Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Need guidance for complex sleep apnea and leaks follow-up
RE: Need guidance for complex sleep apnea and leaks follow-up
My apologies.  Thank you for explaining that Geer.  I knew artifacts are errors (or possible errors) that can occur and are disregarded.  A home capnometry/oximetry test I took had all of the artifacts isolated and in their own section.  I didn't realize that you should disregard the extreme outliers.  Kind of like the standard deviations in statistics.  It is ok to throw out the extreme outliers.
Post Reply Post Reply






Donate to Apnea Board  
RE: Need guidance for complex sleep apnea and leaks follow-up
The way to tell that reading was an artifact is how the only times his heart rate dropped below 60 it was a large drop that returned back to the same level almost instantly.
Post Reply Post Reply
RE: Need guidance for complex sleep apnea and leaks follow-up
(03-15-2022, 07:09 PM)Jay51 Wrote: A home capnometry/oximetry test I took had all of the artifacts isolated and in their own section.  I didn't realize that you should disregard the extreme outliers. 

Well, you shouldn't disregard the extreme outliers, especially if one channel (HR) appears to be artifact, while the other (saturation) does not.  An abnormal beat (like a PVC, or a missed beat) could sneak in there.  If the artifacts had their own section in your study, it means that somebody got out of SkyLab View, looked at much smaller windows and manually identified and edited out the artifact.

Now I'm looking at this study with essentially fixed heart rate and going WTF's up with that?

You got a pacemaker? Pile of medications?  Cardiovascular autonomic dysfunction?  In the kind of central apnea we're talking about here (and even that's unclear to me since that appears to be an internet diagnosis) there should be a ton of signature Heart Rate Variability and there is zero, nada, goose egg, zip.

Blood returns to right heart via inspiration.  In central apnea then, blood return to the heart is impaired during the apnea, resumes during resumption of breathing but requires an increase in heart rate to get rid of the surge in blood return.  The length of central apneas determines the cycle of Heart Rate Variability (Low or High)  Any HRV is clearly absent here.

What is also clear is that unmonitored, arbitrary high EPAPs probably aren't a good idea either.
Post Reply Post Reply
RE: Need guidance for complex sleep apnea and leaks follow-up
Sorry ' bout the empty DropBox.  I tried to delete all the old trash and leave only copy of current /SD card - "F."  Overkill, but I'd hoped to let the knowing ones pick and choose their preferred waves.  I've got nothing to hide there.  

Here goes another trial - here is link I hope.:  //www.dropbox.com/sh/39yk4iie26buzh1/AADhIVrlEVK95Z3DaiMFdLk4a?dl=0 b

If the magic is bad, here is a sample of data based on Geer1's sugestions.    
 https

     

     

   
Post Reply Post Reply






Donate to Apnea Board  
RE: Need guidance for complex sleep apnea and leaks follow-up
I'll try one last cast of the net.  Can't seem to get data into DropBox so will just try 3 more screenshots- another night with no program changes.  (BTW never had cardiac DX or SX's.  Only meds are modest amt for BP - HCTC, amlodipine, and Tekturna. I'm happy with my cardiac rhythm strips.  I don't think there are any answers there.) 

   

     

   
Post Reply Post Reply
RE: Need guidance for complex sleep apnea and leaks follow-up
I see you went back to the nasal mask, is there a specific reason for this? If not I would be curious to see you try FFM at these settings as that is what you were using on your best day (March 6th).
Post Reply Post Reply
RE: Need guidance for complex sleep apnea and leaks follow-up
(03-17-2022, 08:39 AM)jmayer180 Wrote: I'm happy with my cardiac rhythm strips.  I don't think there are any answers there.

OK that's fine.  My job isn't to convince you do do anything.  Actually I don't even have a job.

But just to illustrate my point, here is what happens typically in central sleep apnea (this one is due to heart failure, so cycle time is longer than CompSAS but should illustrate the point)(BTW this guy was put on ASV with an EF of 30%.  Guess they didn't read the warning label).

The heart rate variability is clearly seen here.  In your oximetry, there were 246 desaturations, but no HRV to speak of.

So maybe there is an answer there.  Namely, you don't have CompSAS and are using a machine that is simply creating havoc.

CompSAS often/usually resolves on it's own, and you've got incomplete data from 5-16 years old so IMO this arbitrary dial wingin' is at the very least unproductive and an NPSG titration is called for.  You were supposed to see a new doc around November.  Did that happen?

Do you have any of the data (not opinions) that came up with the conclusion that you have CompSAS)?



[Image: VzlSisr.jpg]
Post Reply Post Reply






Donate to Apnea Board  
RE: Need guidance for complex sleep apnea and leaks follow-up
Here's the question you need to ask.

"When I have stable breathing, is it because of ASV, or in spite of it?

[Image: oHtaNSz.jpg]

[Image: q8C9vm3.jpg]
Post Reply Post Reply
RE: Need guidance for complex sleep apnea and leaks follow-up
(03-18-2022, 06:36 AM)Rubicon Wrote: In your oximetry, there were 246 desaturations, but no HRV to speak of.

The report actually had 28 pulse events (Change in rate by at least 6 bpm, for a minimum duration of 8 seconds) but since most of those occurred during periods of supposed artifact, I probably would have edited them all out.
Post Reply Post Reply
RE: Need guidance for complex sleep apnea and leaks follow-up
(03-17-2022, 11:39 PM)Geer1 Wrote: I see you went back to the nasal mask, is there a specific reason for this? If not I would be curious to see you try FFM at these settings as that is what you were using on your best day (March 6th).

Alas, as is my pattern after a fairly decent night the next run shows leaks and increased events bouncing all over, back with a vengeance with no change in settings.  I have been told by my old sleep-doc and it has been my experience that the smaller the surface area of my mask the less the leak.  I have tried literally dozens of masks over the years looking for the perfect one.  I get the best results using a head-harness with forehead support.  However, due to forehead skin breakdown from constant high pressure, I must periodically switch to a harness that does not use the forehead.  But unfortunately, the hooting of mask leaks then exceeds spousal tolerance!   

Neither of the two sleep studies I had (9 & 5 years ago) were really satisfactory, and most of the earlier evaluation and adjustments were by trial and error and SleepyHead reports. I remember so clearly about five years ago when after extensive Forum discussion the consensus opinion seemed to be “why was my sleep-doc taking so long to switch me to ASV for my complex apnea."

I commented on my new sleep-doc some time ago.  In brief that visit brought me back to the Forum.  But the “final thought” is – would it be reasonable to propose to her an at-home sleep study?  I have found very little information on that.  Can they be helpful?
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  Leaks while Side Sleeping 3xod1a 5 168 2 hours ago
Last Post: clownbell
  New F&P Evora Full Face Mask--Leaks! DaveL 83 2,689 Today, 03:13 AM
Last Post: yankees123
  [CPAP] how to reduce leaks, full face mask newmar 59 3,335 Yesterday, 11:53 PM
Last Post: newmar
  Just found out I have sleep apnea - kaiser Gogirl 10 338 08-06-2022, 07:24 PM
Last Post: mecutl3r
  Leaks controlled but AHI up Chalkie 30 1,168 08-02-2022, 05:53 AM
Last Post: Chalkie
  Self-Treating Sleep Apnea | First Night with CPAP = 0,87 AHI | Central Apnea? Dumdi 22 1,574 08-02-2022, 05:26 AM
Last Post: Dumdi
Question COPD & Sleep Apnea - looking for info Hydrangea 2 125 08-01-2022, 04:06 PM
Last Post: Sleeprider


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.