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Periodic Breathing?
#1
Periodic Breathing?
Can anyone explain to me what this section of my results means? Is it something I should be worrying about? Most nights I will have a little bit of this (perhaps a minute or two), but last night's was nearly 9 minutes. Is it dangerous? Is there something I can do to reduce or eliminate it? 

AHI last night was 2.48 (pressure ranged from 12 to 17.3). I've been a CPAP user for 4 years and only rarely see results of less than 1 AHI. In the past two weeks they've ranged from 0.57 to 4.63.


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#2
RE: Periodic Breathing?
Your periodic breathing appears to be obstructive rather than central. If you zoom in a bit more on the flow wave, I suspect it is extremely flow-limited with flat or downward sloping peaks. You continue to breathe but with a lot of effort. I'm going to further guess it is positional in nature. Your System One 60 Series Auto CPAP is getting pretty old. When you replace it, be sure to get the Resmed Autoset which will give you some pressure support (EPR) and much more response to flow limitation, and with the amount of flow limitation I see in this chart, you may be better off with bilevel (Aircurve 10 Vauto). Meanwhile you might read up on positional apnea and the soft cervical collar. I don't know that you need a soft cervical collar, but you do need to be aware of chin-tucking and avoid pillows or sleep positions that might cause it.
http://www.apneaboard.com/wiki/index.php...onal_Apnea
http://www.apneaboard.com/wiki/index.php...cal_Collar
Sleeprider
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#3
RE: Periodic Breathing?
Thank you. I'm probably due for a new machine in February, but I don't yet know how Kaiser handles that and what choices I'll have.
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#4
RE: Periodic Breathing?
Here's a little more zoomed-in section, is this enough to determine?
   

Also, here's the view of the whole night. Is there anything else I should consider? I do get clusters of OA events like the one seen here at 5:15a.
   
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#5
RE: Periodic Breathing?
My machine has A-Flex, which from what I'm reading is a type of EPR. I've had the A-Flex set at 1. Would I benefit from raising it to 3? It's very odd how I'll see sections where my inhale/exhale wave is all above the zero line.

The last two nights were particularly revealing. Friday night my AHI was only 0.94:
   

But on Saturday night it was 6.76, one of my worst nights in ages:
   

I had changed nothing in my equipment or settings. But I set up a security cam to catch my sleep on video. The event clusters correspond to any time I rolled from my side to my back. While on my back I get clusters of OA events. I do not appear to be chin-tucking. While on my back my head/neck position is basically straight, while on my side my neck is usually extended somewhat, head tilted back.

Sleeprider, is it possible to tell from this whether I'd benefit from a soft cervical collar?
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#6
RE: Periodic Breathing?
Unfortunately A-Flex does not have the same effect as EPR. Flex is capable of reducing pressure up to 2-cm at settings of 2 or 3 and the pressure returns to CPAP before the end of expiration. EPR is a true bilevel pressure that provides separate inhale and exhale pressure with a difference up to 3-cm. While we have seen EPR resolve flow limitation, we have not observed any therapeutic benefit for Flex.

In my last response, I linked to the positional apnea and soft cervical collar wikis. Your most recent chart confirms you have the characteristic obstructive clusters we associate with this problem. Please read those wikis and consider using the soft cervical collar.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
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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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#7
RE: Periodic Breathing?
You may also want to look at the Flow Limitation wiki http://www.apneaboard.com/wiki/index.php...limitation

Results with Kaiser vary, but getting a Resmed Airsense 10 Autoset should not be a problem.
Sleeprider
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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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#8
RE: Periodic Breathing?
Thank you very much! I read the Wikis you linked to, and will be ordering a soft cervical collar.
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#9
RE: Periodic Breathing?
I ordered the soft cervical collar and tried it out. Unfortunately, it didn't fit right.

However, I changed my bed pillow out for a thicker one and it seems to have had a good effect -- my AHI has been trending much better lately, with many days below 1.0, and no days above 3.0.  

Today I called Apria for a resupply (mask, pillow, humidifier chamber, etc.), because signing up for their automatic resupply has so far been an utter fail. I also asked them about a new machine, since my Respironics 60 series is more than 5 years old. I was told that I am indeed due for a new machine and that it will be an Airsense S10!  There's also an option for a BIPAP machine, but that will require a new prescription/authorization.  After what you said, Sleeprider, I'm definitely looking forward to trying out the Airsense S10!
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#10
RE: Periodic Breathing?
Winterfrost - Please be aware that there are several S10 versions. You want either the Autoset or the Autoset for Her model. You DO NOT want the Elite or CPAP models.
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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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