Weird Breathing/Shallow Breathing?

[asuter060514]

So, my apnea treatment seems to be going well as I am having less than 2 events per night every night now. However, I am noticing I am getting some interesting periods of sleep where I am breathing rapidly and shallow. I'm not sure what would cause this or if it is cause for concern. 

I have attached two graphs. There doesn't seem to be a correlation between apnea events, pressure, flow limit, etc, but it does seem like these periods last for a large amount of time pushing my respiration rate to 20+ for 30-40 minutes at a time.

I am not noticing any trends in heart rate or oxygen levels during these times, either. My levels for both HR and SPO2 are fine. So, I'm not sure that there is an immediate concern.

Is this potentially just supine breathing related issues? I have issues laying on my back and breathing as I often feel like I can't take full breathings when laying on my back. I've had a cardio checkout (EKG, CT Scan, XRAY) and no problems there. I am overweight, so not sure if thats an issue. I'm using a CPAP pillow, too, but no cervical collar.

Anyway, if this is not issue to be concerned about, thats fine. I don't know if maybe I'm in REM and breathing shallow? Is that a thing? Maybe its REM and/or supine sleeping?

Any thoughts?

[SarcasticDave94]

I don't have any good analysis for you but others might have some ideas. Hang tight while others take a look.

[cathyf]

Right-click on your flow rate curve and override the y-axis -- set it to something like -30 to 30. It's hard to see much when you have it squashed down so much.

[OpalRose]

The breathing does look a little irregular during that time, but I'm inclined to think it's a combination of sleeping on your back and REM sleep. Do you remember dreaming?

You stated that you have a harder time breathing while on your back, so you will need to find a way to stay on your side as much as possible. Try using a body pillow or anything thing that would help keep you from sleeping on your back.

As long as you don't see this type of breathing on a regular basis, I wouldn't worry too much over it.

[cathyf]

Right-click on your flow rate curve and override the y-axis -- set it to something like -30 to 30. It's hard to see much when you have it squashed down so much.

...and also include your flow limit graphs -- those look like pretty classic flow limits.

Here's a picture of a run of flow-limited breathing which is reset by an arousal:
http://www.apneaboard.com/forums/attachm...?aid=34055

Here you can see first an OA which has one classic flow-limited breath at about 3:02:28 as I  in the crash into the OA. Then at 3:05 you see the flow-limit event that gets scored as a hypopnea, followed by the OA at 3:06 which in shape is kind of halfway between that hypopnea and the 3:02:30 OA.
   
https://www.dropbox.com/s/y4o21jplgk0rph...M.png?dl=0

What this is showing you is the relationship between flow-limited breathing as kind of "junior hypopneas"

But, anyway, when you are talking about a ResMed machine, you really need to see flow rate, flow limit & leak so you can see what the machine thought was going on at the time.

[asuter060514]

The breathing does look a little irregular during that time, but I'm inclined to think it's a combination of sleeping on your back and REM sleep.  Do you remember dreaming?  

You stated that you have a harder time breathing while on your back, so you will need to find a way to stay on your side as much as possible.  Try using a body pillow or anything thing that would help keep you from sleeping on your back.  

As long as you don't see this type of breathing on a regular basis, I wouldn't worry too much over it.

I don't remember dreaming during that time, but I do have dreams nearly every night that I can recall upon waking up. My dreams are typically pretty vivid. I've been experiencing periods of REM rebound fairly often due to pretty inconsistent sleep. The night before this particular sleep I had a severe migraine that made it difficult to sleep much as I would continue to wake up off and on throughout the night.

I'll have to try the body pillow or something. I don't have these events all night long, but it does appear I usually shallow breath a few times a week for 30-40 minute increments. This happened again last night for about 20 minutes which I think probably points to a REM cycle. Heart Rate during that time was 47-60 with the 47 reading corresponding with a 95% SPO2 reading (nothing concerning there, my low is typically 94% SPO2 on my Apple Watch which is frequently 1-2% lower than a pulse oximeter).

I've attached charts from last night

[asuter060514]

Looks like no flow limit is associated with these events that I can tell. I took your recommendations for the chart, but my flow limit never gets high enough to show much movement. 

I had another period of breathing like this last night, well actually two of them. Both events lasted about 20 minutes. 

I think thats enough evidence to point to REM related breathing. From the research I've done, it appears that higher breathing rates is quite normal during REM.

[asuter060514]

...and also include your flow limit graphs -- those look like pretty classic flow limits.

Here's a picture of a run of flow-limited breathing which is reset by an arousal:
http://www.apneaboard.com/forums/attachm...?aid=34055

Here you can see first an OA which has one classic flow-limited breath at about 3:02:28 as I  in the crash into the OA. Then at 3:05 you see the flow-limit event that gets scored as a hypopnea, followed by the OA at 3:06 which in shape is kind of halfway between that hypopnea and the 3:02:30 OA.

https://www.dropbox.com/s/y4o21jplgk0rph...M.png?dl=0

What this is showing you is the relationship between flow-limited breathing as kind of "junior hypopneas"

But, anyway, when you are talking about a ResMed machine, you really need to see flow rate, flow limit & leak so you can see what the machine thought was going on at the time.

On second thought, it looks like you might be correct with flow-limited breathing here. I have attached both periods I saw this breathing yesterday. No events were recorded after these periods ended, though.

I suppose it is also important to note that I am feeling fine after sleeping. No headaches, no concerns, not waking up gasping or racing heart rate and my events last night were AHI 0.60. So, I'm certainly doing awesome on CPAP. 

It does look like at the end of each period, I roll over as I see a massive increase in mask pressure and breathing rate shortly after these periods.

So, my thought is I'm on my back/REM sleeping and, as you mentioned, I roll around/have an arousal to correct the breathing.

My question is, when do I become concerned about this?

[GuyScharf]

I think you changed the Y-axis settings on the wrong graph. Set the Y-Axis for Flow Limits. graph to Default. Flow Limit values range from 0 to 1.0, and the default settings work for that.

For more detail on the Flow Rate graph, set it's Y-Axis range from -80 to 80 and you should see a more detailed view of the flow graph.

[sheepless]

your night long rr stats in post #1 are quite normal, even enviable. even your 95th percentile under something like 32 is fine. there may be short spurts of higher but imo nothing to worry about.

same with flow limitations with 95%tile of .11 in post #8. if that's typical & you're feeling reasonably rested, no worries. many of us would be thrilled to see .11 in our own charts.