Anyone else experience this?

[PaytonA]

OK, thanks for the info. I was puzzled why the graph for the Aircurve 10 auto was only showing one trace and for my S9 VPAP Auto shows a trace for EPAP and one for IPAP. That would 'splain it. Thanks again.

Best Regards,

PaytonA

[richb]

Hi wxmcpo,

Take a closer look at your data. There is a section between 20:00 and 21:00 that looks suspicious. Highlight 5 or 10 minute sections of your flow rate graph to see how you are breathing breath to breath. I suspect that your are experiencing periodic breathing in that section as well as many other sections.

richb

Richb,

So I took a look at the section you were mentioning. Below is 5 minute sections starting at 2100 and going for almost 24 minutes. I will admit I am not 100% sure what I am looking at there, but I can see signs of where it looks like my breathing may have slowed or stop at times. Is that what you were looking for?

I have had a lot of trouble with my machine since it was re-programed with a new prescription by my provider. I checked my settings and found the machine was set for Vauto min 4 and max 15. The big problem is the PS was set for 8. Previous setting was Vauto min 5 max 16 PS 4. I was unable to get to sleep and so I checked the setting and re adjusted the PS to 4. Slept better but got an AHI of 20. My settings were supposed to be Bi-pap 11 15. This setting produced lower AHI during my 2nd titration. I am going to try that setting tonight and then try CPAP straight 5 the next night. PaytonA suggested I look for a low setting where the events minimize. I think I will see more Hypos at the lowest setting just as I did when I went to straight CPAP 9.

So my machine is also set to VAuto but with min 4 and max 25. A couple of nights ago I turned my PS down from 4 to 3 and my AHI went from 20+ to 9. So last night I left PS at 3, but turned my TiMax down from 3 to 2 and my AHI dropped to 3.2. This is one of my best numbers ever. Here's a screenshot of last nights data;



I am going to leave settings where they are for now and see how that does me over the next couple of nights. One big difference I noticed from previous nights is I didn't have an AHI spike early in my sleep, but rather late in my sleep.

Hi wxmcpo,

Yes. The rising and falling pattern with very shallow breaths between is the periodic breathing I am referring to. How are you sleeping? That type of breathing especially when it goes into CAs can be disruptive to sleep. Look at sections of your latest really good night to see if there is a pattern of periodic breathing without any marked CAs or HAs.

richb

[wxmcpo]

Hi wxmcpo,

Take a closer look at your data. There is a section between 20:00 and 21:00 that looks suspicious. Highlight 5 or 10 minute sections of your flow rate graph to see how you are breathing breath to breath. I suspect that your are experiencing periodic breathing in that section as well as many other sections.

richb

Richb,

So I took a look at the section you were mentioning. Below is 5 minute sections starting at 2100 and going for almost 24 minutes. I will admit I am not 100% sure what I am looking at there, but I can see signs of where it looks like my breathing may have slowed or stop at times. Is that what you were looking for?

I have had a lot of trouble with my machine since it was re-programed with a new prescription by my provider. I checked my settings and found the machine was set for Vauto min 4 and max 15. The big problem is the PS was set for 8. Previous setting was Vauto min 5 max 16 PS 4. I was unable to get to sleep and so I checked the setting and re adjusted the PS to 4. Slept better but got an AHI of 20. My settings were supposed to be Bi-pap 11 15. This setting produced lower AHI during my 2nd titration. I am going to try that setting tonight and then try CPAP straight 5 the next night. PaytonA suggested I look for a low setting where the events minimize. I think I will see more Hypos at the lowest setting just as I did when I went to straight CPAP 9.

So my machine is also set to VAuto but with min 4 and max 25. A couple of nights ago I turned my PS down from 4 to 3 and my AHI went from 20+ to 9. So last night I left PS at 3, but turned my TiMax down from 3 to 2 and my AHI dropped to 3.2. This is one of my best numbers ever. Here's a screenshot of last nights data;



I am going to leave settings where they are for now and see how that does me over the next couple of nights. One big difference I noticed from previous nights is I didn't have an AHI spike early in my sleep, but rather late in my sleep.

