Bipap Unclassified Apneas

[Insomniac230]

Been having constant Unclassified apneas (UA) on Resmed Aircurve 10 ST. Often I wake up at 3am and struggle to fall back asleep but have no issue with going to bed and falling alseep the first time around at 10pm. Wondering if theres something going on with the flat lining of flow rate showing UAs? I tend to have less than 2 AHI mostly from UA and hypopneas.

[gainerfull]

Considering the mask pressure activity is not correlating with the flow rate activity would suggest the unclassified apneas are obstructive events. Since you're on a timed aircurve it's trying to force you to take a breath and you're unable to because your airway is obstructed.

[SarcasticDave94]

I'll wait for better answers, but I'm under the impression the ST reports UA (unidentified apnea) like the ASV. In that case, UA is central apnea.

It could be a long breath hold or an actual central apnea event. I'm thinking both would appear similar to the machine. I also think there's going to be clues within some of the charts on Oscar.

The area you're highlighting has some disruption to the regular breathing just prior then flat, then a blip in the middle, and again disruption after the second area of the flat spot.

[stevew77]

I doubt the UAs reported as unclassified are central. The ST is similar to the ASV in that it ventilates if the respiratory rate is not followed. Interestingly, it appears that the ST mask pressure is pulse width modulated between two pressures, whereas the ASV has a more gradual transition between two varying pressures.

[PeaceLoveAndPizza]

Do you have EasyBreathe turned on or off? It would also be helpful to see all the settings. I think if you can scroll down on the left column it should show them.

[Sleeprider]

The ST does not use the forced oscillation technique to determine apnea type, so it reports UA for apnea. The graphs posted show events that are breath-holds. We see an inspiration and there is no expiratory flow ahead of the event. Why were you prescribed ST? It is a completely fixed pressure algorithm with a timed trigger to IPAP, and both of the events you show here have no response to the IPAP pressure. That's obstructive or a breath-hold.

[stevew77]

As usual, you've got it right!

[Insomniac230]

Dont believe it has easy breathe function unfortunately.

[Insomniac230]

Very insightful. Not sure why I was prescribed an ST. I initially was given a 17/12 prescription and it was way too much pressure and AHI so I changed the pressure to what it is now which resulted in lower AHI. Thought about a ASV bipap but never tried one, and have used a cpap auto in the past that i purchased myself and gave me slightly better results in AHI than the ST especially in comfort. I do notice if i tuck my chin when im awake I get more restricted out breath but not in breath so maybe a cervical collar would help as well?

[PeaceLoveAndPizza]

You are correct, I am wrong about it supporting control of EasyBreathe. Apologies for misleading.

I wonder if it is a default on ResMed machines, but only a few allow control of it. Hopefully someone more knowledgeable can explain.

Here is a current thread on EasyBreathe with a good explanation by SleepRider.