apnea vs hypopnea

[KSMatthew]

Right now I have Flex enabled, and set to the minimum (1). I'll give it a week and see what happens. I just made a prescription change and need to give it some time. Plus, I've been dealing with a bit of a pollen problem that's inflamed my sinuses just enough that it may be part of the problem

[rkl122]

OpalRose: From the Wiki: see top of page.
Apnea - Cessation of breathing for 10 or more seconds during sleep. There are two basic types of sleep apnea: Obstructive Apnea is caused by a closure of the air passage despite efforts to breathe; Central Apnea is a lack of effort to breathe. Obstructive Sleep Apnea is by far the most common type. True apnea during wakefulness is extremely rare.

The definition I find in the Wiki is
"Apnea, apnoea, or apnœa (from the Greek, meaning to breathe) is a term for suspension of external breathing. During an apnea event there is no movement of the muscles of respiration and the volume of the lungs initially remains unchanged. "

This is in line with generally accepted medical terminology. So it doesn't have to be while sleeping. (If it were, the condition from which we suffer would be called "apnea" rather than "sleep apnea.") Holding the breath eg. swimming under water, is technically an apnea condition.

/nitpicker

EDIT - I see where the OpalRose quote comes from. It's different from my source (in the same Wiki): http://www.apneaboard.com/wiki/index.php?title=Apnea which I do think is correct.

-Ron

[OpalRose]

Flex settings 1, 2, and 3. for PR machines
You can receive up to 2cm pressure relief, but is flow based.
• C-Flex – Provides pressure relief upon exhalation.
• A-Flex/C-Flex+ – Provides pressure relief taking place at the end of inhalation and at the start of exhalation.

From the Wiki: see top of page.
http://www.apneaboard.com/wiki/index.php...efinitions

Apnea - Cessation of breathing for 10 or more seconds during sleep. There are two basic types of sleep apnea: Obstructive Apnea is caused by a closure of the air passage despite efforts to breathe; Central Apnea is a lack of effort to breathe. Obstructive Sleep Apnea is by far the most common type. True apnea during wakefulness is extremely rare.

Hypopnea - An episode of diminished breathing during sleep, caused by a partial airway obstruction, and resulting in arousal. Usually accompanied by oxygen desaturation. Hypopneas may be just as serious as apneas and have the same troublesome effects.

[PaytonA]

Apnea- a cessation of breathing
Sleep Apnea - a cessation of breathing while asleep. Defined requirement of at least 10 seconds of duration

I am not sure that I agree that hypopneas are as troublesome as apneas. By the definition hypopneas include a defined degree of oxygen desat. Our CPAPs do not measure oxygen saturation so when they score a hypopnea it may or may not be a true hypopnea. By the definition hypopneas can be as troublesome as apneas but what we see reported as hypopneas from our machines may or may not meet the full definition of an hypopnea and if it does not then it is, in my opinion, not as troublesome as an apnea. Our problem is that we have no way of knowing without using a recording pulse-ox while we sleep and lining the results up with the hypopneas.

Best Regards,

PaytonA

[KSMatthew]

Apnea- a cessation of breathing
Sleep Apnea - a cessation of breathing while asleep. Defined requirement of at least 10 seconds of duration

I am not sure that I agree that hypopneas are as troublesome as apneas. By the definition hypopneas include a defined degree of oxygen desat. Our CPAPs do not measure oxygen saturation so when they score a hypopnea it may or may not be a true hypopnea. By the definition hypopneas can be as troublesome as apneas but what we see reported as hypopneas from our machines may or may not meet the full definition of an hypopnea and if it does not then it is, in my opinion, not as troublesome as an apnea. Our problem is that we have no way of knowing without using a recording pulse-ox while we sleep and lining the results up with the hypopneas.

Best Regards,

PaytonA

One of the disadvantages of relying on a self-titrating CPAPs vs a sleep lab is that you don't get all the same data for a complete analysis.

The machines record apneas and hypopneas, and generate the AHI score that so many of us rely on. This score may be different from what you get in a lab. I did see, somewhere, that PR will flag a hypopnea when it seens certain waveforms, but because it doesn't do any pulse-ox measurements it's going to be a best guess only.

In my case, my apnea index has been at or below 1 most nights. But my AHI scores have been 3+. The other night I was > 9, but that was a one-off (car problems, tow truck, 3AM kind of one-off) and I didn't sleep well. The next night, last night, I was around AHI=3. My guess is that when I look at the breakdown on SH, I'll see apnea index = 0 and hypopnea index = 3.x.

The problems come when we look at AHI>=5 being OSA definitions, but our AHI scoring on the machine isn't going to be the same as what the lab will show.

[PaytonA]

For Resmed machines scoring OSAs the definition and the machine scoring are quite close together. Both the CPAPs and the sleep lab use secondary indicators in order to determine whether an apnea is a CA or an OA. The FOT is over 95% accurate. I think that we can all agree that the machines can certainly detect when the patient quits breathing and for how long.

The definition of hypopneas leaves room for interpretation.

Best Regards,

PaytonA