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Breathing Stops When First Falling Asleep
#41
(08-18-2012, 05:43 PM)Moriarty Wrote: I don't have many CA's and I think most of them are wrongly tagged but, interestingly, a number of my 'genuine' CA's are after I have inhaled indicating that I am taking a breath then holding it in my sleep. Of course I didn't need the machine to tell me that - my wife has been saying it for years..... Smile

Interesting. Well at least you are taking a full breath before it happens. I would say 95% of my CA's start by exhaling fully, then I inhale only 50% and stop. They generally last 45 seconds or more and then end with the completion of the original inhale to 100%. Then in a bad spell, it will repeat exactly the same pattern 5-10 times in a row with an occassional one lasting over a full minute.

In contrast, the OA's will sometimes start with a damped oscillation look - like a triangle of breathing with less and less depth until it stops for 30 seconds or more. It's amazing to see these waveforms come and go as the sleep levels change. They have a character of their own and stay in groups until an event occurs, maybe a new sleep level or sleeping position - and new groupings appear. Fasinating.


I'm trying to get used to high pressure. I intially had a phobia about breathing against the wind. So for practice, I took a nap this evening for 2 hours and ran the S9 in the CPAP mode at 18 cm/H20 just to see how I do. I was amazed! After about 10 minutes, it felt like I was breathing in zero gravity and didn't even notice the exhale resistance. It actually felt quite pleasant and I noticed the high pressure was forcing me to inhale better. I thought just maybe it would help the CA due to this, but I was wrong. When I awoke, I looked at the chart and it showed AHI=0 for 90 minutes as I tried to fall asleep marveling at the ease of braething. But as I fell asleep the CA's started up big time and my AHI rose to 79 over a 20 minute period. They were averaging about 30-40 seconds in duration.

I KNOW they were CA's cuz I was sleeping on my side (low OSA AHI mode) and as I drifted off I woke a few times and found I was not breathing. I felt no gagging or throat restriction whatsoever. This happened many times after I drifted off. Later, I looked at the chart and saw 32 CA events in a row. There were only 4 OSA's the whole 2 hour session. For what it's worth.

BTW, how does a hypopnea get labeled? I see them ocassionally, but can't understand why they were labeled where they are. There is no breathing stoppage, just a sharp slope in the middle of nowhere. I thought hypopnea was more like a triangle waveform where the breathing slowly increases in amplitude and then decreases over time into an apnea, no?

Tom


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#42
Try raising the lower pressure a notch, e.g. 5 or. 6 cm. That helped a lot for me.
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#43
(08-19-2012, 12:22 AM)JohanKarl Wrote: Try raising the lower pressure a notch, e.g. 5 or. 6 cm. That helped a lot for me.


Thanks for the suggestion, Karl. I've tried it at 6cm min, but not much difference for me.

Well, I missed a major conclusion in my recent sleep study report. It said I had complex apnea BUT I also exhibited Cheyne-Stokes respiration syndrome. (CSR) That is why I see the triangular breathing patterns ending in long apneas. It all makes sense now. I didn't understand what it meant before doing some more reading.

Here's an interesting study done on patients who exhibited cental apneas and Cheyne-Stokes breathing patterns. The doctors found that the CPAP or O2 did not help much or even made it worse. But an ASV machine had an outstanding effect to stablize the breathing pattern.

http://www.aasmnet.org/JCSM/Articles/020212.pdf

I wish I had just simple OSA like most folks, but now I realize it is idiopathic CA and CSR syndrome. (less than 5% of sleep apnea cases) At least it's not heart failure or brain stem damage related, which is common. Had a full heart test and it was fine. I'm sure the doc will let me try an ASV and see if it does the trick.

Tom



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#44
The auto bipap works pretty well -I have 8% CA. The auto cpap works great for OSA. Most Drs don't realize how severe CA is. I use to get the CAs around 5am with the autoset. Best thing is, and it ain't easy when you're so sleepy, but I'll just sit there and breath in and out to retrain breathing until I can once again sleep and breath at the same time.

Before the respirator I went fours years unable to fall asleep without apnea. Didn't know my breathing was stopping until I had a real sleep lab so I kept telling Drs that it feels like my heart stops when I dose off -needless to say most Drs are too dumb to say anything other than oh well if your if your heart stopped you'd be dead or that you're psycho -I was so sick those 4 years -pretty much laid flat 23 hours a day
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#45
I was getting a lot of CA's too at the beginning. I went after the OA's first and knocked them out with the pressure.
By that time my eyeballs were starting to get pushed out from the back by the sinus cavities behind the eyes.
I switched to the total face mask and got instant relief for the eyes and the CA's have all but dissappeared.
Looks to me that the total mask has so much more dead space in it the residual CO2 gets to build up to healthier levels so
the brain still triggers a good breathing rythem on CO2 level. (the smaller masks tend to flush out the CO2 a bit too well sometimes)

If nothing else works try using a total face mask and see if your CA's leave.
CONS: its bigger, clunkier, and feels a bit stuffier that an FFM, you need to spend more time getting used to it and running down leaks
PROs: I am getting a lot more days with AHI less than 2.0 and often get some scores of 0.0!

In general, this is good.

Hope your problem solving quest goes well.

Smile
"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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