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Question about Bunch Ups
#1
Question about Bunch Ups
So, my events are under 5 every night now and are even down around 2 or below every night. The events that do happen seem to bunch up and I notice a changed breathing pattern right before that happens.

My questions are:
  • Is some of this maybe just SWJ (I have MANY instances of baby crying where my wife wakes up with him, but I never do or don't remember waking up)
  • My respiration rate is usually 26 or below for max, but typically between 12-20.. what does that mean?
  • Is there a correlation with my pressure being too low causing the change?
My current settings are 6-20cm, EPR 1, humidity 80 degrees. I know this is obsessing over good results, but I just want to learn more! I've attached a sample of the bunch of I saw.


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#2
RE: Question about Bunch Ups
Maybe it is SWJ if you're sleep is disrupted. Again maybe but not certain. I typically can point others to SWJ at the bookends, beginning or ending of the sleep session. If you had several, more than 2 like this, I'd be more likely to say positional Apnea. But again there's only 2. Maybe it was a stubborn Obstructive event that opened a bit, just enough to flag it as 2 separate events.

My respiration rate is typically 10. Meaning one full breath cycle every 6 seconds. 6x10=60 At RR 20 this is full breath cycle in 3 seconds. 20x3=60 you breathe faster than I do. That's probably all there is to it. Note I have COPD as why I'm slower. I need more exhale time.
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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#3
RE: Question about Bunch Ups
Yeah, this only happens a couple times a night. Maybe positional is the answer. Prior to optimizing my pressures, it was much, much worse. I do notice that my breathing is typically worse on my back when awake in general, so that’s probably a good tidbit. 

Even so, I think I can feel pretty good about even these events, right? I know not all events will be cleared.

Okay, thanks for the respiration rate. I didn’t know if it meant anything at all.
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#4
RE: Question about Bunch Ups
Well just keep in mind that a PAPs job is to minimize Apnea not eliminate all. If you see a 0.0 AHI OK congrats, but it's not REQUIRED to sleep and be well rested. What I'm saying is zero isn't the tell goal, but rest and comfort are. If you had those 2 flags on every OSCAR and that was about it, and you're resting well, just shrug and move on. If there were a lot more flagged events, then OK be concerned, but it's not.
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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#5
RE: Question about Bunch Ups
Perfect! That’s the reassurance I needed!
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#6
RE: Question about Bunch Ups
I noticed that you had a very high Flow limit (0.50) just before your events in the clip, and then I checked the stats for flow limitations. Your 95 percentile was over .10, and your max (actually 99.4 percentile) was .33.
My guess is that the flow limitation triggered the events.

I think you would reduce your flow limitations quite a bit if you changed your EPR to 3, although you may be more comfortable using EPR 2 for a while. It's possible that EPR at 3 might increase your very small number of CA events; that's something to keep checking. It can be tough to balance flow limitations against CA events.
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#7
RE: Question about Bunch Ups
(07-01-2021, 04:07 PM)pholynyk Wrote: I noticed that you had a very high Flow limit (0.50) just before your events in the clip, and then I checked the stats for flow limitations. Your 95 percentile was over .10, and your max (actually 99.4 percentile) was .33.
My guess is that the flow limitation triggered the events.

I think you would reduce your flow limitations quite a bit if you changed your EPR to 3, although you may be more comfortable using EPR 2 for a while. It's possible that EPR at 3 might increase your very small number of CA events; that's something to keep checking. It can be tough to balance flow limitations against CA events.


So that’s the funny thing. I reduced EPR because the majority of my events before were central events and my AHI would be closer to 3-5 every night. I tried the same pressures with EPR at 2 and ended up with over 5 AHI. All of my events, especially centrals, were much higher
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#8
RE: Question about Bunch Ups
How many nights of data did you base reducing the EPR? I hope it wasn't just one night. You may have some CAs until your body normalizes to the new settings.
Crimson Nape
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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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#9
RE: Question about Bunch Ups
OK, if you've already tried EPR at 3 and it was worse, stay at 1. You already have good results.

I think you will find that the changes to ramp and minimum pressure will make you more comfortable, which is a primary goal.
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#10
RE: Question about Bunch Ups
(07-01-2021, 04:41 PM)Crimson Nape Wrote: How many nights of data did you base reducing the EPR?  I hope it wasn't just one night.  You may have some CAs until your body normalizes to the new settings.

I’ve been on current settings for 1 week. I had 2 weeks of higher EPR And I had AHI of 4.86 on average for those 2 weeks.
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