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Apneas or Cheyne-Stokes Respirations?
#21
RE: Apneas or Cheyne-Stokes Respirations?
In addition to what Fred suggested, as your minimum pressure drops, you can probably reduce pressure support slightly and get even bigger benefits for CA events, while maintaining comfort. Try reducing PS to 2.4 or 2.6 and see if that helps to stabilize your breathing as well.
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#22
RE: Apneas or Cheyne-Stokes Respirations?
I set my machine at 6.0/6.0 last night.  

AHI was 4.9, with most of the events recorded as hypopneas.  Only .6 apneas per hour.  

However, I'm still seeing a lot of periodic breathing, just without the apneas in between.

Here's a sample that is indicative of the periodic breathing that seems to occur on and off throughout the night.  Any thoughts?

[Image: attachment.php?aid=11129]


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#23
RE: Apneas or Cheyne-Stokes Respirations?
my layman's understanding is that periodic breathing is quite symmetrical w incremental increases in volume followed by incremental decreases so the whole pattern is rounded. these don't look that way, having spikey bookends instead. did your sleep study report periodic limb movements?
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#24
RE: Apneas or Cheyne-Stokes Respirations?
(04-05-2019, 07:59 PM)sheepless Wrote: my layman's understanding is that periodic breathing is quite symmetrical w incremental increases in volume followed by incremental decreases so the whole pattern is rounded.  these don't look that way, having spikey bookends instead.  did your sleep study report periodic limb movements?

You described CSR, 1 form of periodic breathing.  This is Periodic breathing, but cause??? I don't know.

How do you feel?
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#25
RE: Apneas or Cheyne-Stokes Respirations?
obviously I don't know either. periodicity is a feature of periodic limb movement and this pattern looks enough like what I think plm looks like in my flow to ask about / suggest a possible cause that might not otherwise be thought of.
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#26
RE: Apneas or Cheyne-Stokes Respirations?
Neither of my sleep studies noted periodic limb movements.  I have my own camera system and I've reviewed video of me sleeping over a several day period.  I don't believe that I have PLM.

I didn't sleep as well last night as I usually do, but I attribute that to switching off the 3.0 Pressure Support.  I'll probably sleep better, and deeper tonight, and I expect a corresponding increase in my AHI... Smile
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#27
RE: Apneas or Cheyne-Stokes Respirations?
glad you can rule that out then. sleeping deeper and better is the goal, even with a corresponding increase in ahi, depending on - as bonjour asked - how you feel.
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#28
RE: Apneas or Cheyne-Stokes Respirations?
what jaswilliams said in post #17. asv is said to be the answer to central apnea / hypopnea and periodic breathing. I don't know anything about the vauto and FOT but I do use asv and while asv pressure support swings pretty wildly, I don't notice it or any pulses.
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#29
RE: Apneas or Cheyne-Stokes Respirations?
FOT pulses are designed to detect central apneas so that your provider can then prescribe an ASV or a Timed machine.

ASV Machines and Timed machines don't attempt to detect central apneas.  They are designed instead to treat them.  As a result, ASV and timed machines don't sent pressure pulses/FOT in response to apneas.  ASV machines respond by increasing pressure immediately, within the defined limits of the setup.  T machines do the same on a timed basis with a fixed amount of pressure support.
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#30
RE: Apneas or Cheyne-Stokes Respirations?
(04-06-2019, 03:55 PM)Reznik Wrote: FOT pulses are designed to detect central apneas so that your provider can then prescribe an ASV or a Timed machine.

thanks for the explanation.  I was thinking that you were looking for a solution but you obviously already know something about this stuff and that asv might handle ca and pb better.  maybe just curious about the flow pattern for now?  I'll be following along hoping to hear if/when you figure out what it is, if eventually you determine asv evens it out and what to do about it in the meantime. 

Eat-popcorn
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