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chicapap
Unread post  Post subject: Events wearing CPAP when awake...how can that even be?  |  Posted: Thu Jun 04, 2020 3:08 pm

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I'm helping my mother-in-law with her CPAP therapy. We've taken it really slow, as she has early stage dementia. To acclimate her to the therapy and to tweak the fit, we had her wear it several times while awake and watching TV. The machine showed apneas, hypopneas and even snoring, while she was just sitting there breathing normally and watching TV or doing a word search puzzle. How is that even possible?! Can anyone explain this? Can you trust the accuracy of the event counts? She was talking to herself some while working the word search (helps her concentrate, lol)...would that register as events? Especially interested because she talks and makes more noise during sleep, while dreaming I assume, since beginning CPAP, so want to know if that could affect the numbers...


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Pugsy
Unread post  Post subject: Re: Events wearing CPAP when awake...how can that even be?  |  Posted: Thu Jun 04, 2020 6:57 pm
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The machine only measures air flow. It has zero way to know if we are awake or asleep.
Awake breathing is very irregular and we pause our breathing often and the machine only sees something irregular and it gets flagged as some sort of apnea event. Think of them as false positive flags. Ignore them.
The machine is flagging awake irregular breathing because there is no way for it to tell asleep breathing from awake breathing.

In terms of AHI evaluation we have to mentally remove known awake time flagged events from the therapy evaluation.
If we aren't asleep they simply don't count.

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Respirator99
Unread post  Post subject: Re: Events wearing CPAP when awake...how can that even be?  |  Posted: Thu Jun 04, 2020 7:06 pm
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G'day chicapap. It's actually pretty common for a machine to record fake or "ghost" events while the patient is awake. Remember that the machine just has a couple of pressure sensors and relies on these to detect and interpret all the signals that become part of your data. So they can be fooled by events such as talking with the mask on or holding the breath.

CPAP machines are, of course, optimised to work during your sleep, when breathing is mostly regular and fairly even. If you're awake, your breathing is quite erratic. If you're concentrating on something like a crossword (or formulating a reply on a forum) it's very easy to hold your breath for 10 - 20 seconds without even being aware of it. This will be recorded as an apnea.

To sum up, CPAP machines are pretty accurate when you're asleep, but not when you're awake.

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chicapap
Unread post  Post subject: Re: Events wearing CPAP when awake...how can that even be?  |  Posted: Thu Jun 04, 2020 8:41 pm

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oh, ok, thank you so much...I couldn't imagine how someone could have apnea while awake!


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chicapap
Unread post  Post subject: Re: Events wearing CPAP when awake...how can that even be?  |  Posted: Thu Jun 04, 2020 8:42 pm

Joined: Thu Jun 04, 2020 1:16 pm
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Now, how would it interpret sleep talking, noises...would they also be ghost events, do you think?


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Pugsy
Unread post  Post subject: Re: Events wearing CPAP when awake...how can that even be?  |  Posted: Thu Jun 04, 2020 9:12 pm
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Probably as false positives as well because the flow rate or breathing isn't going to be nice and regular.

You can go here and learn how to spot real vs arousal/awake related flagged events. While it is mainly talking about clear airway/central apneas....false positives aren't limited to centrals. Any category event can be a false positive. I have them all the time. Probably 75% of my AHI is arousal related because I do a lot of tossing and turning and have arousals because of pain issues.
http://freecpapadvice.com/sleepyhead-free-software

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chicapap
Unread post  Post subject: Re: Events wearing CPAP when awake...how can that even be?  |  Posted: Sat Jun 06, 2020 9:30 pm

Joined: Thu Jun 04, 2020 1:16 pm
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PAP Mask: Dreamwear Full Face
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Will check that out, Pugsy...thanks very much to both of you!


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