Difference between revisions of "Justifying Advanced PAP Machines"
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== Justifying ASV == | == Justifying ASV == | ||
[[Central sleep apnea (CSA)|Central Sleep Apnea (CSA)]] is the cessation of respiratory effort result in a lack of respiratory movements. During sleep, your breathing is disrupted regularly because of how your brain functions, your brain simply doesn't tell your body to breathe, and therefore you don't try to breathe. | [[Central sleep apnea (CSA)|Central Sleep Apnea (CSA)]] is the cessation of respiratory effort result in a lack of respiratory movements. During sleep, your breathing is disrupted regularly because of how your brain functions, your brain simply doesn't tell your body to breathe, and therefore you don't try to breathe. | ||
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| + | Apnea: 80% to 100% reduction in airflow for >= 10 seconds | ||
| + | Hypopnea: 50% to 80% reduction in airflow for >= 10 seconds | ||
| + | Flow Limitation: <50% reduction in airflow for >= 10 seconds | ||
=== Five types of Central Sleep Apnea === | === Five types of Central Sleep Apnea === | ||
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# Paradoxical breathing | # Paradoxical breathing | ||
| − | A central hypopnea will have none of the above. | + | A central hypopnea will have none of the above. |
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| + | Central Hypopnea. Central hypopneas are associated with reductions of purely in-phase thoracic and abdominal effort or movement signals, followed by an increase in chest and belly movements at the end. There is no evidence of phase shifting or paradoxical breathing, no airflow flattening, and no snoring throughout the entire central hypopnea. | ||
A Central AHI is composed of Central Apnea and Central Hypopnea. | A Central AHI is composed of Central Apnea and Central Hypopnea. | ||
| − | The Central Apnea numbers are easily extracted from modern PAP machines which report detailed efficacy data. We need to concentrate on Central Hypopnea numbers to demonstrate a '''Central AHI >5''' and that '''Central apneas and Central hypopneas >50% of total AHI''' | + | The Central Apnea numbers are easily extracted from modern PAP machines which report detailed efficacy data. We need to concentrate on Central Hypopnea numbers to demonstrate a '''Central AHI >5''' and that '''Central apneas and Central hypopneas >50% of total AHI''' |
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| + | Central Hypopnea. Central hypopneas are associated with reductions of purely in-phase thoracic and abdominal effort or movement signals, followed by an increase in chest and belly movements at the end. There is no evidence of phase shifting or paradoxical breathing, no airflow flattening, and no snoring throughout the entire central hypopnea. | ||
=== Charts identifying Central Hypopneas === | === Charts identifying Central Hypopneas === | ||
[http://www.apneaboard.com/CSA-and-ASV-Updated-Morgan.pdf CSA-and-ASV-Updated-Morgan.pdf] | [http://www.apneaboard.com/CSA-and-ASV-Updated-Morgan.pdf CSA-and-ASV-Updated-Morgan.pdf] | ||
Revision as of 02:05, 1 December 2018
Contents
Justifying ASV
Central Sleep Apnea (CSA) is the cessation of respiratory effort result in a lack of respiratory movements. During sleep, your breathing is disrupted regularly because of how your brain functions, your brain simply doesn't tell your body to breathe, and therefore you don't try to breathe.
Apnea: 80% to 100% reduction in airflow for >= 10 seconds Hypopnea: 50% to 80% reduction in airflow for >= 10 seconds Flow Limitation: <50% reduction in airflow for >= 10 seconds
Five types of Central Sleep Apnea
per the Mayo Clinic
- Primary CSA, which is the same as idiopathic CSA–the patient has no known related diseases.
- Cheyne-Stokes breathing CSA, which may be a product of heart failure, stroke, or possible kidney failure.
- Non-CSB CSA associated with other medical conditions, including heart and kidney problems.
- High-altitude CSA, which often appears during sleep at altitudes above 15,000 feet, and induces a form of Cheyne-Stokes breathing with noticeably shorter cycles than classical CSB.
- CSA induced by the use of certain drugs, typically opiates.
Diagnosis of Central Apnea
- Must have clinical symptoms to make the diagnosis - Sleepiness, insomnia, snoring, apneas, awakening with Shortness of Breath, A‐fib, CHF, or neurological disorder (such as stroke, MS)
- Central AHI >5
- Central apneas and Central hypopneas >50% of total AHI
- Not better explained by another sleep disorder
Hypopneas - Obstructive and Central
How can you tell the difference between obstructive and central hypopneas?
An obstructive hypopnea contains one or more of the following:
- An increase in PAP flow signal
- Snoring during the event
- Paradoxical breathing
A central hypopnea will have none of the above.
Central Hypopnea. Central hypopneas are associated with reductions of purely in-phase thoracic and abdominal effort or movement signals, followed by an increase in chest and belly movements at the end. There is no evidence of phase shifting or paradoxical breathing, no airflow flattening, and no snoring throughout the entire central hypopnea.
A Central AHI is composed of Central Apnea and Central Hypopnea. The Central Apnea numbers are easily extracted from modern PAP machines which report detailed efficacy data. We need to concentrate on Central Hypopnea numbers to demonstrate a Central AHI >5 and that Central apneas and Central hypopneas >50% of total AHI
Central Hypopnea. Central hypopneas are associated with reductions of purely in-phase thoracic and abdominal effort or movement signals, followed by an increase in chest and belly movements at the end. There is no evidence of phase shifting or paradoxical breathing, no airflow flattening, and no snoring throughout the entire central hypopnea.
Charts identifying Central Hypopneas
CSA-and-ASV-Updated-Morgan.pdf
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