High Number of Central Apneas

[HungryPanda]

Hello,

I have been using my CPAP consistently for about 4 months now, and have found that I seem to be having a large number of Clear Airway events. My doctor and I had talked about treatment emergent central apnea, and that it would likely reduce or go away over time, however, it seems that as of the last few weeks, the central apnea events have actually been increasing. I definitely feel that my sleep quality has gotten worse this last month and I am not sure why, as I haven't made any changes to the CPAP settings.

I have been tracking the data in Oscar, but could use some help looking at the data, as I don't understand much past the surface level of what it is showing me. Here are shots of the last 3 nights from Oscar. Any help would be much appreciated!

   

   

   

Thank you!

[staceyburke]

You are having some positional apnea. You can see positional apnea where either H or Oa events are clustered together. Getting rid of as many as you can will lower your AHI. Positional apnea can NOT be controlled by pressure changes. You have to find out what position you are getting into and cutting off your own airway. Have you changed your sleep position? Sleeping on your back? Using more (or new) pillows? These things can cause positional apnea by chin dropping to your sternum and cutting your airway. Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar. I have a link to collars in my signature at the bottom of the page. It shows people who are not wearing a collar and the SAME person wearing a collar. There is a huge difference between the two.

[Deborah K.]

Yes, you do have positional apnea.  Correcting that will help a lot.  Also, your settings need adjustment.  I suggest you raise your low-pressure setting to 7 and your high-pressure setting to 14.  5 is too low for most adults and you are bumping up against your 11 way too often.  As to your CAs, did you have a lot of them in your sleep study?  If not, they are probably treatment-emergent, just taking a long time to go away.  If you had a lot, posting a redacted copy of your sleep study would be very helpful.

[paulag1955]

It might also be helpful if you could post a chart from a night from before your central apneas got worse.

[HungryPanda]

Thanks for taking the time to respond! I haven't changed pillows, and have not intentionally changed sleeping positions, but tend to be a side and back sleeper. I was planning to try a thinner pillow and find some way to prop myself so that I will stay on my side, as I understand sleeping on your back is normally the position that tends to cause airway collapse. I'll definitely look into a collar if those changes don't seem to be enough.

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Yes, you do have positional apnea.  Correcting that will help a lot.  Also, your settings need adjustment.  I suggest you raise your low-pressure setting to 7 and your high-pressure setting to 14.  5 is too low for most adults and you are bumping up against your 11 way too often.  As to your CAs, did you have a lot of them in your sleep study?  If not, they are probably treatment-emergent, just taking a long time to go away.  If you had a lot, posting a redacted copy of your sleep study would be very helpful.

Hi Deborah,

As far as I am aware, I did not have any CAs during the sleep study. I will reach out to my doctor to see if I can have them adjust the pressure settings based on your suggestions. I really appreciate the help!

[SarcasticDave94]

You might not be aware, but you can adjust your CPAP legally and free. You only need to access the clinical menu, then edit the settings. Otherwise, asking doc to do it typically causes a billable office visit.

Your info lists your CPAP as ResMed 11, correct? Access to the clinical menu is using 2 fingers, touch and hold the blue colored "My Options" and the purple "My Sleep View" boxes at the same time. After a few seconds, the background color will change to white. This signifies access to the clinical menu where you can edit pressures.

Now, there's a blue box called Settings. Click and you'll see mode and pressures. Click into the appropriate areas and edit them. Example, pressure range on AutoSet shows a pressure chart much like a digital calendar, click the low and high limits and then click blue box OK to lock it in. When you've done editing, there's a Home icon top left corner in the white background, click to exit and return to patient area.