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[CPAP] What does it mean if central apneas are preceded by uneven breathing?
#1
Question 
What does it mean if central apneas are preceded by uneven breathing?
So I've been on APAP for about a week and a half now. Was a rough start, with it causing some anxiety and suffocation feeling, but I'm getting much more used to it now.

From the beginning, my issue has mostly been central apneas. Home sleep study showed AHI of 9 with basically all central apneas. APAP has seemed to slowly been improving that, and last night it's down to about 4, and I believe I'm feeling slightly better during the day.

However one thing I notice (looking at sleepyhead data) is many many of the central apneas are preceded by "jaggy" breathing. I'll attach some example screenshots so you know what I'm talking about. 

Does this likely mean I just woke up for a moment, or am moving around (sometimes changes in leak rates suggest this)? Or am transitioning sleep stages? In the data it's not usual that I just straight up stop breathing with nothing preceding it.


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#2
RE: What does it mean if central apneas are preceded by uneven breathing?
Welcome to the forum.

In this case we needed to see the close-ups, but a more expanded view would help with interpretation.  Also you should include an overall chart because it provides context.  The info in the left bar is important.  Please see the optimize link in my signature for how to set up your screenshots.

That said, All of these instances showed flow limitations leading up to a "disturbance" or arousal, possibly changing your sleeping position and holding your breath while doing so. This pretty much defines a RERA.

On a bilevel I would increase your PS/Pressure support to manage the flow limitations, on a ResMed I would do the same thing modifying (increasing) both your pressure and EPR settings.  Then observe what happens to your numbers and flow rate.

Fred
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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#3
RE: What does it mean if central apneas are preceded by uneven breathing?
(02-22-2019, 11:51 AM)bonjour Wrote: Welcome to the forum.

In this case we needed to see the close-ups, but a more expanded view would help with interpretation.  Also you should include an overall chart because it provides context.  The info in the left bar is important.  Please see the optimize link in my signature for how to set up your screenshots.

That said, All of these instances showed flow limitations leading up to a "disturbance" or arousal, possibly changing your sleeping position and holding your breath while doing so. This pretty much defines a RERA.

On a bilevel I would increase your PS/Pressure support to manage the flow limitations, on a ResMed I would do the same thing modifying (increasing) both your pressure and EPR settings.  Then observe what happens to your numbers and flow rate.

Fred

Appreciate the help, I'll attach some additional screenshots with the full chart (can't seem to figure out how to edit the original post so I'll put it on this one). And some higher resolution screenshots zoomed out from some of the examples. Basically it looks like the sleep is undisturbed for a good amount of time before and after most events.

I'm thinking the possibility of changing position is likely, especially since many of these are just barely over 10 seconds. I'd say only half of them all night are over 15 seconds. Though occasionally there are some very long ones, such as one attached example for 43 seconds.


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