Central vs Mixed

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Central vs Mixed

Postby MrBig » Fri Jul 08, 2016 7:19 am

What do you think? Central apnea (red line) or Mixed apnea (blue line). Note, the green lines are 5 seconds apart, not 1.
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Re: Central vs Mixed

Postby StuKing » Mon Jul 11, 2016 2:49 am

Personally, I would call it a mixed apnea. The rule for mixed apnea says:
Score an apnea as mixed if it meets apnea criteria and is associated with absent respiratory effort in the inital portion of the event, followed by resumption of respiratory effort in the second portion of the event


My understanding has always been that the intention of the mixed apnea rule is for the event to continue as apneic in the obstructive portion.

However, let's look at this event in the light of the rule:
    1. The event meets the criteria for an apnea (>10 seconds of >90% decrease), so the first criteria of the rule is met (ie: meets apnea criteria).
    2. The initial portion of the event (ie: the component which meets the apnea criteria) is associated with absent respiratory effort (so the second criteria is met).
    3. The second portion of the event shows resumption of respiratory effort, so strictly speaking the final criteria is also met
So I would be comfortable in interpreting the mixed apnea rule as applying to this event, provided the initial central portion meets the apnea criteria in it's own rights (which it does).

Nice cardiac oscillation on the pressure signal by the way.
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Re: Central vs Mixed

Postby somnonaut » Mon Jul 11, 2016 11:13 am

Don't yell at me, I scored it Mixed.
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Re: Central vs Mixed

Postby somnonaut » Mon Jul 11, 2016 11:13 am

BTW, its June epochs 24-25
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Re: Vmware Online Training

Postby MrBig » Mon Sep 26, 2016 5:40 am

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Kill yourself.
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Re: Central vs Mixed

Postby RayMeece » Thu Dec 22, 2016 8:53 pm

It's 2 events - a Central apnea followed by a hypopnea. The 2nd "half" is clearly obstructive, but it does not meet the apnea criteria, so the hypopnea is scored
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Re: Central vs Mixed

Postby andrew234 » Sat Jan 21, 2017 6:22 am

Central waves are good enough...
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Re: Central vs Mixed

Postby StuKing » Mon Jan 23, 2017 11:39 pm

RayMeece wrote:It's 2 events - a Central apnea followed by a hypopnea. The 2nd "half" is clearly obstructive, but it does not meet the apnea criteria, so the hypopnea is scored


AASM Scoring Manual, VIII C (Scoring of Apneas): Note 2. If a portion of a respiratory event that would otherwise meet criteria for a hypopnea meets criteria for apnea, the entire event should be scored as an apnea.
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Re: Central vs Mixed

Postby slope » Fri Jan 27, 2017 12:22 am

mixed
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Re: Central vs Mixed

Postby RayMeece » Mon Jul 17, 2017 4:04 am

Okay, I'll go with a mixed apnea, but I'l go kicking and screaming. LOL
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Re: Central vs Mixed

Postby Onesight1 » Mon Mar 26, 2018 7:50 am

Personally, I'd score it center and try to see if the other flattening carries a desaturation that qualifies for a hypopnea.

However, depending on the other events I've seen for this patient..., then I'd score Mixed.

however StuKing posted this " AASM Scoring Manual, VIII C (Scoring of Apneas): Note 2. If a portion of a respiratory event that would otherwise meet criteria for a hypopnea meets criteria for apnea, the entire event should be scored as an apnea."

and I cant disagree. Going forward I will try to stay true to that rule.
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