AHI that varies GREATLY daily - CSR and Periodic breathing

[Daisylouu]

Desperately trying to figure out why my numbers change so dramatically from day to day. Results of a sleep study are not very accurate for someone like me whose results very WIDELY from day to day.

Saturday had my best number ever, 2 AHI, only to be followed by Sunday, in which I woke up at 2:30 am with a 17 AHI and 6% periodic breathing, My morning number 15 AHI (I have attached 2 screen shots)

I do have irregular heartbeats, I have been put on a holter-monitor for a month - shows PVCs and PACs but they tell me all ok. I'm a 51 year old female 125 lbs who feels like crap. Been doing this a year and am beyond frustrated.

[Crimson Nape]

By chance are you a back sleeper? Also do you take any meds, prescription or OTC?

[Daisylouu]

I was a back sleeper, but I now sleep on a recliner. I can not sleep on my side due to joint pain and circulation issues. The medications I take are Inderal (which I've taken for 25+ years) and Prilosec.

[richb]

Sounds like issues with your sleeping position. Try sleeping with your head turned to the side.

Rich

[green wings]

Hi Daisy. Do you know if your apnea was lots worse during REM sleep during your sleep study? I'm just looking at the way the obstructive events cluster in the graph you posted. Can you post a graph showing the whole night from the date above and then one from a night when your AHI was low for comparison? No knowledge here about the PB. Thanks.

[PoolQ]

A couple of things:
1. periodic breathing when talking about sleep apnea is a very specific condition. Some of your wave forms are indeed periodic, but are not SA periodic breathing.
2. What caught my eye was your CSR percent. From what I know these machines are pretty good identifying these. Does this happen often? If so this is a specific that needs to be dealt with. Many people (myself included) have posed about periodic breathing and I think that sometimes the senior people may not look as closely as they might if the post is titled something like "machine reported CSR". Many people have also posted CSR when the machine said no.

If you are having consistent CSR then you need a different machine- ASV. You also need to know if you have heart issues as the more serious of these can be effected by ASV therapy.

The waveforms you posted tell me that your lower pressure limit may need to be increased, actually there are several things that suggest this. Snore is one of them, this should not be happening. Your hypopnea count is too high and again as above lower pressure limit.

Please keep this thread bumped up to the top to make sure more people get to look at it. Hang in there, you will get answers here.

[Daisylouu]

I'm so confused as to why my numbers change so drastically from one day to the next, when I'm in the exact same sleeping position etc.
Here are the additional screen shots as requested:

[Daisylouu]

I can't post any other screen shots because it's telling me I reached my quota

[Daisylouu]

My machine tells me I have CSR almost everynight....anywhere from 1-6 times per night, and anywhere from 1 minute to 4 minutes 7 seconds. It varies almost daily as to when it occurs, as I said, NOTHING is consistent, I could go from one night and a 2 AHI and 1 brief CSR to the next might and a 17 AHI and 6 CSR with each being up to 4 minutes long.

My average time in CSR% is:
3.30% last session
1.25% last week
1.16% last 30 days
1.17% last 6 months
1.08% last year

Doctor doesn't take time to look at how different each day is......nor does he comment about the CSR, because early on in my treatment they were in a panic about my reports and had me come in for another sleep study, thinking they would take me from cpap to bi pap to ASV (for insurance purposes)......but then my study was "ok" and they kept me on A-flex cpap and just increased my top number to 16. I've only gotten worse since then. I do have a lot of irregular heart beats that bother me (NOT fast rate, just very irregular beats all jumbled) so I certainly don't want to go to ASV if that would make my heart worse?

---

A couple of things:
1. periodic breathing when talking about sleep apnea is a very specific condition. Some of your wave forms are indeed periodic, but are not SA periodic breathing.

Please keep this thread bumped up to the top to make sure more people get to look at it. Hang in there, you will get answers here.

What does that mean about my wave forms? Or what should I be looking at on my reports, I really don't understand most of that stuff, wave forms, tidal volume, etc. etc.

[richb]

I can't post any other screen shots because it's telling me I reached my quota

You can open an account at http://imgur.com/ and upload images there. You can than post a link to the images.

The groupings of events still suggests an issue with your sleeping position. You could be hyperventilating and getting into CSR. Notice that when you don't have the clusters of events you don't have the CSR. Try using various kinds of pillows to keep your head turned to the side. Also your mask is a hybrid. It might make a difference if you are breathing through your mouth or nose or both. If you switch from nose to mouth you could be moving a lot more air as the graph indicates during your event clusters. Moving more air washes out more CO2 and encourages CSR. You might want to try a different type of mask as well. Just some thoughts to stimulate more conversation.

Rich