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[CPAP] Please interpret recent SH incidences
#1
Please interpret recent SH incidences
I seem to have periods recently where I do not appear to be exhaling much but inhaling with very short breaths for an extended period of about 20 minutes. It has not occurred often but seem to at least once or twice a month. 

Can anyone help me understand why that might be? Have attached flows of the whole night and also zoomed in segments.


https://imgur.com/a/iCnre
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#2
RE: Please interpret recent SH incidences
Pretty interesting talent...you are inhaling through your nose and mask, and exhaling through your mouth without creating a large leak.  The leak is greater than your average during these episodes, but still not out of control.  No one can inhale without exhaling, but that is what you might conclude looking at this.  Nice twist!  What does the mask pressure chart look like?

Your event rate is completely fine, so your doctor is unlikely to consider this important.  I don't recall if we ever talked about using some EPR...did we?

[Image: HzM9r2T.png]
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Please interpret recent SH incidences
SR, I started my CPAP life on pressure of 16.8 and EPR of 3. Early days had loads of CAs and was advised to reduce EPR which I did gradually till was brave enough to turn it right off. It did help with CA reduction.

.......'The leak is greater than your average during these episodes'..........how can you tell, SR? Also how do you conclude I was breathing out through my mouth?

Mask pressure appear fine as seen below

https://imgur.com/a/8ikRM

Does the spike in the expiration time confirm that I did draw large exhales?

On the whole my numbers are good-mostly below 1. Also finding my energy levels much improved. To be honest have seen these oddities many times before but had not felt too alarmed till its appearance seem to be regular.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Please interpret recent SH incidences
As well as there being no exhale flow rate, the tidal volume and minute vent chart should also confirm it. An easy way is to use a FFM for a night. Given the space of time, you may like to try some EPR, the pressure induced ca should have settled by now..plus it would be an interesting thing to see, if they start up again Smile
you may need to raise the max, as much as you add epr. So the epap stays at 11
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#5
RE: Please interpret recent SH incidences
(11-18-2017, 08:14 PM)Apnea Infant Wrote: SR, I started my CPAP life on pressure of 16.8 and EPR of 3. Early days had loads of CAs and was advised to reduce EPR which I did gradually till was brave enough to turn it right off. It did help with CA reduction.

.......'The leak is greater than your average during these episodes'..........how can you tell, SR? Also how do you conclude I was breathing out through my mouth?

Mask pressure appear fine as seen below

https://imgur.com/a/8ikRM

Does the spike in the expiration time confirm that I did draw large exhales?

On the whole my numbers are good-mostly below 1. Also finding my energy levels much improved. To be honest have seen these oddities many times before but had not felt too alarmed till its appearance seem to be regular.

AI, the leak rate is pretty good here, but is high enough to confirm exhalation form your mouth, but the dead-giveaway is the zero exhale rate.  It's pretty easy to do...inhale through the nose, exhale through the mouth, and you have perfected it.   Also, the inspiration is flow limited based on the downward sloping peak.  In terms of conservation of mass, what goes in, must come out.  This chart shows only inhale.  The exhale is going somewhere, and my bet is through your mouth.

Your AHI is amazingly good now.  Maybe try slowly introducing EPR?  It's possible you have adapted to CPAP and would not have as much CA with exhale pressure relief.



[Image: 2x3cP1K.png]

Notice how the leak rate correlates with the zero exhale flow rate:

[Image: tV5eXRt.png]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Please interpret recent SH incidences
Thank you Ajack, I had such horrific leaks and disrupted nights when I used a FFM that I do not think I would want to return to that, if you do not mind. Also night temperatures are close to zero now and being in a cold wind tunnel is not a welcoming prospect. You are right, the tidal volume in that period of supposed no exhale went down to 160 and minute vent to 2.6.

SR, I am aware of more leaks recently. Think I have to change my pillows as I feel the leaks through them more now than ever before. Also am awaken by air leaking through my mouth and there are some after effects of aerophagia too. So that explains the zero exhale on the charts.

I'm going to see how new pillows will affect therapy before bringing back EPR. I worked so hard to remove it and reduce pressure. As the numbers have been good I have kept reducing pressure to help with leaks and aerophagia.

Thanks for reassurance, guys.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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