Should much higher Clear Airway Index than Obstructive Apnea Index be concerning?
Hi. I'm about ten days into APAP use (with auto pressure ranging from 6 to 16, averaging around 7 nightly) and see my nightly numbers consistently showing much more Clear Airway events (which I construe to mean central apnea) vs. Obstructive Apnea. I've read that CPAP/APAP is not the ideal device for those who primarily have central apnea, but meanwhile I'm mindful that my AHI has been lowered substantially since starting use of the machine. The weekly average is 3.36 of which 2.47 was CA and 0.66 was OA. Meanwhile my initial polysomnography report, (back in January, long before actually getting the machine) on the first (baseline) of my two overnight sleep studies (the second being titration) showed 43.4 AHI using the AASM scale, and 13.5 using the CMS scale. My statistics for last night are copied/pasted below. Should I be concerned about the significant imbalance which discloses much more central apnea vs. obstructive, or are these numbers so small and the improvement so notable with CPAP that this should be dismissed as minutaie?
AHI
2.73
AHI Median
2.73
Obstructive Apnea (OA) Index
0.15
Hypopnea (H) Index
0.00
Unclassified Apnea (UA) Index
0.15
Clear Airway (CA) Index
2.42
RERA (RE) Index
0.00
95% Flow Limitation
0.03
% of time in Cheyne Stokes Respiration (CSR)
0.00%
RE: Should much higher Clear Airway Index than Obstructive Apnea Index be concerning?
Can you post some OSCAR charts? It's better to actually see them.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Should much higher Clear Airway Index than Obstructive Apnea Index be concerning?
Sorry, Dave, but my charts are not displaying properly and what I've got is not useful. "Crimson Nape" is trying to help in the Software Support Forum, but so far, no fix.
05-04-2024, 12:52 PM
(This post was last modified: 05-04-2024, 12:54 PM by SarcasticDave94.)
RE: Should much higher Clear Airway Index than Obstructive Apnea Index be concerning?
Ok copy.
The higher CA can mean a few things, it could be treatment emergent Central Apnea, or if you had the CA on your sleep study, this then indicates you may need to address the CA maybe with an ASV. Alternate is the avoidance plan, no Ramp, less EPR, shorter pressure range, etc. If that doesn't work well, a ResMed VAuto using high trigger can help.
What applies is not yet determined.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Should much higher Clear Airway Index than Obstructive Apnea Index be concerning?
Dave, I think what you first mentioned is the answer: treatment emergent CA. I checked my two polysomnography reports from three months ago. Neither showed any CA, nor any OA; it was all obstructive hypopneas (hence my chosen screen name here, lol.) In addition, my wife went back a year to check her OSCAR data. It showed more CA than OA; now she mainly has RERAs and hypopneas and only small amounts of OA and CA. So perhaps this will settle down; I'm only about ten days into APAP usage, and I didn't know that there was even such a thing as treatment emergent CA. I'll watch the numbers and discuss with the sleep physician who wanted to see me after I have about a month of this under my belt. That will be late in May. Thanks for your comments.
RE: Should much higher Clear Airway Index than Obstructive Apnea Index be concerning?
If there were no CAs in your sleep study these are treatment-emergent and will lessen as time passes.
Machine: ResMed AirCurve 10 Vauto
Mask: Bleep DreamPort Sleep Solution
RE: Should much higher Clear Airway Index than Obstructive Apnea Index be concerning?
Deborah, that confirms what Dave first said. In addition, based on your calling my attention to the initial sleep studies (2), I checked the reports and in neither case were there any CAs. It was all obstructive hypopneas (hence my screen name). Thanks for helping put my concern to rest.
RE: Should much higher Clear Airway Index than Obstructive Apnea Index be concerning?
I think I might have a similar issue to the original poster. My AHI is pretty good overall, but it seems to be very concentrated into a small time when the machine upped the pressure (presumably because of a small number of OA and H events) and then I had a whole bunch of consecutive CA events. See the attached zoomed in on the time in question - the times are off by an hour but I don't think that matters). I've only been going a few days so far so I'm not concerned yet, but does anyone have experience on how often something like this happens before one should be concerned and go back to the Dr. about it?
05-15-2024, 08:26 PM
(This post was last modified: 05-15-2024, 08:28 PM by SarcasticDave94.)
RE: Should much higher Clear Airway Index than Obstructive Apnea Index be concerning?
ac123,
If we could get you to increase your min pressure to 7, this may take care of the Obstructive Apnea and Hypopnea (OA & H), leaving only those few Central Apnea (CA).
You can do this yourself in the clinical menu by holding both Home and Dial in for about 5 seconds then scroll to the correct setting field, click then scroll to edit, click again to lock it. Then the home button to exit.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Should much higher Clear Airway Index than Obstructive Apnea Index be concerning?
(05-15-2024, 08:26 PM)SarcasticDave94 Wrote: If we could get you to increase your min pressure to 7, this may take care of the Obstructive Apnea and Hypopnea (OA & H), leaving only those few Central Apnea (CA).
 I've literally been doing this for only two nights, about to start my third. The first night I didn't realize the device had no SD card, so really I only have one night of data (unless you count the sleep studies). I'd like to gather at least a week of data (not to mention get fully used to it, I think I did pretty well for a newbie), and then check and make changes from there. If this keeps up that will be my first thing to try.
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