(05-07-2016, 03:29 PM)PoolQ Wrote: ...
Note the periodic breathing, that the "professionals" tell me not to worry about
The zoomed-in section shows clear signs of partial obstruction.
Any breathing pattern starting with recovery breaths (strong peak Flow) but with the peak Flow gradually reducing over several breaths to a point (with the envelope of the Flow waveform looking like an arrowhead) and then restarting again with sudden strong recovery breaths, is clearly obstructive.
If your doctor has said not to worry about Periodic Breathing I think he/she would have been trying to communicate that a minor amount of central nervous system caused
Periodic Breathing is not a big deal and not to let it worry you, as long as your overall AHI or RDI is less than 5.
The term "Periodic Breathing" is most widely understood as referring to breathing patterns which have central rather than obstructive causes.
I think your doctor would not have meant you should be unconcerned about back-to-back obstructive breathing, which is sometimes occurring in the zoomed-in section of your data and which I think some of us confusingly (and in my view mistakenly) refer to as being Periodic Breathing merely because a pattern is repeating, back-to-back.
In the zoomed-in section you posted, it looks to me like you are sleeping very shallowly with the EPAP significantly too low, leading to sleep/wake central PB as well as the main problem, which in my view is the repetitive obstruction of your airway, causing awakenings or back-to-back arousals into shallower sleep as evidenced by recovery breaths (the arrowhead pattern in the Flow waveform).
I suggest very gradually walking your Min EPAP higher until, for your somewhat unusual case, it is within 1 cmH2O of your 95% EPAP. (I usually recommend raising Min EPAP to anywhere in the range 2 to 4 cmH2O lower than the 90% or 95% EPAP.)
Lowering PS usually reduces the number of CA we have, but I suggest placing the greater emphasis toward reducing the obstructive characteristics in your breathing by raising the Min EPAP.
Good luck and take care,