddenly have spiked and is progressively getting worse.

Are you aware that CPAP machines often falsely flag events as central apneas? The machines can't tell whether you are awake or asleep. If you are awake and reflexively stop breathing for ten seconds or more, the machine will falsely flag this as a central apnea. But these events are nothing to be concerned about.

It's possible that your return to work at physical labor is causing you to sleep restlessly. You might be reflexively holding your breath when you change positions in the bed. You have to be awake, but possibly not aware of the awakening, to change positions.

These false centrals can be identified by zooming in on them in OSCAR (SleepyHead). This video, starting at about 3:13, shows how to identify false centrals - https://youtu.be/1OQFESwNXm0?t=193

I will say this could be part of the problem. Last night, it took a while for me to go to sleep, and I had the mask on. I decided to take a look at my numbers before falling to sleep and my AHI was over 20, yet I was still awake. Still a mystery though as to why all of a sudden it would do this, and also it coinciding with me going back to work.

[Miss Emerita]

I don't know why this has started happening recently. You are using a lot of pressure support; it'd be helpful to know why. Could you let us know?

[Tcahull87]

My Clear Airway Apnea events suddenly have spiked and is progressively getting worse.

Are you aware that CPAP machines often falsely flag events as central apneas? The machines can't tell whether you are awake or asleep. If you are awake and reflexively stop breathing for ten seconds or more, the machine will falsely flag this as a central apnea. But these events are nothing to be concerned about.

It's possible that your return to work at physical labor is causing you to sleep restlessly. You might be reflexively holding your breath when you change positions in the bed. You have to be awake, but possibly not aware of the awakening, to change positions.

These false centrals can be identified by zooming in on them in OSCAR (SleepyHead). This video, starting at about 3:13, shows how to identify false centrals - https://youtu.be/1OQFESwNXm0?t=193

Mystery continues. After watching the video you provided, it doesn't look like the central apneas i'm getting are false. I've attached a screenshot of the Central Apneas i'm getting zoomed in at 15 second intervals

[Tcahull87]

To sum it all up after looking at the data more in depth, and using all of your feedback, I have more information on my issue.
1) The Central Apnea events I am getting appear to NOT be false.
2) Even though in the screenshots some of the leaks appear to be large, looking at substantial amounts of periods over time, my leaks are somewhat normal and have not contributed to any apnea events in the past.
3) My Central Apnea events have almost doubled every night since going back to work, which is heavy labor.
4) Last night , with the mask on, but still awake, My Central Apnea events were through the roof.
5) I've been on a diet and lost about 60 pounds over a 5 month period, but that would not explain why my CA numbers would spike overnight.

[Tcahull87]

I don't know why this has started happening recently. You are using a lot of pressure support; it'd be helpful to know why. Could you let us know?

My original prescription dictates it. Weight issues the cause for my Sleep Apnea diagnosis in all likelihood.

[Pugsy]

1..I am not so sure that those centrals/CAs that you zoomed in on are real asleep centrals. I don't see asleep breathing flow rate there. I see awake/arousal irregular breathing there.

2.. PS of 7....pretty much a real cause for the triggering of central apneas in a lot of people. Maybe with your recent weight loss and the rather high PS...it is causing the centrals. Suggest reducing the PS to 4 and see what happens to the number of centrals.

[Tcahull87]

1..I am not so sure that those centrals/CAs that you zoomed in on are real asleep centrals. I don't see asleep breathing flow rate there. I see awake/arousal irregular breathing there.

2.. PS of 7....pretty much a real cause for the triggering of central apneas in a lot of people. Maybe with your recent weight loss and the rather high PS...it is causing the centrals. Suggest reducing the PS to 4 and see what happens to the number of centrals.

When you say PS you mean epap pressure?

[Tcahull87]

I don't know why this has started happening recently. You are using a lot of pressure support; it'd be helpful to know why. Could you let us know?

I believe the pressure support is at 4, its on the screenshots to the left, but I dont know what pressure support is, lol

[Julie]

You said it started about when you went back to work... have you seen your MD? Had a proper cardiac check-up?

Not something (Epap aside) you want to fool around with.