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Central sleep apnea periodic breathing
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richb Online

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Other Comments: Idiopathic Central Apnea

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Post: #61
RE: Central sleep apnea periodic breathing
(07-10-2015 02:48 PM)tedburnsIII Wrote:  
(07-10-2015 12:44 PM)tedburnsIII Wrote:  
(07-10-2015 10:58 AM)richb Wrote:  Doc isn't ready to go there yet. My guess is that I will end up with an ASV machine, medication or both. He still wants to rule out a faulty machine. I think my original sleep study was misread.

I'd agree with Sleeprider, who knows more than I.

Also, it's a 'long shot' that your study was misread AND your machine is faulty. Chances are 'pretty slim' for those two things happening.

(07-10-2015 02:32 PM)richb Wrote:  I seriously doubt that the machine is faulty. I will find out in a couple of days.

Rich

So that may only leave your sleep study in question, but if your sleep study conformed to review procedures, the RAW data was reviewed by three professionals- your sleep technologist, a supervisory sleep technologist, and by a board-certified sleep doctor who supposedly writes a separate report with doc's findings.

p.s. Please use the 'Reply with Quote' button when doing so, rich.

I don't think they looked at the waveforms very well.
07-10-2015 05:16 PM
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richb Online

Advisory Members

Posts: 541
Joined: Jun 2015

Machine: Resmed AirCurve 10 ASV
Mask Type: Nasal mask
Mask Make & Model: ResMed Mirage FX
Humidifier: Built in
CPAP Pressure: Epap 6 Ipap 8 Auto ASV
CPAP Software: ResScan SleepyHead

Other Comments: Idiopathic Central Apnea

Sex: Male
Location: Vermont

Post: #62
RE: Central sleep apnea periodic breathing
(07-10-2015 05:16 PM)richb Wrote:  
(07-10-2015 02:48 PM)tedburnsIII Wrote:  
(07-10-2015 12:44 PM)tedburnsIII Wrote:  I'd agree with Sleeprider, who knows more than I.

Also, it's a 'long shot' that your study was misread AND your machine is faulty. Chances are 'pretty slim' for those two things happening.

(07-10-2015 02:32 PM)richb Wrote:  I seriously doubt that the machine is faulty. I will find out in a couple of days.

Rich

So that may only leave your sleep study in question, but if your sleep study conformed to review procedures, the RAW data was reviewed by three professionals- your sleep technologist, a supervisory sleep technologist, and by a board-certified sleep doctor who supposedly writes a separate report with doc's findings.

p.s. Please use the 'Reply with Quote' button when doing so, rich.

I don't think they looked at the waveforms very well.

When I visited with the Tech last week I brought printouts from my SleepyHead reports. They had some pages from ResMed but never referred to them. They are having trouble believing the data from over a month of machine use. I will be using a replacement machine starting on Sunday.

Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here: http://www.apneaboard.com/wiki/index.php...SleepyHead
07-10-2015 05:46 PM
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tedburnsIII Offline

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Other Comments: Dx moderately severe OSA. Overnight pulse oximeter-CMS50D Plus

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Post: #63
RE: Central sleep apnea periodic breathing
Best wishes!

Sincerely,
07-10-2015 11:21 PM
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mollete Offline

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Post: #64
RE: Central sleep apnea periodic breathing
(07-03-2015 08:26 AM)richb Wrote:  
(07-03-2015 07:58 AM)swwalden1 Wrote:  Met with my sleep doc (Pulmonologist/Internist) yesterday. He said this breathing pattern is not Cheyne-Stokes.

The pattern we are referring to mimics Cheyne Stokes breathing but the period peak to peak is usually not as long as Cheyne Stokes. Cheyne Stokes is usually associated with congestive heart failure and the peak to peak is usually about a minute or more.

So trying to follow this.

Are not swwalden1's peak to peak times about a minute, therefore this IS CSR?

swwalden1, can you post the 30 minute block immediate prior to your original image?

Thanks.
07-11-2015 04:25 AM
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vsheline Online

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Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
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CPAP Pressure: 15 EPAP, PS 5-10
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Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

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Post: #65
RE: Central sleep apnea periodic breathing
(07-09-2015 06:35 AM)richb Wrote:  
(07-08-2015 09:49 PM)quiescence at last Wrote:  when you leave your card out, you get the exact same score, just not the highly detailed data. so, that night you really did have an AHI < 5.

If only that were true. I left the card out for 2 nights in a row, Both reported AHIs under 5. No CAs. The next night with the card in I had an AHI of 38 all CAs.

Hi richb,

I suppose it is possible some software bug in the machine causes the number of centrals to be misreported unless the SD card is installed but I think it far more likely this would somehow be only a SleepyHead bug.

However, if ResScan or the machine's screen also repeatedly report no centrals unless the SD card is installed, then I suggest you call ResMed Customer Service and report the bug.

