[Diagnosis] High Clear Airways

[PB1974]

This is my first post but I have been a long time CPAP/APAP user. I have always had high Clear Airways events with all my different machines over the years and my doctors have constantly told me that the treatment is working and acceptable even though my AHI is often well over 10, with most of the events being Clear Airways. I am attaching a screen shot of a typical night. Does anyone have any input on what settings might help with lowering my Clear Airawys events? 

Thanks in advance. 

[Dormeo]

Hello, PB 1974. Your doctors are completely wrong; your CA index is unacceptably high. Do you by any chance have a copy of your most recent sleep study? I ask because it would be quite helpful to know whether you had a high CA index at that time. If you don't have a copy, I would suggest you request one. In the U.S., you have a right to have a copy.

I will happily defer to any experts who may comment, but given how few obstructive events you have, I will suggest that you turn off the EPR and set your minimum to 8 and your maximum to 8. This is an experiment to see whether maintaining lower pressures will lower your CA rate without allowing an uptick in your obstructive events.

To change your pressure settings, see the link for manuals at the top of the page.

Not sure why so much "junk" appeared in your post; maybe a tech-savvy person can help.

[SarcasticDave94]

You may want to post your sleep study info in detailed, redacted format. If you live in the US, you are legally permitted to obtain a copy of your medical info such as this. If you've been on PAP therapy over 3 months, and the CA aren't going away, I'd say your doctor is blind to CA and doesn't know how to treat these. If that's true, and given we don't know what's in the sleep study, it's possible you are on the wrong PAP machine. It may be you need an ASV, the only one that can treat CA. Other PAP machines can avoid it only.

Some of the current machine settings can't be viewed as posted. If you're using EPR or Ramp, I'd suggest both need to be Off. These add to pressure swings that add CA. I don't think this will be enough to clean up that messy chart however.

It looks like some link or code didn't get posted properly.

[Gideon]

You have EPR = 2 currently. Please set it to zero or off to reduce your Central Apneas.

It's a start anyway definitely an unacceptable CAI

[Sleeprider]

The path to reducing CA events is to use steady pressure without EPR, so as usual Bonjour is right on. I will add the suggestion to use fixed pressure at 10.0 and eliminate EPR and see what happens. I really think your ultimate solution is to change doctors, and find one that recognized complex apnea and properly treats it with ASV. We can deal with that later. The use of fixed pressure and no EPR should bring about a reduction, however we have learned that CA events are consistently inconsistent.

[rebirth]

I'm just starting and not accepting my 2.5 CA's. I'm not kidding you when I say that I would not use a machine if it gave me that many CA's. I don't know what country you are from but if it's the U.S. I know some doctors (from personal experience) aren't even doctors. Fake degrees and all kinds of medical corruption and scams. I would be doing some serious investigation. IMO this doctor is not real or is incompetent. I would trust the people on these board advice over your DRs. But even so, you want a real and competent doctor.

Just to make sure these are actual CA's. Try setting up a camera on yourself sleeping with a clock in view. You could check the footage at the time of your CA's. and see what's going on. I'm about to try this myself.