03-12-2017, 08:53 AM
BiLevel Pressures Needed for Managing Clear Airway Events
I am 76 years old with a history of a-fib and a-flutter and have a pacemaker implant. My flutter was “cured” after two ablations. I have been in sinus rhythm for about 8 months and stopped anti-arrhythmia meds 6 months ago when starting bi-level cpac therapy. I use a RESMED AirCurve 10 S with settings of 16-10 and a Phillips Amara View mask.
My average monthly AHI’s over the past 6 months has been between 2.4 and 4.3. During this period my Obstructive index has declined from 1.17 to 0.03, while my Clear Airway (CA) events initially decreased then increased slightly (from 2.93 to 1.59 to 3.86). My Hypopneas’ have been consistently less than 0.01. From my relatively neophyte view, I would think these results are pretty good since my sleep study AHI was 15.3.
Although the number of CA events are within the normal range (<5), the vast majority of my AHI events are now Clear Airway events (initially 69% now almost 90%). Most of the CA events are clustered in the hour before awaking. I have read that patients with A-fib are likely to experience central sleep apnea, or vice versa. My cardiologist thinks that the diligent use of CPAC may prevent a recurrence of a-fib. So far that has been the case. My compliance numbers are greater than 99% with an average usage of 7 hours and 30 minutes a night.
So all seems to be going well … but I do have a question about my pressure settings. It would seem that “clear airway” events would not need the high pressures I have been using? Or are these pressures necessary to ensure that the obstructive events stay less than 1.0?
I would appreciate any insights you may have about these questions.
My average monthly AHI’s over the past 6 months has been between 2.4 and 4.3. During this period my Obstructive index has declined from 1.17 to 0.03, while my Clear Airway (CA) events initially decreased then increased slightly (from 2.93 to 1.59 to 3.86). My Hypopneas’ have been consistently less than 0.01. From my relatively neophyte view, I would think these results are pretty good since my sleep study AHI was 15.3.
Although the number of CA events are within the normal range (<5), the vast majority of my AHI events are now Clear Airway events (initially 69% now almost 90%). Most of the CA events are clustered in the hour before awaking. I have read that patients with A-fib are likely to experience central sleep apnea, or vice versa. My cardiologist thinks that the diligent use of CPAC may prevent a recurrence of a-fib. So far that has been the case. My compliance numbers are greater than 99% with an average usage of 7 hours and 30 minutes a night.
So all seems to be going well … but I do have a question about my pressure settings. It would seem that “clear airway” events would not need the high pressures I have been using? Or are these pressures necessary to ensure that the obstructive events stay less than 1.0?
I would appreciate any insights you may have about these questions.
very much appreciate everyone's replies ... I have been on the fence about making any changes....I will wait until I take a look at March info. Next doctor's appointment is in early June so that still leaves time to do a little tweaking and seek what happens.