BiPAP Induced Central Apneas for New User (help)?

[Sleeprider]

Thanks. All I see is uninterrupted breathing rate and flow through the period with a glitch in the data that breaks the Dreamstation's data stream. Nothing there, explains the drop in SpO2 being reported...no apnea, no events. The dip occurs over 30 seconds. It appears there is a CA immediately before this dip starts, but this seems like too much lag-time for that event to have caused this desaturation. I am going to stick with the idea this is a dislocated sensor or other data anomaly, and not real.

[Spy Car]

@Sleeprider, when I had my latest sleep study the Oximetry sensor they used could have doubled for a torture device. I moved the sensor to smaller fingers (a couple times) in an effort to relieve the pain.

When I did so the tech came flying into the room saying to stop doing that as I was setting off what looked like hypopneas on the charts. Looking here there appear to be quite a few hypopneas (11?) during the desaturation period.

I'm not sure if this validates your hypothesis, but I put it out there.

Bill

[STB123]

I don't think the Dreamstation and oximeter timeframes are lining up with the desaturation zoomed.There's a 30 second desaturation period here, which visually aligns with about 4 hours of hypopneas.

[Sleeprider]

STB123, the breathing in the above sequence looks flow limited. It would help if you right clicked in the left margin of the flow rate graph and select Format Y-Axis, and add the dashed line at zero. I think pressure support might help flow limit, but we know it adversely affects CA. This is where ASV can intervene with a breath by breath pressure support, and still prevent the OA. It's amazing that we are trying to treat complex apnea with a simple BiPAP, and succeeding reasonably well, but as I said in my first post, and post #12, I don't think BiPAP is ideal for this case, but it is producing clinically acceptable results with low pressure and low PS. Had we left you with the AHI of 25 your doctor's settings caused, I'm pretty sure he would have eventually gotten around to looking at ASV.

As far as the data alignment, a slightly larger view might help establish what is going on. There should normally be a lag between an event and the oxygen results. What concerns me about the reliability of this particular event is that there is an apparent loss of data with a sudden jump in statistics when the data resumes.

[STB123]

I had 0 CA's in my sleep study, so I'm not sure we can characterize machine induced as complex, can we? My sleep apnea study had 80 hypopnea, nothing else. Therefore it seems reasonable to extrapolate that my 140 Central's per night with the addition of BiBAP are not Complex Apnea, and are machine-induced, especially when a setting and mask change eliminate them.

My comment was directed at spy car, " Looking here there appear to be quite a few hypopneas (11?) during the desaturation period."

I was pointing out they seem to be comparing a 30 second desaturation window to a 4 hour event flag window from the dream station. There were certainly not 11 hypopneas in those 30 seconds of saturation.

[Sleeprider]

You're right, we have not looked closely enough at the events to determine if they are central or obstructive. The machine is not increasing pressure based on the fact is has not "detected" obstruction. If you want to try slowly raising the EPAP minimum pressure without changing pressure support, it might be interesting to see if these residual events respond, or get worse.

[STB123]

A few questions, if I may:

- Is there a way to set event parameters in Sleepyhead for apneas like there are for desaturations? For desats, I see I can set parameters for, say, min 4% and 10 seconds, which eliminates most of them.

Of my 31 Apneas, 17 of them were under 10 seconds. 26 were under 20 seconds. In my (admittedly limited) interpretation, those aren't really apneas and maybe Philips is being aggressive with their calculations.

- What's the consensus about apneas under 10 seconds being recorded? If they aren't apneas by medical definition, why are they being recorded?

- Considering O2 naturally drops a bit during sleep, is a 96%-92% really "normal" or should we be specifically isolating sleep events under, say 90? As I understand, levels normally drop a few points with the decreased heart rate and alveoli during sleep.

Again, Thanks.

[Crimson Nape]

- Is there a way to set event parameters in Sleepyhead for apneas like there are for desaturations?  For desats, I see I can set parameters for, say,  min 4% and 10 seconds, which eliminates most of them.

Look at File->Preferences->Oximetry for adjustments.

[STB123]

- Is there a way to set event parameters in Sleepyhead for apneas like there are for desaturations?  For desats, I see I can set parameters for, say,  min 4% and 10 seconds, which eliminates most of them.

Look at File->Preferences->Oximetry for adjustments.

Thanks, but Looking (wishing) for this for CPAP, to filter out apneas under 10 seconds.

[Walla Walla]

Nope sorry.