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Is this real Cheyne Stokes Respiration or not ?
#31
RE: Is this real Cheyne Stokes Rerspiration or not ?
                   

Thanks to all who have assisted me in this journey.

I wanted to circle back and seek additional advice.

Have been riding with the new settings moving minimum to 7.0 and EPR at 3. This has apparently resolved the respiration rate issue.

I have had fluctuations in the AHI but relativelty low with what I assume to be SWJ driving the numbers up.

Included summary charts with my last week or so numbers.

Last night, however, it went off the rails and skyrocketed. Woke up at 2:50 and kept mask off for awhile. Tried to sleep but just barely drifted in and out all the way until 7:00.

Felt like several times would stop breathing when drifting off.

Do I chalk this up to just a bad night and SWJ or is there something I should really be concerned with immediately ?
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#32
RE: Is this real Cheyne Stokes Rerspiration or not ?
Have you noticed any trends on your stats or on how you feel? I can have many near zero AHI for several days and then for no reason I'll get a 4 AHI. I can't say I felt different at 0 or 4. I look at things more often only if the bad trends 2 or more days.

Here's a thought, put a good vs bad session up and let's compare these.
Dave

OSCAR
Standard OSCAR Chart Order
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Dealing With A DME
Soft Cervical Collar Wiki
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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#33
RE: Is this real Cheyne Stokes Rerspiration or not ?
       

Here is a comparison with a good night just a few days ago vs. last night.
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#34
RE: Is this real Cheyne Stokes Rerspiration or not ?
The problem with centrals is they are consistently inconsistent. Given your success at the same settings, there is not any good reason to suggest a change based on a bad night or two. I think these are going to happen from time to time, but as Dave suggests above, a trend is what we need to watch.

Please try to minimize the monthly calendar in future graphs.
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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#35
RE: Is this real Cheyne Stokes Rerspiration or not ?
I am wondering at what point they are considered true CAs. Also if the machine can truly flag these accurately. My two sleep studies showed no centrals but I also want to be aware of the possibility of treatment emergent problems. The breathing has become concerning to the point that I feel at times like I am unintentionally holding my breath. As I drift off, this happens and it jolts me awake. This does not happen when falling asleep at the start of the night. Only after waking and drifting in and out. Almost like I have developed a phobia to it.
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#36
RE: Is this real Cheyne Stokes Rerspiration or not ?
We can address the rest of this in a bit, but I had a scenario to think on. Out of 7 consecutive days, which of that comparison of good vs bad can you produce? I'm in no way suggesting ignoring bad sessions, but these will happen to us all.


Without trend info I can only create possibility scenarios so keep that in mind. Worse case 7 days: For myself on that 7 day timeframe, I'm not tossing out 4 good nights because of 3 bad even if they're consecutive. To have produced 4 good nights, settings could not have produced it if they were off kilter.

As for central apnea and breath holding, I know I have and do both. When I change sleep positions, it almost always happens. It's part of my sleep package. Your sleep package is going to be different than everyone else's. Maybe it does include treatment emergent centrals but it's not a certainty. You'll need to identify all things within that sleep package that you can make a positive impact. There will be some things that cannot be controlled and will be randomly good sometimes and bad at other times. For those that do have them, Centrals are almost always random and inconsistent. Other health and life aspects affect sleep in various ways.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#37
RE: Is this real Cheyne Stokes Rerspiration or not ?
It is fairly consistent that if one were to look at my data, sometime after 5:00am (when wife's alarm goes off) is the gross majority of issues. There are nights when I actually have good numbers throughout, but my average can really get skewed with that last 2 hours of drifting, moving, and breath holding bringing on a huge dose of anxiety. All of which were not there prior to starting therapy in May of this year. I could nap with no problem up until that point but can not now as I have begun to anticipate the breathing issues that have developed. This all being said the therapy has been really tough to get used to. I can't say that I am sleeping better overall but there are decent nights.

At times I wonder if a mask change might help as I find the one I have to seal best and work consistently but always feel like it is overly warm and constricting even with tube temp at 67 and humidity at 4. Problem is I have always been a mouth breather so anything but full face is out of the question.
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#38
RE: Is this real Cheyne Stokes Rerspiration or not ?
(10-31-2019, 03:35 PM)jsljsljsl Wrote: It is fairly consistent that if one were to look at my data, sometime after 5:00am (when wife's alarm goes off) is the gross majority of issues. There are nights when  I actually have good numbers throughout, but my average can really get skewed with that last 2 hours of drifting, moving, and breath holding bringing on a huge dose of anxiety. All of which were not there prior to starting therapy in May of this year. I could nap with no problem up until that point but can not now as I have begun to anticipate the breathing issues that have developed. This all being said the therapy has been really tough to get used to. I can't say that I am sleeping better overall but there are decent nights.

At times I wonder if a mask change might help as I find the one I have to seal best and work consistently but always feel like it is overly warm and constricting even with tube temp at 67 and humidity at 4. Problem is I have always been a mouth breather so anything but full face is out of the question.

Not that long ago, I was retired, but my wife worked, ad woke up at 5:00 AM. My sleep after that alarm was not great, and that would be enough to cause the SWJ events.  I eventually let go of my guilt and found I slept better in the morning.  We are both retired now, so no more alarm, but I really hate it when she reaches over to her iPhone to check the time.  That is always worth a couple CAs.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#39
RE: Is this real Cheyne Stokes Rerspiration or not ?
There's a number of full face masks out there that you could consider for replacing your current one. You're likely to find something similar but better suited to you.

As for the fairly consistent timing of your breath holding while going through sleep disruptions, it sounds like a difficult obstacle you're dealing with. Difficult but not impossible. I don't think there's evidence suggesting machine or setting changes that I've noticed. It sounds to me more of a comfort based issue. I'm not sure how long you've been on CPAP but there is a period of time needed to repair that damage done while apnea was untreated. When one starts the journey back from unhealthy apnea sleep to reduced apnea, sometimes abrupt changes like this are disturbing in itself. Time on therapy has a way of getting things back on track.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#40
RE: Is this real Cheyne Stokes Rerspiration or not ?
(10-31-2019, 10:13 AM)jsljsljsl Wrote: I am wondering at what point they are considered true CAs. 

Lots of great work going on in this thread.  Just replying to this comment.  

A good detailed look through OSCAR from a two minute view of each event often can go a long way to clearing up the "are these true CAs" question.  If you want help with that post those two minute views here and get help from the group.  

If you get really concerned about what impact they are having on you wear a pulse-oximeter overnight to see if you SpO2 is dropping at that time or not.  

WillSleep

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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