Central apneas

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Central apneas

Postby donkeybalz » Fri May 02, 2008 4:16 am

Is is ok for a pt to have central apneas as long a their not desating. I was titrating a pt and he kept haven central apneas here and there during titration but with no desats. I fairly new at the game so any info on how to titrate centrals would be nice. The pt has no medical history of respiratory ailments either other than severe severe apnea. Pt had 65% drops in o2 during base study. With cpap at 10 cm Pt looked very good and then the centrals starting happening.
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Postby Sleepladypalmdesert » Fri May 02, 2008 12:35 pm

We don't worry about a central here and there with no desat, if there is no arousal. Lots of times these can be seen while in REM sleep and that is not of concern to us. As long as they are here and there and not causing desats or arousals they are not really scoreable. Remember, you can have up to 5 events an hour and be within normal limits.
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Postby Drake » Tue Dec 18, 2012 5:41 am

Ok,so what is going on when you put a pt on Cpap ,and they start to have Centrals,but they are mostly awake? I had someone like this and I did increase the pressure until it stopped,as I did the pt seemed to be in and out of REM..So was the pt just holding their breath for about 20sec many times or what?
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Postby SLOW_WAVE775 » Tue Dec 18, 2012 11:40 pm

What you described sounds like sleep onset events...In my facility, they are not considered clinically signifigant and are not scored(assuming they resolve 5 minutes or so after sleep onset). If the epoch is scored as "WAKE" then the event shouldnt be scored anyways. If they continue, then this is typically a sign of therapy intolerance or a result of therapy acclimatization. If it's intolerance, then an alternate therapy may be indicated...if it's because the patient is acclimating to therapy, then the events should resolve on their own.
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Postby Drake » Wed Dec 19, 2012 4:43 am

Thank you.I did allow time for it to resolve,but it kept happening for a good 15-20 mins.After I increased the pressure it began to slowly fade away.
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