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Posted by RPSGT on February 09, 2003 at 10:45:53:In Reply to: central hypopneas posted by central hypopneas on February 08, 2003 at 03:48:54:
Polygraphic examples can be seen in John Shepard Jr's "Atlas of Sleep Medicine" pp 98-99 and 155.
Our lab criteria is:
Central Hypopnea: Minimum 10 second duration of >30% airflow reduction, amplitude-locked with reduced effort, no snoring during the event but frequently seen during recovery breaths at arousal, no paradoxng of respiratory excursion belts, beginning and ending with a decrescendo/crescendo and primarily seen in a cyclic pattern in stages 1 and 2. We also have an arousal and/or desat requirement.
The Atlas of Sleep Medicine suggests that these events should be scored as central hypopneas when repetitive arousals and recurrent desaturations are present.
Central Hypopneas are similar to Cheyne-Stokes and periodic breathing and can occur at the same time. They can also occur with hypoventilation syndrome.
Central Hypopneas are not obstructive in nature so it is easy to overtitrate CPAP or ruin a titration if the recording tech does not understand what the physiology behind these events really is.
Sometimes Bilevel will help, when titrated with a high gradient in stable sleep, like titrating bilevel in CSR.
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