Question about Cheyne-Stoke breathing

[TheHu]

Hello,

i have a question about CSA. 

Does Cheyne Stoke's breathing occur every night when you have CSA?

I'm not sure if I suffer from CSA at all. 

Every 2-4 days I see a CSA episode in OSCAR, although I'm not sure if it's CSA at all. Please take a look at the screenshots of Oscar and let me know your opinions. In addition, my AHI value is always very high between 6.0 and 15.0, whereby the proportion of hypopnea is regularly very high, mostly 80-90 % of the AHI

Resmed Airsense 10
Airfit F30i
Pressure 10 fix

Thank you



P.S.: Excuse my bad English, i am from Austria

Sorry, I can't attach my screenshots here, because I'm a new user, and I can just insert a screenshot here until having 4 posts on my own.

[Gideon]

Welcome to the forum.

First ResMed calls ALL periodic breathing CSR. It is very rare that we see true CSR.

Second in a few suseptible individuals simply the use of a CPAP or the use of EPR may, not will, cause a pattern that is similar to CSR.

One crucial difference is if you had central apneas during your diagnostic sleep test. Central Apneas at the nadir of the flow rate without CPAP is one of the measures that is different between CSR and Periodic breathing.

You can attach your charts here as a brand new user. You cannot link them.

[TheHu]

Ok, i try to attach the Screenshots.

   

   

   

---

thx, it worked 

[Gideon]

Great. You do not have CSR. If you had it your Central apneas would be more prevalent on all 3 nights.

You are showing signs of 2 other issues.

Treatment Emergent Central Apnea/Complex Apnea and a form of positional apnea

The positional apnea is identified by the clusters of obstructive events including OA, H, and Flow Limitations.
This typically indicates an issue with your neck or cervical alignment while sleeping. We commonly call this chin tucking. This might be fixed with a pillow modification. Try 1 vs. 2 pillows, flatter and less firm. Think of positioning your head for rescue breathing. If that doesn't work there is the soft cervical collar. Read the link in my signature for details.

Treatment Emergent Central Apnea occurs when you flush too much CO2 from your system. When your CO2 levels go below your apneic threshold a central apnea will occur. This is typically a cyclic pattern cause by gradually increasing breaths (flow rate) then gradually decrease in breaths as you approach your apneic threshold with central apnea frequently at the low.

FYI it is the need to reduce CO2 in your body that is your drive to breathe. The need for oxygen usually makes us breathe faster, but the drive to. Reathe comes from the need to expell CO2. That is the simple explanation. Blood acidity come into play but that too is CO2 drive n.

To manage this we want to slowly cut back on your breathing and we do this by slowly decreasing EPR.

So Set EPR=2. Then repost.
.

[TheHu]

The last of the three Screenshots (Date = 09.08.2022) is a sleep night where EPR = 0

Should i even test EPR=2 this night or is it obsolete?

Thx

P.S.: What i forgot to mention: My PLM-Index ist about 50. Can this cause an abnormal breathing too? 
But to be honest, i dont realize this PLM movements in my sleep, and dont care about it.

[Gideon]

Your flow limits are significant enough that you want to use as much EPR as you can. But this is a tradeoff for anyone who exhibits treatment Emergent Central Apnea.

[TheHu]

First, a few facts that may be important. 

Since 2015, I have been undergoing treatment for sleep apnea. 

After waking up, I am often so tired that I could sleep again immediately. Also I have a brainfrog feeling, and I am very unfocused all day long and I feel a tingling sensation in my hands (this last Friday too).

Screenshot from last Friday. 

   

Yesterday i forgot to insert the card into the machine, Sry, so there is no screenshot.

[TheHu]

Last Night (Sunday 14.08.1922):

   

   

   

Please taks a look at my Tidal Volume and Flow Rate. Whats wrong here? 

Its a constant up- and down, i'm scared.

[TheHu]

Shall i reduce the EPR-Level to 1 ?

[TheHu]

Hmmm, 0 Answers?