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[Diagnosis] Periodic breathing
#11
RE: Periodic breathing
Take your screenshot from the daily page.  Everything will fit that Sleeprider listed if you eliminate the calendar and pie chart.  
Follow the tutorials in my signature line. The example screen is what we are looking for.
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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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#12
RE: Periodic breathing
when are you going for the results of your sleep study?

The reason I asked if you had your mask on was because between 18:36 and 21:48, there are no events. I really would try a soft foam, cervical collar, to see how much of this is positional.
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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#13
RE: Periodic breathing
the size of each plot section can be reduced or enlarged (up and down width) so each of the plots can fit.

I like your resp rate, your minute ventilation, and your tidal volume.

I would echo Sleeprider's suggestion, and point out that your machine setting is on APAP mode.  So, if this were mine I would change the mode to CPAP mode, and set minimum at 8 and maximum at 10 for now.  We hope to see most of the CA drop out but probably will allow several obstructive events to go through that would have otherwise been prevented with the higher pressure. (realize that your pressure did not really stay below 13 cm throughout your one posted night.)

You came to the right place.  We will attempt to bridge the gap until the medical folks kick in.

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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#14
RE: Periodic breathing
Normally I don't ask for resp rate, because it normally looks like a straight line. I suspect yours looks like a wave, and just wanted to confirm. Normally the leak data is what I would include there.

My pressure suggestions were in APAP mode, but I'm eventually looking for the most effective fixed CPAP pressure. Limiting the pressures to 8-10 should put you in the sweet spot for most people that have your particular pattern, but we won't know until we see it. Any pressure range we select below 16 will probably result in you being at the maximum most of the night, so at 8-10 I sort of expect to see pressure at 10 all night. My suspicion is that you don't actually have many obstructive apnea, but that your lungs become full of air at higher pressures and since they won't expand, the machine reads the central apnea as obstructive. My plan would be to try lower pressures not higher as we move forward.
Sleeprider
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#15
RE: Periodic breathing
One more thing. Please ask your doctor for an immediate referral for cardiac echocardiogram. He probably can't perform that himself, and you need one for diagnostic purposes.
Sleeprider
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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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#16
RE: Periodic breathing
I wrote a reply to accompany the 8 screenshots (having loaded sleepyhead on laptop and successfully downloaded both sessions for last night.)  I still need to sort out sleepyhead on this machine.  I have been trying for 3 hours to get imgur to do what i am expecting without success.  I am so shattered that I can do no more tonight.  many thanks for all the help so far I will see if I can master imgur tomorrow 

Tony
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#17
RE: Periodic breathing
Hi Big Tonio

In reply to your question about changing settings here in the uk - I have with the help from the Gurus on this forum. I am at the end of the 3 months that Guys have said they would monitor me on. Have not had any contact from Guys Hospital but I have ended up having to turn up unannounced to get seen as there was no other way which got a reply. It was slow and painful and I suffered tremendously till I took my therapy into my own hands with the kind attention and guidance from the experienced members here.

So I would change settings if I were you. I am no expert at all, hence my user name, but the gurus here have advised plenty in other areas of your health too which appear sound.

Good luck to you.
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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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#18
RE: Periodic breathing
Added these at Bigtonio's request.

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#19
RE: Periodic breathing
Hi Bigtonio. Welcome to the Apnea Board.  Follow SR's advice and make those pressure changes.  You should try to find a sweet spot where the CAs and Periodic Breathing are minimized.  You should also get that Echo-cardiogram.  You need to rule out or confirm that Congestive Heart Failure might be involved.  Using an ASV machine as a treatment for CAs Periodic Breathing and Cheyne Stokes Respiration is contra indicated if the Echo shows a RV ejection fraction less than 45%.  This is pretty much standard procedure before looking at an ASV machine to treat your symptoms.  In the mean time try those setting tweaks with your present machine.  There is a good chance you can improve your results.  I would also suggest that you look at some 5 to 10 second blowups of your flow rate to check for periodic breathing not scored by your machine.  

Rich
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#20
RE: Periodic breathing
Thanks to Dave for posting the images. What I'd really like to know is what was going on in terms of pressure and other parameters between 03:15 and 06:15 when there were no events! That is what we'd like to see all night long. When the events chart is highlighted to a limited time, we can't see the charts for the other time periods. If possible, please include the entire night in the screenshots. The begining and end of the session on 7/17 were quite a mess, but it would be helpful to know what was going on in the middle when things were quiet.

What we can see is that there are relatively low event rates at the beginning of the night from 1:20 to 02:05 with pressure from 4-6 cm. As soon as pressure starts rising above that, the centrals and periodic breathing begin. On the other hand, we see another ramp period from 06:25 where events basically start right away at low pressures. Everything at high pressure is filled with events. The chart shows your AFlex is on and level is at 3...TURN IT OFF! Here is how to access the menu: http://www.apneaboard.com/dreamstation-c...structions

I don't know about the UK procedures for getting diagnostic procedures like an Echo, but sooner is better than later. The CSR breathing alone should be sufficient to justify the diagnostic.
Sleeprider
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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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