Deep Breath Prior to Central Apnea

[sanger]

I've noticed in my flow rates a pattern that I'm seeing over and over again. I'll be breathing normally then suddenly I'll have a deep inhalation, deep exhalation then one normal breath then a central apnea. Curious is anyone has any understanding of what's going on here Just curious.

Flow attached.

[under pressure]

It's most probably you waking up and then rolling over or changing your position in bed. The big breath before is your arousal and the central is irregular awake breathing which we often do have very erratic breathing while awake and if you pay close attention next time you do roll over in bed most people actually tend to hold their breath while repositioning.

I have a question for you tho......you have F&P Icon listed in your equipment profile but your flow rate chart seems to be from a different machine, eh? Icon won't differentiate between obstructive and central, that looks more like a ResMed machine with the FOT flow.......which machine produced the flow chart you posted......I am just curious.

[sanger]

My trial device was an F&P. Got an S9 Auto when I purchased and hadn't updated my profile. Profile is correct now. I'll make a note of the time on the clock the next time I consciously roll over and see if that corresponds to the flow chart.

Thanks for the info.

It's most probably you waking up and then rolling over or changing your position in bed. The big breath before is your arousal and the central is irregular awake breathing which we often do have very erratic breathing while awake and if you pay close attention next time you do roll over in bed most people actually tend to hold their breath while repositioning.

I have a question for you tho......you have F&P Icon listed in your equipment profile but your flow rate chart seems to be from a different machine, eh? Icon won't differentiate between obstructive and central, that looks more like a ResMed machine with the FOT flow.......which machine produced the flow chart you posted......I am just curious.

[TyroneShoes]

The xPAP seems to have a difficult time telling the difference between holding one's breath and a CA event, probably because all it monitors is the pressure feedback of respiration. If you stop breathing because you are holding your breath as you change position (most do this because if you don't hold your breath moving around knocks the wind in and out of you) it simply thinks your CNS is not telling you to breath, rather than you made a conscious decision not to breathe. If you stop holding your breath yet pause before resuming breathing (also normal) the FOT pulse coming during that time indicates the airway is open. The xPAP uses those two simple raw pieces of information to jump to a conclusion and flag a CA, and in this case, it's always incorrect.

I have trained myself to continue to breathe and change positions carefully if I am awake with the mask on, to avoid such false positives.

Another thing is deep breaths. A deep breath is common, sometimes referred to medically as a "sigh". Hypops are flagged by a breath that is shallow compared to the ~5 breaths surrounding it (algorithms vary). If one of those breaths is a purposefully deep breath, this skews the comparison and the xPAP can then incorrectly flag a hypop that does not, in actual reality, meet the threshold.

xPAP is smart. Just not omniscient.

[under pressure]

My trial device was an F&P. Got an S9 Auto when I purchased and hadn't updated my profile. Profile is correct now. I'll make a note of the time on the clock the next time I consciously roll over and see if that corresponds to the flow chart.

Thanks for the info.

OK, you had me scratching my head for a moment.....I know the Icon can't flag a central because they don't have that technology on board, so I was thinking for a minute that maybe they came out with a new Icon that had an FOT type function.

Nice to know my ResMed guess was correct

You're keeping me on my toes !