Hi wxmcpo,

Yes. The rising and falling pattern with very shallow breaths between is the periodic breathing I am referring to. How are you sleeping? That type of breathing especially when it goes into CAs can be disruptive to sleep. Look at sections of your latest really good night to see if there is a pattern of periodic breathing without any marked CAs or HAs.

richb

I actually feel like I am sleeping pretty good, even on nights when I have higher AHI numbers. I may simply be telling myself that because I still get the tired feeling in the afternoons and want to take a nap in my recliner the instant I get home from work. I know that is normal for a lot of folks, but moreso for those of us that suffer with severe apnea. I am hoping that last nights result and 3.1 AHI is a sign that therapy is finally working or I have settings dialed in closer. I know I had lower AHIs without touching any settings so this may have simply been one night of good sleep after many rough ones. I am still having the periodic breathing that you mention even on good nights. Here's a few flow data shots from last night;



So in the first graph it shows an upwards and downwards spike, do you know what these represent? Is that where I am actually struggling to breath? In the middle graph you can see the CA event, but what also appears to be an event before the CA event. Then in both the first and last graphs you can see where the flow rate flatlines, but has a downwards spike in the middle. Any idea what that is telling me? Thanks

[richb]

Richb,

So I took a look at the section you were mentioning. Below is 5 minute sections starting at 2100 and going for almost 24 minutes. I will admit I am not 100% sure what I am looking at there, but I can see signs of where it looks like my breathing may have slowed or stop at times. Is that what you were looking for?




So my machine is also set to VAuto but with min 4 and max 25. A couple of nights ago I turned my PS down from 4 to 3 and my AHI went from 20+ to 9. So last night I left PS at 3, but turned my TiMax down from 3 to 2 and my AHI dropped to 3.2. This is one of my best numbers ever. Here's a screenshot of last nights data;



I am going to leave settings where they are for now and see how that does me over the next couple of nights. One big difference I noticed from previous nights is I didn't have an AHI spike early in my sleep, but rather late in my sleep.

Hi wxmcpo,

Yes. The rising and falling pattern with very shallow breaths between is the periodic breathing I am referring to. How are you sleeping? That type of breathing especially when it goes into CAs can be disruptive to sleep. Look at sections of your latest really good night to see if there is a pattern of periodic breathing without any marked CAs or HAs.

richb

I actually feel like I am sleeping pretty good, even on nights when I have higher AHI numbers. I may simply be telling myself that because I still get the tired feeling in the afternoons and want to take a nap in my recliner the instant I get home from work. I know that is normal for a lot of folks, but moreso for those of us that suffer with severe apnea. I am hoping that last nights result and 3.1 AHI is a sign that therapy is finally working or I have settings dialed in closer. I know I had lower AHIs without touching any settings so this may have simply been one night of good sleep after many rough ones. I am still having the periodic breathing that you mention even on good nights. Here's a few flow data shots from last night;



So in the first graph it shows an upwards and downwards spike, do you know what these represent? Is that where I am actually struggling to breath? In the middle graph you can see the CA event, but what also appears to be an event before the CA event. Then in both the first and last graphs you can see where the flow rate flatlines, but has a downwards spike in the middle. Any idea what that is telling me? Thanks

You are not struggling to breathe. You are forgetting to breathe. During the lull or shallow breathing period your body builds up CO2 and responds by having you breathe. When you have reduced the CO2 level your body thinks you have done enough breathing and slows down. The carotid body near your carotid arteries is the measuring device for CO2 levels. In people with CA- periodic breathing the carotid body is not working properly. It works by measuring the acidity of the blood. Increases in CO2 increase the level of acidity. Breathing removes CO2 and lowers acidity. The worst case of this cyclic breathing looks like Cheyne Stokes breathing. In any case periodic breathing interferes with normal sleep.

richb

[quiescence at last]

hi wxmcpo,

the breathing you were doing in the "good" periods does not look bad to me.

hope that calming will continue.

my opinion on the big hill at the beginning of the July 20 chart was you getting used to PS of 3, a good move I think.

QAL