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Introduction; Periodic Apnea without hypoxia
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hobanfan Offline

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Joined: Aug 2016

Machine: ResMed AirSense 10
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: integrated
CPAP Pressure: 5-20, typically 8
CPAP Software: SleepyHead

Other Comments: New to apnea; chronic atrial fibrillation with an efficient pulse rate

Sex: Male
Location: San Diego

Post: #1
Introduction; Periodic Apnea without hypoxia
    I have newly recognized apnea and have finished my first week of CPAP. The forum’s reports about devices and software have been invaluable already.
I want to share a salient feature of my initial CPAP data. Most nights I tend to fall into a periodic breathing pattern despite clear airways. The frequent complete cessation of flow on these occasions (for up to half the time for periods of minutes) appears quite alarming. Yet I am not obviously symptomatic. Interestingly the oximeter data (CSM50D+) are also somewhat reassuring. In the attached screenshot, the oxygen saturation drops only from 96% to 95% after 2.5 min of apnea in a 4.5 minute window. (The slowish and very irregular pulse is characteristic of my atrial fibrillation, which has been continuous for the past decade or so but still supports a fairly high level of aerobic fitness with no suggestion of congestive heart failure. Pressure from the Airsense 10 CPAP device here was 7 mm inspiration, 5 mm expiration)
With an AHI over 20 prior to CPAP, I am ready to believe that CPAP can improve my quality of life even though I am not markedly symptomatic to begin with. But results like these raise a general question: is apnea necessarily damaging even if it doesn’t much affect oxygen saturation, pulse rate or quality of sleep? I see many reports of bad health conditions associated with apnea, but those reports usually include disclaimers to the effect that the nature and direction of the causal influence is not clear. So: how much apnea is compatible with good health? If there is no general answer, that is itself an answer that might allay some apnea anxieties.

A relevant discussion of CSA without heart failure --Manzhukani and others, ‘primary central sleep apnea’: doi:10.1016/j.jsmc.2013.10.006
08-14-2016 03:47 PM
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trish6hundred Offline

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Posts: 6,424
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #2
RE: Introduction; Periodic Apnea without hypoxia
Hi hobanfan,
WELCOME! to the forum.!
Hang in there for answers to your questions and much success to you with your CPAP therapy.

trish6hundred
08-14-2016 04:00 PM
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klv329 Offline

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Posts: 27
Joined: Aug 2015

Machine: Resmed s9 Adapt
Mask Type: Nasal pillows
Mask Make & Model: Resmed LT
Humidifier: 80
CPAP Pressure: 8.2, 1.4-10.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: St. Petersburg, FL

Post: #3
RE: Introduction; Periodic Apnea without hypoxia
If my charts looked like that, I would definitely feel it in a bad way, really bad.

But it's okay for you, as you indicate in your post and in your daily notes.
08-14-2016 06:51 PM
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Dawei Offline

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Posts: 342
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Other
Mask Make & Model: Respironics "FitLife"
Humidifier: H5i
CPAP Pressure: 10-20
CPAP Software: ResScan SleepyHead

Other Comments: Began CPAP in 2006; spent the first 6 years with a "brick"

Sex: Male
Location: Western North Carolina

Post: #4
RE: Introduction; Periodic Apnea without hypoxia
Welcome to the forum. You pose an interesting question, hobanfan. From what I have learned, apnea, by definition, is incompatible with good health, period.
That's why an AHI of under 5 was set as the goal for treatment. That doesn't mean I understand what's going on in your situation. Those centrals don't look good to me, yet your saturation hardly changes, as you pointed out. I also wonder what relationship, if any, might there be between your a-fib and apnea. So, I, too, have questions. Perhaps others here will be able shed some light.

David
08-14-2016 07:53 PM
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richb Online

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Posts: 518
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: #5
RE: Introduction; Periodic Apnea without hypoxia
Hi hobanfan,

Welcome to the Apnea Board Forum. I have a question. What do the codes PC and SD refer to in the event flag portion of your data?

Rich

Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here: http://www.apneaboard.com/wiki/index.php...SleepyHead
08-14-2016 08:07 PM
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klv329 Offline

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Joined: Aug 2015

Machine: Resmed s9 Adapt
Mask Type: Nasal pillows
Mask Make & Model: Resmed LT
Humidifier: 80
CPAP Pressure: 8.2, 1.4-10.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: St. Petersburg, FL

Post: #6
RE: Introduction; Periodic Apnea without hypoxia
Pulse Change events and Sp02 Drop events that are user definable in sleepyhead.

Looks like the default sttings might be 6bpm change in 8 seconds for PC events and 4% change in 10seconds for SD events. But these can be changed by the user.
08-14-2016 09:12 PM
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hobanfan Offline

Members

Posts: 4
Joined: Aug 2016

Machine: ResMed AirSense 10
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: integrated
CPAP Pressure: 5-20, typically 8
CPAP Software: SleepyHead

Other Comments: New to apnea; chronic atrial fibrillation with an efficient pulse rate

Sex: Male
Location: San Diego

Post: #7
RE: Introduction; Periodic Apnea without hypoxia
The PC and SD entries were automatically created by Sleepyhead when it imported the CMS50 oximeter data. There are good instructions for doing that on the forum under the title 'Importing_CMS_50D_Plus_oximeter_data_into_SleepyHead'.

The PC line flags significant pulse changes, and the SD flags sudden drops in the SpO2 values. In my record, PC 'events' are happening all the time as expected with fibrillation, but SD events are rare and minor, never dipping below 93.
08-15-2016 12:36 AM
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richb Online

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Posts: 518
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: #8
RE: Introduction; Periodic Apnea without hypoxia
Thanks for the clarification hobanfan and klv329. I would want to check the accuracy of the pulse oximeter. Borrow one and do some experiments. Also, hobanfan, do you know if anything was different during the first half of the night when there weren’t any events recorded? Another question hobafan, can you confirm that you do not have Congestive Heart Failure? Lots of questions but we need more information to help you figure out what is going on here.

Rich

Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here: http://www.apneaboard.com/wiki/index.php...SleepyHead
08-15-2016 06:40 AM
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hobanfan Offline

Members

Posts: 4
Joined: Aug 2016

Machine: ResMed AirSense 10
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit P10
Humidifier: integrated
CPAP Pressure: 5-20, typically 8
CPAP Software: SleepyHead

Other Comments: New to apnea; chronic atrial fibrillation with an efficient pulse rate

Sex: Male
Location: San Diego

Post: #9
RE: Introduction; Periodic Apnea without hypoxia
Thanks, richb, I'll be checking with my cardiologist. I notice that your profile indicates 'idiopathic central sleep apnea'. That diagnosis (idiopathic or primary sleep apnea, which I take to mean CSA that isn't attributable to some other recognized pathology) could fit my case also, although I gather the long-standing fibrillation may have helped set it up (in ways that AFAIK are not well understood!). I'll ask my sleep doctor about that. I gather idiopathic CSA is not common?
08-15-2016 09:51 AM
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richb Online

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Posts: 518
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: #10
RE: Introduction; Periodic Apnea without hypoxia
Yes. What I have is very rare. Took a long time to finally get my ASV machine. Your case is interesting and questions have to be answered. I am concerned about the accuracy of your oximeter as well as the other questions I had. I hope you can get this figured out.

Rich

Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here: http://www.apneaboard.com/wiki/index.php...SleepyHead
08-15-2016 11:04 AM
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