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Cheyne-Stokes high AHI
#1
I had posted before that I an a newbie and do not yet have the software. I sent an email to my Nurse Practitioner about my unresponsive high AHIs - She downloaded my data on her end and is telling me that I have periodic breathing and Cheyne-Stokes.

Can anyone help me with what this all means?

In my original study I had 19 ahi (over 30 during REM) and all were obstructive and 1 central. During my titration study I did not sleep much but was having hypopneas that were not corrected by increase in pressure. Started on fixed 8, then switched to flex 8-14, with no change, still having AHI of 10-30

I'm scared and clueless. Have to go in for another sleep study.
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#2
It's OK to be scared; just don't be afraid (paraphrasing Steve McQueen in The Reivers). Scared is good, because it motivates you to keep coming here for answers, and to do what the sleep doc is suggesting.

And once you get answers, no more clueless (I loved that movie too).

Basically, this means you do not have a classic version of OSA, and you will probably need a different type of machine than a classic CPAP or APAP. But the therapy is pretty similar, and similarly effective.

I am not sure why a second study is needed, but if the experts say so, makes sense to comply.

The good news is that you are doing what you need to do. Don't fret, there is typically a happy ending for this sort of diagnosis. Let us know how this goes. We got you.
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#3
if periodic breathing was not diagnosed during first sleep study, then you have reaction to CPAP treatment (which is non-life-threatening) easily resolved. strike easily but not a major thing.

a second reason I say periodic breathing not a major issue is because you had minimal central apnea which would have been prominent.

hope you get software soon so you (and we) can see what is really going on.

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.
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#4

There are several of us on Apnea Board who are struggling with un-responsive apneas. Your original sleep study may not have shown the extent of your night-time breathtaking difficulty. Now that you are on a machine you will be recording data that can be downloaded and shared with fellow travelers. I for one had lots of Hyponeas show up during my sleep study. I was titrated and put on Bi-Pap (higher inhalation lower exhalation pressures). From the first night on the machine I was getting AHIs in the 18 to 38 range nearly all Central Apneas. Looking at my wave forms my breathing consisted of long intervals of periodic breathing and Cheyne Stokes like Central Apneas. Is my machine causing these? You can follow my and others dealing with Central Apnea in two threads 1. Central sleep apnea periodic breathing and 2. Theophylline for Periodic Breathing . As 'quiescence at last" said above you may be experiencing periodic breathing induced by the machine which can often be controlled by adjusting the pressure. If Obstructive Apnea and Central Apnea are both issues there is another type of machine (ASV) which might be helpful. In addition there are medications for certain types of Central Apneas. I met with my Primary Care Dr. yesterday and shared lots of data and research papers (she actually knew one of the authors). My Doc suggested that if I can't resolve my issues with my sleep center Doc that I should see someone in the nearby teaching hospital. So, I and you both have lots of options to get to the bottom of our apnea difficulties. I for one have become much more hopeful after reading the progress others have made here and I have enjoyed learning a great deal about treatment options.
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
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#5
Sleep Center doc was so concerned with my data (of which I can't see) that she insisted I come in ASAP, didn't even want me to wait for next week. So I'm scheduled for tonight (Thursday 7/16).....so after having ahi's in double digits, and periodic breathing from day 1....guess what my ahi was tonight??? A 2.. A two!? So I'm going tonight, it will cost me a fortune(that I don't have) and they probably won't get any info. Beyond disgusted
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#6
Good luck. I just returned from an "emergency" titration that was testing higher pressures and a chin strap. The techs and Doc will be giving me a new prescription. We'll see what happens.
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
Post from Imgur


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#7
(07-14-2015, 01:05 PM)Daisylouu Wrote: I do not yet have the software.

You need to download the Sleepyhead software package and install it on your computer. You can then download your data. You can then take some screenshots and post your data so that others can comment on what they see. You will feel more empowered knowing what is going on.

Rich

Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
Post from Imgur


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#8
Just returned from my overnight. Orders were to move me quickly from cpap to bipap to autosv....for insurance purposes. However, I was sent home on same machine, instead of 8-14 it's set at 11-14. The tech ran me from cpap to bipap to some other kind of bi pap. It was pumping air into me in pre-set bursts of time. It was scary waking up to that. But evidently the doc thinks I should just stay on regular cpap......my few central apnewas didn't bother him and ahi of 20 didn't bother him... and he said my periodic breathing stats are "annoying" and the face the nurse practitioner told me I was having cheyne stokes, was most likely the machine, which frequently makes things look worse than they are????? Now I'm REALLY REALLY REALLY confused.
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#9
Cha-ching! Money in the bank for the clinic...not so much for you. At least get the report. You paid for it and you can always get a second opinion, even here. If the doctor's comments comments were so cavalier, that is unfortunate. "Annoying" centrals, probably means he doesn't think they are numerous or long enough to be a health concern, and his opinion is that he thinks these will pass as you adapt...at least we can hope that was the intent.

Periodic breathing and numerous centrals are a significant concern if the frequency and duration is high. It can also be a normal part of adapting to CPAP for some people. We asked you many times to post some data on the forum so we might be able to more accurately help you understand what is going on. I think it was also suggested that you increase the minimum pressure, when you reported your 90% pressure was 14 cm.

Start using the software. Ask questions and keep working on the therapy. You have a study that showed some centrals, and if they continue, then there might be a reconsideration by your doctor.
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#10
OK...just upgraded SleepyHead. Noted Cheyne Stokes for first time. Last titration showed RERAs. Just bought a new DS760. Hope it can deal with Cheyne Stokes events. See neurologist next week, will discuss getting sleep study at Cleveland Clinic near Lauderdale, FL.

In the meantime...from the above posts my limits should be closer. Have them at INPAP 17, IPAP 6. Should I switch from auto to straight BIPAP?

Have Encore Basics. Does not see Cheyne Stokes
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