[CPAP] Clear airway apnea

[mahfuzsujan]

I am a new user of Resmed airsense 10 auto machine with Resmed airfit n10 nasal mask. I am not using any humidifier. My pressure level is set as 4 to 15. Mode is APAP. Recently I installed SleepyHead software. My average statistics is enclosed herewith, where it shows that my Clear Airway Index is always 2 or 3 times more than my obstructive index. Total average AHI is more than 3.5 and sometimes it is over 5 or even 6. One night statistic: AHI = 6.27 (CA = 3.69 + OA = 2.09 + H = 0.49). Please note that earlier my Central Apnea index was 0 in my sleep test study.

I am worried about my CA index. Should I change the mode (which is currently APAP) or should I change the pressure level (4-15). My machine supplier suggested me to change the machine. Can anyone suggest me what should I do now?

[DeepBreathing]

G'day mahfuzsujan. Welcome to Apnea Board.

It's not unusual to experience some clear airway apneas when you first start using xPAP therapy. In most cases they will go away after a few weeks or so as your body gets accustomed to the pressure. If your average AHI is 3.5, then you're doing pretty well, and the small number of CAs you're getting probably aren't worth worrying about.

It would help if you could attach a screen shot from SleepyHead showing a typical night - we need the data panel (the pie chart and the stuff below it), events, pressure, flow rate and leak rate. Once we see those charts we can give you some more detailed advice.

But there's no need to worry unduly, and don't let them talk you into buying a new machine just yet...

[Crimson Nape]

Hi mahfuzsujan,
Welcome to the forum.

Like DB said, this is a normal occurrence when starting therapy. This might be nothing more than a pressure induced CA. A pressure induced CA is akin to sticking your head out of a moving car and trying to breathe. Another possibility is that you took a deep breath prior to the CA. and you didn't need another breath for more than 10 seconds.

Since you have SleepyHead, look at when a CA occurs. Expand the Flow Rate chart looking at your breathing pattern prior to the CA, as well as, looking at the pressure around that point in time. Also look at the duration in the Events tab.

Your numbers don't seem to show any cause for alarm. All I can say is to relax and enjoy the restful sleep.

Good Luck!

[mahfuzsujan]

Tanks for the replies. Actually I have been using this machine for 17 weeks (from December 26, 2015). On January 3, 2016, AHI-4.26, CA-1.94, OA-1.16 & H-1.16, where on February 4, 2016 AHI-5.27, CA-3.65, OA-1.22 & H-0.41, indicating CA has been increased. As suggested by both of you I tried to capture the screen shot accordingly.[attachment=2154].

Please advise.

[pholynyk]

With 17 weeks of data, you have enough to look at the overview charts for the last two or three months. That will enable you to spot trends over time, instead of comparing two (semi-)random days.
You will be able to see AHI as well as its components. Then you can look at the other charts to see if you can spot some correlations - by eyeball, at this stage.

[mahfuzsujan]

Sorry it was typo error, 7 weeks not 17 weeks. After 1st 7 days, I took the report from the vendor (it was a ResScan report), who informed me that my problem is Central Apnea and not Obstructive Apnea. In the report Central Apnea was also mentioned as 3.5.

My question is: Is Central Apnea data of ResScan is same to Clear airway Apnea of SleepyHead? In the Redmed airsense 10 auto monitor Central Apnea is also been displayed as 2.2 to 2.5 now a days. Sorry once again for typo error.

[DeepBreathing]

Is Central Apnea data of ResScan is same to Clear airway Apnea of SleepyHead?

Yes they are. It's just that you really need some additional instrumentation to say for certain that you're experiencing a true central apnea, so SleepyHead uses a more cautious terminology.

Although your central apneas are dominating, your total apnea is not too bad. Not enough to go for an ASV machine just yet (they are really expensive). One thing you might try in the meantime is to turn off the EPR (exhalation pressure relief). The EPR reduces the pressure as you breathe out, making it easier to exhale. However it is known to cause central apneas in some patients. Try reducing it from 3 to 2 or 1, or even turn it right off, and see if this makes a difference.