[Treatment] High Clear Airway Apneas

[Disp33]

Hi all,

I've posted once before regarding high AHI and it was a big help so I figured I would try again. I have been using my Phillips Dreamstation for just under a year now and all in all it has been going alright. For a few months I was using the dreamware nasal mask and that was going well but I had to switch back to the dreamware full face mask since my seasonal allergies started to kick in and I was breathing through my mouth at night. I was using a medium face mask for a few nights and switched to the large last night since the medium was feeling a little tight. 

I've attached a screenshot from the data from last night. I took a nap in the afternoon and during that time I had 3 OA's just from moving around. I then put the machine on for an hour and must have woke up and taken it off at some point. I put the machine back on at 4:50 when I noticed I had taken it off. From around 4:50AM to just past 7AM I had 27 clear airway events, 7 hypopneas and 1 obstructive. My original sleep study had an AHI of 5.4 with no indication of central apnea. I was wondering if anyone can figure out why my clear airway events are so high. My min pressure is set to 8.5 with a max of 16. OA events seem to be controlled but I keep having a bunch of clear airway events. I do have AFLEX turned on to 1, I have tried turning it off in the past but I find it hard to get to sleep. 


Thanks in advance!

[SarcasticDave94]

OK I'm not sure if you've posted your diagnosic sleep study data, but if not you should. You should have your own copy of each of the diagnosic and titration in a personal health file. And you should post a redacted version here. Specifically, the chart that shows event type and count to clarify the kind of CA this might be.

After almost a year in on a PAP, these aren't likely to be treatment emergent CA. Even so, specifically, how many CA showed on the diagnostic? Maybe these are idiopathic CA, unknown cause. OK then you need to create a book, noting your symptoms and complaints against the DreamStation treatment or lack of it. You will need to tell your doctor of the untreated status, therapy isn't helping as it should, fatigue still present, arousals from untreated events, similar other things, basically all the negatives to your current lack of treatment that this CPAP isn't addressing. Include the high CA and ask for a titration with ASV. If you get far enough to get an ASV script, demand a ResMed AirCurve 10 ASV and not Respironics. ResMed is the better machine on every level. This isn't just personal bias, most on the forum do better on ResMed.

[Gideon]

Turn off your flex.

Give us a 10 minute view of your centrals.

Also a 3 minute view to verify your flow limits.

I think an ASV may be in your future, we just need to support that hunch.

[Disp33]

Thanks for the reply’s! I’ve attached my sleep study data to this post. It may be important to note that I did take a few week break from CPAP when I was being treated for bronchitis. The coughing made cpap use near impossible. I also do wake up occasionally for my son/pets.

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For some reason it wouldn’t let me add multiple attachments from my phone.

[SarcasticDave94]

OK thanks, viewing that CA were roughly double the Obstructive. It's not as conclusive as a lab diagnostic, but so be it. It does look to me by these numbers a predominant Central Apnea diagnosis would be more appropriate for you, meaning an ASV will be your best bet IMO. Still it won't hurt to have a big stack of complaints on the untreated feeling.