Degressive Order of Apnea?

[MaskedOne]

Maybe a dumb question but, health-wise, are CAs worse than OAs or UAs worse than Hs or one type of apnea worse than another?  Is there a degressive order in the types of apnea & hypopnea?  Asked another way, is it best to have fewer CAs than OAs or fewer OAs than UAs or fewer one type of apnea than another?

[Sleeprider]

If this is your event breakdown, then I would bet most of your CA and H events are actually obstructive and your flow limitations are out of sight. Any obstructive events means you are using high respiratory effort which creates a very high differential negative pressure between your chest and the source of obstruction which is stressful on you heart, lungs and disruptive to sleep. CA events tend to be passive, and normally respond due to pauses in respiration because ventilation needs are met, and a lack of CO2 is not driving respiration. There are exceptions where it is certainly not good for your health or is the result of health problems, but for the most part I want to resolve obstruction first, and CA second, and if CA cannot be resolved, then use a therapy alternative that targets that.

[staceyburke]

Apnea is a period of time not breathing. They are classified at the bottom of this post. So one is not “better or worse”. To be a full apnea it must be 10 seconds or longer. You can put your mouse on top of the line indicating an apnea to see how many seconds it lasted.

If they don’t last 10 seconds they will not be counted as apnea but could be considered a flow limit.

So I would say the duration and how close together they happen would be what would cause more of a worry instead of which kind.

Last is a central or clear airway is a different type of apnea where there is no obstruction - you just did not breathe for at least 10 seconds.

[MaskedOne]

Thanks all for the explanations.  See, I thought central apneas were more concerning than obstruction apneas because I've read that CAs are a brain malfunction whereas OAs are a physical or airway malfunction.  Always good to hear someone else's reasoning.

I rechecked the night of the event breakdown (1/15/24) and I had three CAs lasting 10-13 seconds, none showed a concurrent flow limitation.  I had 4 hypopnea events, all associated with flow limitations as they should be.

[Sleeprider]

CA events are way over-rated. While they can be related to serious problems like heart failure, neurological conditions, pulmonary or metabolic imbalances and other causes, the infrequent ones we see in most peoples therapy from time to time is "idiopathic" or without cause. Most of them are simply a breath-hold or pause as a person arouses and moves at night, or experiences a change in sleep stage. About 15% of individuals that use CPAP therapy will have therapy onset central apnea resulting from the increased ventilation. We will see periodic breathing and unstable volumes near the apneic threshold. These are more of a concern, but still not a serious condition for most, and many of those cases self resolve as the person adapts to CPAP and adjusts to increased ventilation. If you were experiencing 5 to 20 or more CA events per hour we would be more concerned about looking for a solution, but very low occurrence rates are not a problem at all. If you were to monitor your breathing during the day, you would have dozens of CA events from focusing on a task, physical exertion, and just missing breaths. Wake breathing is normally very erratic.

[TechieHippie]

Thank you for such a clear description. Wouldn't the breath holding during the day be problematic too? I suppose only if the oxygen drop resulting from it was an issue. But it seems that there would be an opportunity to improve health if we could improve our daytime breathing also. I suppose that's one reason people meditate.

[Sleeprider]

Your body has a wonderful mechanism to equalize out the problem of breath-holding. It builds up CO2, which drives a strong respiratory response. Hold your breath a few seconds and the next few breaths will be deeper and faster than normal. Hold it for a long time an you will literally pant. Prove me wrong. CO2 mainly drives respiration, and whether you're awake or asleep, you cannot resist its affect on your breathing rate and volume. I dare you to try to die by holding your breath (say many parents to a 6-year old). Hyperventilate for 30 seconds and then don't breathe... you will be perfectly comfortable holding your breath until CO2 builds up, then you WILL breathe. There are actually complex chemical sensors (pons) in your brain that can sense CO2 elevation and cause an autonomic response. As long as your body does not sense this imbalance, it's quite easy to hold your breath longer than 10 seconds, the definition of a central apnea. This article might help explain why we call an apnea "central" https://criticalcarenow.com/the-vitals-u...ory-drive/

Warning, we are diving deeper into the rabbit hole...how far do you want to go? If this doesn't take you to your limits, I have not done my job. https://www.apneaboard.com/wiki/index.ph...tory_Drive