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[Diagnosis] What are my unclassified apneas?
#11
RE: What are my unclassified apneas?
I think he was talking about there being no pressure wave during the apnea. Only two things create a pressure wave, his spontaneous effort or backup rate. There is no pressure wave present because backup rate is off and there is no spontaneous effort due to obstructive apnea.

The reason the apnea is not classified is that forced oscillation technique is not present therefor the machine has no way to determine the type of apnea and flags it as unknown. ST (like ASV) probably doesn't use FOT because the backup rate (what ST is designed to be used for) interferes with FOT process. It may be possible that there is a setting to turn it on if say backup rate is turned off but I am not sure about that.

The ST is almost never the right machine. It is not meant to be used for basic apnea, it is meant for use with a small group of respiratory diseases that don't require ST-A and IVAPS. Can read about it in the Resmed titration protocol if you want. Respiratory disease section starts on page 35, ST titration protocol on page 37.

https://document.resmed.com/en-us/docume...er_eng.pdf
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#12
RE: What are my unclassified apneas?
If I recall correctly, ST will be more or less square waves, On... Off... On ... Off. Meaning IPAP EPAP IPAP EPAP. This was used before ST-A and ASV, may have been used for Central treatment and respiratory disease patients, but had been replaced by the specialized ST-A and ASV.

OP if you have sleep apnea, a VAuto will be a better choice. Unless you have Central Apnea or respiratory disease.

Did you get any diagnosic sleep study testing? We can help if you provide the background data. A self diagnosis of thinking you have Apnea and stumble on an ST for sale cheap isn't the best route to knowledgeable treatment.
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#13
RE: What are my unclassified apneas?
Can you provide a screenshot that shows your Machine Settings? Your mode states "VPAP-S/T" which implies that the backup is set, from your description it should not be. Also what I see on your machine settings you have set a PS of 4 (EPAP = 8 / IPAP = 12) The stats imply an actual PS of 5.
Also sho a 3-minute view at 0119 and another at 0116 or 0118.

The UA's you have zoomed on appear to have a recovery (larger) breath following the event which is an indicator of being obstructive (why I want to see the zoomed views.)
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#14
RE: What are my unclassified apneas?
Gotcha. Thanks, Geer.

I guess I was thinking of the ASV (which IIRC flags OAs but not CAs?)? But yes, same difference, if it doesn't use FOT or some other method, it won't know.

My stepfather is on BiPAP S/T for exactly that reason - because he has severe COPD and genuinely without it, he would be dead by now (and nearly was several times before I finally convinced my parents to refuse to let him come home without the proper machine after his fifth bout of respiratory failure and being made DNR after the last one). It works amazingly well if used for the right things.
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#15
RE: What are my unclassified apneas?
Before posting, I did my pattern searching. The UA's are not centrals nor stokes, nor did I just stop breathing(no large increase of inhale flow at the end of the UA) . It is randomly intermittent. Not a daily occurrence. I was hoping to be pointed to a youtube DIY of opening the cpap and testing for a weak sensor, or corroded wire connection or snap-in. 
Yes I do see the square wave pressure sent to the mask (the mask pressure wave recording). But it is still an air curve 10 model, which is enough for me. I now sleep for 8 hours, I am not sleepy during my day.
Someone mentioned the timing. I have it set for 12 bpm backup, with weak responses, or low pressure. I don't think the backup is needed for me. I am lucky my apnea is not at the serious stage.
I am obese, with a BMI of 40. So I expect hypopneas' My AHI is nice, not perfect, I know. 
I will slowly lower my in-pressure until the AHI blows up, then increase the inhale pressure back upward.
I will go thru the cpap internals if I find a good video. 
I am sorry I wasted anybody's time answering my original post, I should have said I looked for a matching pattern for the UA. What it is, a Unclassified anomaly. The first reply said as much. I should have said at that time that I wanted to take the cpap apart.
I did say in my original post that the UA was not a serious problem to my health.
It just bugs me when it shows up, and that it might be a simple fix.
Fast breathing. I never noticed that. Might be just not adjusted to sleeping with a mask. (Simplus brand full face)


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#16
RE: What are my unclassified apneas?
@Geer1 
I am now reading the Lab Titration guide, you linked to. Lots of information, and terminology I should be using in any posts.
I should have read the replies before my last posting.
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#17
RE: What are my unclassified apneas?
Post a more zoomed in example of a couple of these instances (2 min windows). I am pretty sure these are real apnea, look obstructive to me but the square wave of ST makes it very difficult to interpret breaths pre/post apnea.

The grouping of apnea hints towards obstructive as well and likely due to a positional apnea aspect or possibly rem sleep stage (would somewhat support the high/strange respiration rate and uneven breathing).

One thing makes me think they may possibly be centrals, that is the moments at 1:22:00 and approx 1:23:40 where that is probably a backup rate breath that creates a small breath (in which case obstruction is not present or is minor and overcome by the pressure increase). There is some arousal/recovery looking breathing going on but its so hard to interpret again because of the square waveform of ST.

Imo there is absolutely nothing to indicate there is something wrong with your machine. Everything points to these being real events of some sort.
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#18
RE: What are my unclassified apneas?
I also know that with my central events, I don't always get either triggering large breaths before or recovery breaths after. So either way, with the square waveform and backup settings, it's just going to look a little different, regardless of if it's obstructive or central. But I really don't see anything that would suggest it was broken, in some way.
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#19
RE: What are my unclassified apneas?
(06-28-2021, 10:40 AM)Geer1 Wrote: (2 min windows)
the moments at 1:22:00 and approx 1:23:40
first @ 1:21:59
   
second @ 1:23:30
   

Above was Friday night, no UAs for Sat nor Sunday night.
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#20
RE: What are my unclassified apneas?
Quick read of the titration guide:
I match Obesity Hypoventilation Syndrome (OHS)
Changing my settings to match the guides starting point.
Looking forward to tonight.
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