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Is this real Cheyne Stokes Respiration or not ?
#11
RE: Is this real Cheyne Stokes Rerspiration or not ?
Still need to post full study but here is the latest charts from last night. Weird centrals after waking but kept mask on again as I was drifting in and out before getting up.

Also, is respiration rate an issue ? Doesn't seem correct. Seems too high.

Thank you again for your help !
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#12
RE: Is this real Cheyne Stokes Rerspiration or not ?
Given what is shown on this chart, yes the respiration rate seems high. What else is going on health wise? Anything that affects overall health, heart, or breathing problems?
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#13
RE: Is this real Cheyne Stokes Rerspiration or not ?
I would post several 2 minute segments of your flow rate and respiration rate charts for evaluation. Pick a normal area and a few with higher rates.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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#14
RE: Is this real Cheyne Stokes Rerspiration or not ?
[attachment=16026][attachment=16025][attachment=16024][attachment=16023][attachment=16022]


Here are 5 with 3 showing high respiration followed by the 2 normal charts.

Thanks again !
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#15
RE: Is this real Cheyne Stokes Rerspiration or not ?
Here's a CSR comparison chart via Wikipedia on this

   
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#16
RE: Is this real Cheyne Stokes Rerspiration or not ?
It doesn't fit the profile of CSR but I am wondering if the "sawtooth" breathing pattern is what is contributing to a miscount of the respiration rate.
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#17
RE: Is this real Cheyne Stokes Rerspiration or not ?
We have seen this pattern in the past related to periodic leg movement (PLM) or even a pounding heart rate. I suspect PLM. This is also related to severe flow limitation, and it might be worth trying an EPR setting of 3 to see if we can clear up the flow limitation, or if it makes the central apnea worse. In my opinion you are suffering from a very high flow limitation problem that might respond to a bilevel pressure. I may have missed an earlier post where you were using EPR, but I think that I would start with a minimum pressure of 9.0 with EPR 3 and maximum pressure of 12.0 and see what happens. How much worse can it be?
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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#18
RE: Is this real Cheyne Stokes Rerspiration or not ?
there may be a hint of plm in 3 of those charts. however, while IDK how plm presents in other people's flow rate, I can say that none look like the plm I see in mine.

plm can be confirmed or ruled out by video, audio recordings and witness reports. it's also helpful to look at the entire sleep study, if there is one, to see if plm was noted (it may not be mentioned in the summary).

for me, plm is a sharp inhale followed by a series of flow limited breaths, more or less equal in number before the next sharp inhale throughout the duration of the episode. the inhale 'spikes' are often associated with what looks like a snore but is actually a moan/groan in complaint. I find them most visible with a 6 or 7 minute view scale (although your relatively high breaths per minute may appear differently but your bpm isn't that much higher than my med of 15 to 20 bpm compared to your 24).

with my apap and asv, these inhales-followed-by-flow-limited-breaths cause the machines to increase pressure, which I've come to believe is a fruitless and disturbing action doomed to accomplish little to nothing because I don't believe the machine can compensate enough for my relatively forceful physical and respiratory reactions to the plm. max pressure, desirable for other reasons perhaps, had to be restricted to avoid the many disturbances and arousals that pressure responding to my respiratory response to plm causes (disturbances caused by pressure swings and runaway high pressure). maybe not a problem for you since your max pressure isn't all that high. for me, pressure above about 13cmw results in more leaks and aerophagia as well.

I do see a lot of flow limited breathing in these charts. just .04 in the 95%tile column but many / most may be unflagged. no flow limitation graph in the screenshots to check but I also know most of my flow limitations are not flagged. not sure if you're already at epr 3 or if it's the ramp I see in the daily statistics. if you turn off the pie chart in file/preferences/appearance we can see what your epr setting is. epr may help; if not enough, they say a bilevel with pressure support may work better.

no leak rate graph to look at either: probably a long shot but I wonder if your mask is leaking on inhale.
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#19
RE: Is this real Cheyne Stokes Rerspiration or not ?
Another member Hojo has an extremely high respiration rate as you do. http://www.apneaboard.com/forums/Thread-...#pid223896

I think your solution is going to be difficult, but consider it a challenge to get the care you need.
Sleeprider
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____________________________________________
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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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#20
RE: Is this real Cheyne Stokes Rerspiration or not ?
Sleeprider nailed it. What I saw was a respiration rate of 20 that was jagged and broken up by flow that reversed flow several times resulting in a high false respiration rate.
A camera may indicate what occurred through the night. Sync the camera time with your machine.

Review to see if this is recurring. Happening once means little. It is the consistency that matters.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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