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Apnea on Exhale
#1
Curious, how many will admit to having apnea events on exhale, especially while you're awake and know what's happening?

It seems the entire therapy is driven towards inhale - and exhale naturally benefits - but how many actually have found themselves closing off during an exhale; while awake and able to notice it happening.

The other one is the sense your autonomic breathing response is weak or even at times missing; e.g., without an apnea event, you have to force yourself to inhale or exhale?

Thx
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#2
I have, but only when lying on my side (awake). I cannot stay on either side for more than for a few minutes because of back problems. Therefore, I can only sleep on by back sleep apnea or not.
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#3
When you are awake it is a totally different set of problems and motivators when you breath, and has little to do with sleep apnoea, except in the broadest sense and possibly some types of tissue laxity based problems. Talk of apnoea events while awake bear little relationship to sleep apnoea events for the most part and cannot be used to deduce or diagnose severity or type of sleep apnoea.
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#4
I don't know if you can have an apnea on exhale. Thought I read that somewhere here, but can't find it. Maybe someone else can shed light on this subject.

I do know that when I'm awake, say early morning, I sometimes find myself holding my breath,
and when I look at Sleepyhead, it will show a Clear Airway at about the same time.
I don't acknowledge these events when I'm awake, even though they are flagged and recorded as part of my AHI.
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#5
I have looked back at my flow rate graphs and find that sometimes my OA initiates on an exhale and sometimes on an inhale. I do not know what, if anything, that means.

Best Regards,

PaytonA
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#6
ResMed EPR http://www.resmed.com/jp/patients_and_fa...c=patients

The Event Detection Circuit is a backup feature of the EPR algorithm. Changes in a patient's sleeping position or sleep stage (ie, REM sleep) may cause sudden, unpredictable events to occur without the typical preceding flow limitation or snoring.
When such an event is detected, EPR immediately suspends, and the treatment pressure reverts to set CPAP. EPR remains suspended until the event concludes and normal breathing resumes.
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#7
You ask if apnea is during inhale or exhale. The short answer is, obviously, no breathing occurs (inhale or exhale) during an apnea.

Did you mean that the last breath potion you took was an exhale, followed by cease in breathing? And do you also have times more or less often when you had an inhale, followed by a cease in breathing?

Positive air pressure apnea treatment is definitely concerned with having inhale be effective, as most of the vibratory effect of obstruction (and flow restriction) is during the inhale portion. You'll probably not notice soft tissue resistance much on exhale, if at all.

But the exhale is important, in that if the positive pressure is lost during the exhale the airway will not remain open for the inhale. [a suspension of EPR can cleverly hold the airway open so inhale is allowed the best situation]

The normal waveform for this looks like an exhale followed by a cease in breathing.

QAL

ps. noticing a "snot" resistance event during exhale is dependent on your sinus congestion, and may cause a halt in breathing just before exhale flow would have occurred. halts after inhale are usually for this reason or purposeful breath holding to reposition yourself.
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#8
The algorithms used define an apnea as relative to an entire breath cycle for hypops. They compare the entire breath, both inhale and exhale, to (typically) the two breath cycles before and the two after that breath, and determine whether it meets the qualifications to be flagged as a hypop based on that.

An event that is OA or CA is, by definition, something that happens on inhale. It is a cessation or restriction to inhaling. There is typically never a restriction to exhaling because when you exhale your diaphragm muscles simply release tension and the air flows out of you like a balloon that has been released, because the internal pressure is greater than the external pressure, and your chest cavity is also distended and naturally trying to resume its natural shape. So air goes out unobstructed and unaided by the CNS.

OA obstructions are mostly, if not always, related to inhale. For example, you can always blow through a chunk of rubber tubing, because the internal pressure relative to the external pressure pushes outward against the walls of the tube. When you try to suck air through a chunk of rubber tubing, it can collapse, because the internal pressure is now negative, and the outer pressure can collapse the tube wall. This is quite the same thing that happens with OSA, and is why xPAP is effective.

But the xPAP still regards an apnea as applying to the entire inhale/exhale cycle. One reason may be because an apnea has to have a certain duration to be considered an apneic event; you have to be obstructed or cease breathing for a certain length of time, so the event can't be defined until after it is actually over, for the most part.
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#9
my complete obstructions (that cause me to clamp shut and no breath occurs) nearly always occur before positive air flow (inhale) can start, but after exhale has finished.

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#10
If you have an obstructive apnea on exhale, pressure will build up in your airway and you sort of tend to "CPAP yourself." It's not 100% effective, but you usually don't get sleep apnea on exhale. You might have some snoring or partial obstruction, though.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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