I am confident the machine would not have been designed to behave like that. The machine should have no problem keeping a running total of how many central apneas have occurred during the current session even though the SD card is not installed.

But unless you see this behavior repeated a few more nights and shown in ResScan Statistical Summary (one night no card and no centrals, next night with card and lots of centrals, again one night no card and no centrals, next night with card and lots of centrals) I'm not sure ResMed would believe these coincidences prove the machine is misreporting the number of centrals unless the SD card is installed.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 07-11-2015 11:42 AM by vsheline.)
07-11-2015 11:21 AM
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quiescence at last Offline

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Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

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Post: #66
RE: Central sleep apnea periodic breathing
richb reported that his machine did not score CAs when card was removed, but showed that when card was out there were CAs on his report, just not the same frequency. that just seems weird. But, maybe the new machine will act differently.


QAL

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
07-11-2015 11:47 AM
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swwalden1 Offline

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Post: #67
RE: Central sleep apnea periodic breathing
(07-11-2015 04:25 AM)mollete Wrote:  So trying to follow this.

Are not swwalden1's peak to peak times about a minute, therefore this IS CSR?

swwalden1, can you post the 30 minute block immediate prior to your original image?

Thanks.
Not sure why you are asking but here it is.

[Image: DropBox?authkey=Gv1sRgCJOl8ZLN8KW8LA#6170323140073204770]
(This post was last modified: 07-11-2015 01:49 PM by swwalden1.)
07-11-2015 01:47 PM
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tedburnsIII Offline

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Machine: 3B RESmart APAP
Mask Type: Nasal mask
Mask Make & Model: Wisp nasal; ResMed FX nasal
Humidifier: came with unit-I vary it, currently set at '3', '5' is max
CPAP Pressure: 10 cm CPAP
CPAP Software: Other Software

Other Comments: Dx moderately severe OSA. Overnight pulse oximeter-CMS50D Plus

Sex: Male
Location: San Diego

Post: #68
RE: Central sleep apnea periodic breathing
It may be a bug but it makes sense that more data is reported when SD card is inserted.

For example, my iCode displays data but when I use the SD card and review it there's more detail.

Perhaps richb machine only picks up a set minimum of data without SD inserted. If it were the other way around, one
might find it more problematic.
(This post was last modified: 07-11-2015 02:02 PM by tedburnsIII.)
07-11-2015 02:00 PM
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vsheline Online

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Posts: 1,908
Joined: Jul 2012

Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #69
RE: Central sleep apnea periodic breathing
(07-11-2015 04:25 AM)mollete Wrote:  
(07-03-2015 08:26 AM)richb Wrote:  
(07-03-2015 07:58 AM)swwalden1 Wrote:  Met with my sleep doc (Pulmonologist/Internist) yesterday. He said this breathing pattern is not Cheyne-Stokes.

The pattern we are referring to mimics Cheyne Stokes breathing but the period peak to peak is usually not as long as Cheyne Stokes. Cheyne Stokes is usually associated with congestive heart failure and the peak to peak is usually about a minute or more.

So trying to follow this.

Are not swwalden1's peak to peak times about a minute, therefore this IS CSR?

swwalden1, can you post the 30 minute block immediate prior to your original image?

Thanks.

In CSR, each cycle usually lasts between 30 seconds and 2 minutes.

From Wikipedia:
https://en.m.wikipedia.org/wiki/Cheyne-stokes_respiration

Cheyne–Stokes respiration /ˈtʃeɪnˈstoʊks/ is an abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing called an apnea. The pattern repeats, with each cycle usually taking 30 seconds to 2 minutes.[1] It is an oscillation of ventilation between apnea and hyperpnea with a crescendo-diminuendo pattern, and is associated with changing serum partial pressures of oxygen and carbon dioxide.[2]

References
[1] "Cheynes–Stokes Respiration". WebMD LLC. Retrieved 2010-10-05.
[2] "Cheyne–Stokes respiration". WrongDiagnosis.com. Health Grades Inc. Retrieved 2010-09-03

But I think the doctor may be saying CPAP treatment-caused CSR mimics true CSR, which in his understanding is disease-caused CSR.

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 07-11-2015 02:11 PM by vsheline.)
07-11-2015 02:01 PM
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mollete Offline

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Post: #70
RE: Central sleep apnea periodic breathing
Thanks.

I was curious to see if there were respiratory events that were missed by the machine. Indeed, there is a bit of periodic breathing (put http: in front of that):

//i79.photobucket.com/albums/j147/morbius10/apboard_zpsz5s1y8ze.jpg

In both periodic salvos, the trigger appears to be a arousal, suggesting a CompSAS type of thing. Yet those cycles are long, suggesting circulatory delay may be underfoot.
07-11-2015 02:09 PM
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