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cheyne stokes
#1
cheyne stokes
Would a higher or lower pressure support help with Cheyne Stokes? Right now I am on 1 and showing a lot of Stokes . I know my medication can cause this but I was wondering if I increase the pressure support to 3 if that would help.
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#2
RE: cheyne stokes
The response of CSR and periodic breathing to pressure support varies. If you have a central apnea CSR your CPAP does not offer enough pressure support, or backup timing to resolve the event. The Resmed Airsense 10 EPR provides pressure relief from IPAP pressure as you exhale. What will happen in CSR is a diminishing respiratory effort. Your machine will remain at EPAP pressure until you spontaneously initiate a breath, so I would not expect EPR to make any difference in either central apnea or CSR.

In Sleepyhead, zoom in on the flow rate and mask pressure during these events. You will see the machine remains at EPAP pressure and does not change until the apnea ends by you taking a breath. Even if the periodic breathing is separated by hypopnea with shallow breathing, the mask pressure follows respiration, rather than leading it.
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#3
RE: cheyne stokes
(11-13-2017, 10:12 AM)Sleeprider Wrote: The response of CSR and periodic breathing to pressure support varies.  If you have a central apnea CSR your CPAP does not offer enough pressure support, or backup timing to resolve the event.  The Resmed Airsense 10 EPR provides pressure relief from IPAP pressure as you exhale.  What will happen in CSR is a diminishing respiratory effort.  Your machine will remain at EPAP pressure until you spontaneously initiate a breath, so I would not expect EPR to make any difference in either central apnea or CSR.

In Sleepyhead, zoom in on the flow rate and mask pressure during these events.  You will see the machine remains at EPAP pressure and does not change until the apnea ends by you taking a breath.  Even if the periodic breathing is separated by hypopnea with shallow breathing, the mask pressure follows respiration, rather than leading it.

Thank you very much Sleeprider.
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#4
RE: cheyne stokes
https://imgur.com/a/9HQel


Anybody have a idea why I keep getting these high peaks in my sleep pattern. They go up than down.
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#5
RE: cheyne stokes
Maybe you could include leaks, flow limitations and snore charts? For one thing, you have the scale on pressure at a 4-cm range, and the CPAP uses all of it. This makes the increase look a lot larger than it really is.

Jerry, what is going on? You have had high central events since you joined in July, and at one point had an appointment to discuss it with your doctor. I have no idea what the outcome of that was. You have never achieved a consistent and acceptable AHI. What are you doing about it, and how can we support you in getting ASV?
Sleeprider
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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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#6
RE: cheyne stokes
(11-20-2017, 07:34 PM)Sleeprider Wrote: Maybe you could include leaks, flow limitations and snore charts?  For one thing, you have the scale on pressure at a 4-cm range, and the CPAP uses all of it. This makes the increase look a lot larger than it really is.

Jerry, what is going on?  You have had high central events since you joined in July, and at one point had an appointment to discuss it with your doctor.  I have no idea what the outcome of that was.  You have never achieved a consistent and acceptable AHI.  What are you doing about it, and how can we support you in getting ASV?

What do you mean by "the scale on pressure at a 4-cm range and the CPAP' uses all of it".


the dr. I see wanted me to still use this machine for a while. I guess he thinks this machine will correct my problem. 

I see him in about a month and will talk about the other but until then I would like to get some good sleep.
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#7
RE: cheyne stokes
Jerry, the chart you posted is stretched vertically which accentuates the fluctuations in pressure, and limits what you can include.  By vertically resizing the events, pressure and flow, you could also fit in leaks, flow limits and snores.

I think your doctor's opinion that this machine is going to be an acceptable solution is overly optimistic.  Usually when we see results in excess of 20 with apparent complex apnea, someone needs to do some clinical work to figure out the best course of action. It's true that new users often self-resolve in time, but this seems beyond the pale.  Your sleep study for titration apparently failed to titrate you successfully, but your doctor said "just put it on automatic and I would be ok" http://www.apneaboard.com/forums/Thread-...#pid215265 

I'm losing faith that you're working with the right guy. This is a debilitating event rate and you deserve your health and sleep.  Any doctor should share that reasonable goal and work to get you the treatment you need.  He doesn't seem to be concerned at all and thinks an AHI of 20-30 events per hour...hundreds each night will solve itself. 

[Image: SV6dkS9.png]
Sleeprider
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____________________________________________
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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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#8
RE: cheyne stokes
Anybody have a idea why my numbers are different from sleepyhead charts vs. my sleep machine?
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#9
RE: cheyne stokes
Sleepyhead should be reporting the number of events flagged by the machine as the software has no function to actually report events on its own. The statistical results can vary slightly, for example 95th percentile rather than 90th percentile, or Median instead of mean. What are you seeing?
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#10
RE: cheyne stokes
Jerry,


On your machine in the sleep report check the reporting period is set to 1day and then the stats should match sleepyhead. If it is set to a longer period it will be reporting average values over the period selected 1day,1 week, 1 month, 3 months, 6 months or 1year. You can change the period at will in the sleep report menu and see what your stats look like over different periods.



Jason
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