easy breath - Therapy Thread

[SarcasticDave94]

Your therapy discussion needs to stay in one place. There's already therapy conversation going here. I'll be asking for it to be merged. Thanks for understanding.

[easy breath]

Here is the whole night:
   

[SarcasticDave94]

Your sleep study in the other thread confirmed you have both Central and Obstructive Apnea.

What heart condition is this you're dealing with?

[OpalRose]

easy breath,

In order to keep your history in one place, I have merged your threads and renamed the thread.

Going forward, please keep your questions and posting of charts to this thread.

Thanks!

[jdougc]

OAs and CAs can have similar waveform patterns, but the ResMed machine sends a pulse out and uif the pulse is reflected back by an obstruction then it is flagged as an OA, no reflection then it is flagged as a clear airway event. 
Sorry to hear about your heart issue.

[easy breath]

Thanks for your reply.

I have Hypertrophic Obstructive Cardiomyopathy (HOCM). The Septum (wall between the to sides of the heart) has thickened in a way that reduces efficiency of pumping and also the place where the blood needs to leave the heart to go to the body is somewhat blocked. (If it was worse, they would call it "Heart Failure".) I had open heart surgery about 6-7 years ago and they thinned the Septum somewhat, reducing the problems somewhat. I have to stop to catch my breath after going up one flight of stairs or so. 

Fortunately, my LVEF is 60% which is considered normal and can allow using ASV.

Why do you think I have also breathing obstruction when there is almost no flow limit? If because the CPAP records OAs, I think the machine is mistaken. It looks to me that the CPAP operationally considers any pause in breathing for less than 10 seconds as "OA".The OAs do not seem to connect to flow limit or snoring in my case.

[jdougc]

Flow limitations can result from anatomical narrowing of the airway, they are not a full blockage as an obstructive apnea is.
In addition these machines are terrible at scoring flow limitations. 
You can see this by scrolling around your "zoomed-in" flow rate chart and looking at you breath tops and see how many  flattened breath tops or other irregularities are not scored.

These machines will not score a 10 second or more breathing cessation as an OA unless there is a reflection of the pulse signal.

[easy breath]

OAs and CAs can have similar waveform patterns, but the ResMed machine sends a pulse out and uif the pulse is reflected back by an obstruction then it is flagged as an OA, no reflection then it is flagged as a clear airway event. 
Sorry to hear about your heart issue.

This is interesting. What kind of "pulse" does it send out (air, sound, something else)? How is is reflected?

[Crimson Nape]

Here is an excerpt from the Resmed site.

Central sleep apnea (CSA) detection is an advanced technology that uses the forced oscillation technique (FOT) to determine whether a patient’s airway is open during an apnea. When an apnea is detected, small oscillations (1 cm H20 peak-to-peak at 4Hz) are added to the pressure.

If flow is detected, the airway is open and the apnea is from CSA. The algorithm uses the resulting flow and pressure (determined at the mask) to measure whether the airway is open or closed. If no flow is detected, the airway is closed from an obstruction. The device responds by either increasing pressure or maintaining current pressure and recording the event for the patient’s apnea–hypopnea index (AHI) report.

Basically, it is a variation of Sonar but uses air instead of sound.

- Red

[easy breath]

I took an even shorter segment, so can see the flow rate displays larger.
Is it possible to say that where it is marked OA my brain wanted to breath but I could not manage to breath because of obstruction but for the ones marked CA is was not obstruction rather from my brain?