CA while "awake" or "restless"

[Wcwilson]

Now that I'm getting so good at posting attachments    here they are with Tidal Volume.

Is there an easy way to tell the ResMed software or Oscar to reclassify anything that's a CA with less than 10 sec?

[alexp]

Now that I'm getting so good at posting attachments    here they are with Tidal Volume.

Is there an easy way to tell the ResMed software or Oscar to reclassify anything that's a CA with less than 10 sec?

Ok since you said this is the first time you saw this pattern, I will rule out periodic breathing. The rise in flow rate after each central is not really smooth anyway so it doesn't look like it.

See the big jumps in tidal value compare to your normal level right before the central event? It means you took a couple of deep breaths, inspiring almost twice as much air as normally. Then your body figured out it didn't need air for a while and waited before breathing again. This usually means you were awake, or you were tossing and turning, as the breathing during NREM sleep is normally pretty regular. It happens a lot too when you are transitioning from being awake to sleeping as your body is trying to find it's breathing rhythm. It can also happens in REM sleep when you are dreaming but this doesn't look like REM sleep.

When you are experiencing real central apneas, the tidal volume is usually stable before the event. The tidal value then drops abruptly because your brains doesn't send the signal to breath but again there is no big increase before the event. So use the tidal volume chart as a guide to judge your clear airway events.

[Wcwilson]

Thanks Alex, that's good to know.

[Dormeo]

[Referencing Wcwilson's data for the following questions:]  A question for the experts: I see OAs while the pressure is down at the bottom of its range. Would it be good to try raising the minimum?

I also see that the total time in apnea is around 43 minutes, which  seems like a lot. And one of those OAs in the zooms is impressively long! Given that there does seem to be some clustering, another question for the experts:  Would trying a cervical collar be worthwhile?

[Melman]

According to your profile you are running a constant pressure of 7.4. Apparently that's n0t the case. What is your range? Please update your profile. Also, please post an OSCAR daily chart showing the OA at the low pressure.

Since your question is unrelated to the topic of the tread I will recommend to the moderators that the move it to a new thread.

[Crimson Nape]

A question for the experts: I see OAs while the pressure is down at the bottom of its range. Would it be good to try raising the minimum?

Not seeing your charts, I'd say that if your starting  pressure is over 1.5cm below tour median pressure, then I'f try bumping it up.

.  .  .  Would trying a cervical collar be worthwhile?

You can try a collar.  The normal collars sold have a covering that tends to make you feel hot.  That's fine in the winter but are uncomfortable in warm to hot climates. I'd recommend searching for a "sleep collar"..  They're the same design but have a cooler feeling cover fabric.

[Wcwilson]

Last night was more typical.  I had a significant number of CAs just after waking to go to the bathroom.  I found how to see how long they last (events tab) and most were less than 20 seconds.  What I remember is that during that time I was predominantly on my back.  I would someone know I was holding my breath and at some point I would have to open my mouth in order to release the pressure.  When I'm breathing steadily this is not a problem.

So, I have two last questions.  First, when my doctor prescribed my test it was with an Unattended home sleep study with Itamar WatchPAT 2000 FDA approved device.  The results were:

Interpretation Date : 08/22/19 , study date 8/18/2019.

Body mass index of 25.8kg/m2 , weight 174 lbs.

MOderate sleep apnea syndrome with an estimated overall respiratory disturbance index (RDI) 17 events per hour. (REI - respiratory event index- was 5). 

The ODI oxygen desaturaion index was 2 per hour.

Sleep apnea appeared to be worse in REM sleep (21 events per hour) and no worse in supine sleep (16 events per hour) in comparison to non supine sleep (21 events per hour). 

Nadir saturation 88 %. Hypoxic time below 89% was about <1 minutes. 

Snoring was mild.

There was no subjective hypersomnolence with ESS of 6.
There was no depressive symptomatology ( Zung score 0.46 ).

The thing I remember about the test was that I was extremely restless during the night.  Would such a test be able to differentiate between a CA and an OA?

Secondly, what would be an example of an additional therapy a doctor might prescribe to deal with CAs?  From my data it appears I'm still losing an hour of sleep per night.

Thanks.

[alexp]

Last night was more typical.  I had a significant number of CAs just after waking to go to the bathroom.  I found how to see how long they last (events tab) and most were less than 20 seconds.  What I remember is that during that time I was predominantly on my back.  I would someone know I was holding my breath and at some point I would have to open my mouth in order to release the pressure.  When I'm breathing steadily this is not a problem.

So, I have two last questions.  First, when my doctor prescribed my test it was with an Unattended home sleep study with Itamar WatchPAT 2000 FDA approved device.  The results were:

Interpretation Date : 08/22/19 , study date 8/18/2019.

Body mass index of 25.8kg/m2 , weight 174 lbs.

MOderate sleep apnea syndrome with an estimated overall respiratory disturbance index (RDI) 17 events per hour. (REI - respiratory event index- was 5). 

The ODI oxygen desaturaion index was 2 per hour.

Sleep apnea appeared to be worse in REM sleep (21 events per hour) and no worse in supine sleep (16 events per hour) in comparison to non supine sleep (21 events per hour). 

Nadir saturation 88 %. Hypoxic time below 89% was about <1 minutes. 

Snoring was mild.

There was no subjective hypersomnolence with ESS of 6.
There was no depressive symptomatology ( Zung score 0.46 ).

The thing I remember about the test was that I was extremely restless during the night.  Would such a test be able to differentiate between a CA and an OA?

Secondly, what would be an example of an additional therapy a doctor might prescribe to deal with CAs?  From my data it appears I'm still losing an hour of sleep per night.

Thanks.

Did you have a belt around your chest during that test? If yes, they can tell if your apneas were central or obstructive.

[Wcwilson]

No belt, just a thing on my finger and a thing just below my adams apple, all connected to some sort of watch.

[slowriter]

The belt is used to measure respiratory effort, so presumably that test didn't.

As for your question treating centrals, there's a ton of stuff on this forum; just search for ASV and CAs.