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Please Help Analyze My Data (Pause Event)
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SkinTone Offline

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Posts: 21
Joined: Aug 2016

Machine: DreamStation AutoCPAP
Mask Type: Nasal pillows
Mask Make & Model: DreamWear under the nose Nasal Cushion
Humidifier: DreamStation heated humidifier
CPAP Pressure: 10-13
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: USA

Post: #1
Please Help Analyze My Data (Pause Event)
Hello,

I'm new here and new to CPAP therapy, ~3 months. I am in great need of help from you to interpret the data from my dreamstation. on 07/22 at 0159am there was a pause event recorded on my holter that I am hoping to correlate with the CPAP records. Attached is the sleepyhead data from that day.
From what I can see in the sleepyhead data, it seems likely that there was a pause noted by the CPAP (as I see on the flowrate chart). I would like to know why the CPAP machine did not catch or compensate for this to prevent the pause from happening. Are my CPAP device settings flawed? Any input and/or help you can offer would be great. Thanks.

My charts are here: imgur.com/a/B7ueG
   

I will be more than happy to answer any questions you might have to the best of my understanding.
Thanks in advance.
(This post was last modified: 08-05-2016 02:56 AM by SkinTone.)
08-05-2016 02:47 AM
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justMongo Offline

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Posts: 3,853
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #2
RE: Please Help Analyze My Data (Pause Event)
Your auto-PAP does not prevent events from happening. It adjust based on it's sensors to try to head off events.
Your flow pattern near 1:59 AM was not flagged as an apnea event. This is possibly due to the flow pattern showing activity until 1:58:47. Then a small breath at 1:58:54. Then a return to breathing at 1:59:03. It's sort of a short hypopnea with 7 seconds, then 9 seconds of near zero flow. It takes 10 seconds to score. I postulate the machine didn't score an event based on that pattern.

If that flow pattern correlates with a sinus pause it may be some sort of central event.
A strictly amateur guess might be a disruption of signals in the brain stem -- but, truly, I don't know.

How long was your cardiac sinus pause? What cardiologists sometimes see during a sinus pause is a ventricular escape beat.
It's the heart's way of saying, "Hey, you haven't commanded me to beat, so, I'm going to fire the ventricles anyway."

I would shift focus from the CPAP aspects; and let the cardiologist figure the situation out.
The cardio doc may ask for a neurological consult.

Try not to dwell too much on data. Many people become "hooked" on data.

The depth of knowledge required in your case is beyond the scope of this forum.

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.
08-05-2016 06:51 AM
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PoolQ Offline

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Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #3
RE: Please Help Analyze My Data (Pause Event)
Agree. Many people have issues with Holter (my wife included) in that many time they do not "catch" events. yours did, so this is a good thing. You are using the right equipment to provide your Doctors valid information about what is going on AND it is recording events. If the event was a central, which it looks like given the Holter results, your APAP machine is not designed to deal with it and you may get changed to an ASV type of CPAP which IS designed to attempt to trigger a breath.

That said if your heart was not beating at the time, that is the primary issue. My FIL first got a pace maker to deal with his heart (his pulse rate would go below 30 at times) and then got CPAP do deal with his breathing. He is back golfing and sleeping better than I am now, he just pats his chest and smiles. He used to sleep a lot during the day and now is much more active and happy.
08-05-2016 10:44 AM
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SkinTone Offline

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Posts: 21
Joined: Aug 2016

Machine: DreamStation AutoCPAP
Mask Type: Nasal pillows
Mask Make & Model: DreamWear under the nose Nasal Cushion
Humidifier: DreamStation heated humidifier
CPAP Pressure: 10-13
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: USA

Post: #4
RE: Please Help Analyze My Data (Pause Event)
Thank you both for your feedback. Very helpful. This particular event obviously occured only at night. I wore the monitor for 2 weeks and this isolated event was what was recorded; the remaining set of data by the monitor did not flag anything suspicious or unusual. It occured at night. That was why I hoped that with your experiences with the CPAP you would be able to see if the sleepyhead data reveals anything useful that I can share with the physician.

justMongo, thanks for that detailed time breakdown at 1:59. This is important information I can share with the physician to see when the event happened. I will not dwell much on the data, but I'm hoping to educate myself on this issue so that I can take the appropriate steps. When I find out the length of the pause, I will update you in this thread. Thank you.

PoolQ, I did not know that central apneas are not dealt with by the CPAP(or APAP in my case). These events in my case seem rare at first glance here, so what I would do is ask the doctor to review my sleep study results (or I can too), to determine how many central events I had in a given night. Do central events occur in conjunction which pauses noted on holters?
08-05-2016 01:57 PM
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trish6hundred Offline

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Posts: 6,449
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: #5
RE: Please Help Analyze My Data (Pause Event)
Hi SkinTone,
WELCOME! to the forum and much success to you with your CPAP therapy.
Hang in there for more responses to your post.

trish6hundred
08-05-2016 08:04 PM
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SkinTone Offline

Preferred Members

Posts: 21
Joined: Aug 2016

Machine: DreamStation AutoCPAP
Mask Type: Nasal pillows
Mask Make & Model: DreamWear under the nose Nasal Cushion
Humidifier: DreamStation heated humidifier
CPAP Pressure: 10-13
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: USA

Post: #6
RE: Please Help Analyze My Data (Pause Event)
Thank you very much Trish.
08-06-2016 10:55 AM
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