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[CPAP] Jo1cpap - Therapy Thread
#51
RE: Jo1cpap - Therapy Thread
I agree with Geer1 and I think he nailed that the periodic oscillation in breathing volume is more like a flow limit than being near a central apneic threshold. It might be interesting to try a pressure of 6.0 with EPR 2. I think you will find it comfortable and we might learn more about your therapy.
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#52
RE: Jo1cpap - Therapy Thread
(02-25-2022, 01:16 PM)Geer1 Wrote: Before playing further with cpap settings I think you should get a recording oximeter so you can make sure the changes aren't negatively affecting your oxygenation.

I would like to highlight this.  According to your descriptions and clinical history, you might potentially have some pulmonary issues, which have not been pinpointed and identified by a pulmologist.  Getting SP02 and heart rate data along with your cpap data will give you a much better insight what is working and what is not for your specific situation.  

Also, note that you have flow limits while awake with your nasal mask, which makes sense combined with your history of deviated septum and sinus issues.  Have you ever tried full mask?  Has ENT suggested fixing your septum?

What are your current main complaints with your sleep and CPAP therapy?  Apnea and hypopnea wise you are doing great according to the machine.
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#53
RE: Jo1cpap - Therapy Thread
Hello,

Now I know a bit what to look for.
I knew something is not ok but what?


Cheyne-Stokes Respiration?

I suppose I have to check cardio again?
I also read it could be damage to the respiratory centers.

https://en.wikipedia.org/wiki/Cheyne%E2%...espiration

Kind regards,


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#54
RE: Jo1cpap - Therapy Thread
I believe CSR has a more sinusoidal shape as breathing waxes and wanes, but others will know better than I do. In any case I wouldn't discourage you from showing this to your doctor to discuss what steps, if any, are appropriate.
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#55
RE: Jo1cpap - Therapy Thread
Were you asleep at that time? If so is this the first time your data has shown central apnea like this while sleeping (I don't remember seeing central apnea before)?

4 minute duration zoom say 8:58 to 9:02 would help see the breath shapes better.
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#56
RE: Jo1cpap - Therapy Thread
Hello,

I was sleeping.
I have serveral identic patterns on other days.
I see many similar patterns with a smaller amplitude in the waveform.


Here the detail.
Is there a simple way to select a specific time?

Thank you,

Johan


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#57
RE: Jo1cpap - Therapy Thread
Easiest way is click and drag with mouse to select the time frame you want.

Central apnea can be caused by a number of things. It can be idiopathic in nature (unknown cause), cheyne stokes heart issue related (we rarely see that), medication induced or CPAP treatment emergent. In your case your central apnea have an obvious CO2 effect which is why your breathing increases and decreases the way it does. I imagine yours are either idiopathic or treatment emergent although at only 5 cm pressure and no EPR treatment emergent are less likely. Idiopathic central apnea and the awake bradypnea may potentially be related but this should show up on a sleep study (although results vary night to night so maybe not on the night you had study done). We would expect increasing pressure and EPR to worsen these central apnea and there is no way to treat these central apnea with this machine, another machine (ASV) is what is used to treat central apnea but I could see it having issues with your awake bradypnea since it tries to maintain a faster respiration rate and would be trying to force you to breath faster.

Did your breathing issues come on fairly quickly (days/weeks) or slowly (months/years)?
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#58
RE: Jo1cpap - Therapy Thread
Hello,

I suppose my breath problems came up really slow.
I started complaining about blocked nose and lack of breath (oxygen) in 2006.
2011 septumplastie = surgery at my nose in the hope I would breath easier.
First sleeptest with ahi just to low for treatment.
I kept going on but always trying to mimize effort.
Much IT work and teaching.
2021 I went for Tinnitus to doctor and he ordered a sleeptest.
Since then I have my cpap.
I kept going.

But in september 2021 I crashed.
Slept only a few hours for moths. Got angry on everything. etc.
Often neck, jaw, chest pain.
I thought it was my heart but cardio says it is fine. (not sure if this diagnose is ok)
I always have the feeling I put my body in standby. (slow heart and breath)

Does that mean any difference. If my problems came up slow or fast?


Kind regards, Johan
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#59
RE: Jo1cpap - Therapy Thread
Johan, I would recommend that you request an appointment with your regular doctor so that he or she can give thought to the best specialist for you if he/she can't address these problems directly. That isn't because I see something alarming but because there are enough complex components to your situation to suggest you need medical help rather than volunteer help from an apnea forum.

Before you go to your appointment, I'd recommend preparing some written information, including a time-line of symptoms and treatment, and information from Oscar about your breathing. If possible, have someone go with you; two pairs of ears are often better than one.
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#60
RE: Jo1cpap - Therapy Thread
Hello, 

I will certainly do that. 
As my ahi is mostly below 3 I never bothered to look to the exceptions neither to the graphs. 
I was told my problems were probably stress related.

I don't know what to think.
So all info is welcome. 

Thanks
Johan
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