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[Symptoms] Flowrate pattern
#11
I have two known heart problems: left bundle branch block and supra ventricular tachycardia (rapid heartbeat). I'm a little ways from congestive heart failure (CHF). Just had my yearly echocardiogram to see if my ejection fraction has decreased--it didn't and has stayed steady since 2004 when the block was first discovered. MY PR machine shows CSR--does the ResMed S9? I studied up on CSR when I first became a CPAP user because it was of some concern to me. However I have only once or twice, in earlier use times, have had the CSR waveform as shown in Juanito's post. I've quit worrying about it and my cardiologist didn't seem concerned. I do have CA's, but they usually average under 5/night. Thanks to SleepyHead I can check their length--always under 20 seconds and usually around 10 seconds. My machine does a pressure pulse--which isn't supposed to be a help with CA's, but they usually end right at that time. I don't have CSRs or CAs every night. I'm experimenting now with APAP and can see that they don't occur with higher pressures. Juanito, if it happens again, go see your doctor!
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#12
My doctor and I need to talk! I now have some data!

1) My AHI is alover the map: some nights, I get about 5 but I have had a night where it was 15. It appears that I have an average of 4 event clusters a night: one just after I go to sleep (at about 2130,) one at 2300, one at 0430 and the last about 0600 about 45 minutes before I awake for the day. Each cluster lasts about 30 million nutes to sometimes an hour. These event clusters usually initially start with RERA's, progress to hypopneas and then to CA's. Sum total of the CA's is roughly 30+ anf the hypopneas roughly 40+.

2) I have periodic breathing in 6 to 8 breath cycles that is not being reported by the PRS1 software a good part of the night. When these exacerbate, I get event clusters. At times, however, these will settle into even breathing.

3) The pattern of an inspiration shows a sharp peak followed by a gradual slope and then a sharp down alope into expiration. I interpret this as some type of flow limitation.

4) My expiration is marked by a sharp minimun flow peak follow by a return to zero. Nearing, zero, it flattens out. If there is no event, ispiration starts. When events start, the nearing zero extends out foe some period until inspiration starts. If the extensions are long enough PRS1 scores these as CA's.

Since I live at high altitude, ~6000 feet and above, I suspect some part of this is caused by this. This is reported in the medical literature. I have to travel to Salt Lake City in the near future and I am thinking about bringing PSR1 to test this at a lower elevation. I might even take it to Philadelphia with me although the machine is somewhat bulky.

My concern is that my physician has not studied breathing patterns n any depth and may not be able to advise me correctly. Therefore, I think it is time to ask for a pilmonary consult.

Walt
Walter W. Olson, Ph.D., P.E.
Professor Emeritus
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#13
(01-09-2016, 06:53 PM)wolson Wrote: Each cluster lasts about 30 million nutes to sometimes an hour.

For our members who are not scientists or engineers, a million nutes is about one minute, so 30 million nutes is about 30 minutes.


Edit: Sorry - bad joke

More seriously, I think yes, the high elevation is likely to blame for the CSR-like patterns. The Flow Limitions and RERAs would likely benefit from higher pressure and A-Flex of 1 (which gives the longest-lasting pressure increase during inhalation).

Bilevel therapy may be best for treating the RERAs, but in the other hand raising the pressure or changing to bilevel usually increases the number of centrals we get. But if we are still feeling excessive fatigue and daytime sleepiness then I think it would be worthwhile to carefully experiment with higher pressures in order to minimize overall AHI.

ASV bilevel is able to treat all types of patterns, but it is more expensive and I think is usually covered only if the number of central apneas is more than 5 per hour and higher than the number of obstructive apneas per hour.
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#14
(01-10-2016, 04:01 AM)vsheline Wrote: For our members who are not scientists or engineers, a million nutes is about one minute, so 30 million nutes is about 30 minutes.


Edit: Sorry - bad joke

not that bad... Big Grin
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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