Breath pattern question

[David Clark]

I didn't post this in my therapy thread because I don't suppose it's a question related to my therapy per se', I always see it and I'm just curious. 
What are the little 'peaks' between my breaths?

[SevereApnea]

Hi David,

could be one of these:

http://www.apneaboard.com/wiki/index.php...ew_desktop

If I zoom in enough I can often see them on top of my inspiratory flow too. You can check the timing between these and see if this corresponds to your approximate heart rate. 

In your case it is interesting that they occur in the same phase of expiration each time.


Nice rounded flow charts and low Flow Limitations by the way. Good going.

[Rubicon]

Given the relationship to the expiratory phase, repeatability and FFM, I'm going with soft palate exhalation interference.

[Sleeprider]

This appears to be a partial palatal prolapse, that briefly stops expiratory flow, but opens allowing completion of the breath. Could also be a brief puff of air going out through your mouth. Can you feel the "flutter" as you exhale and are near sleep? How prevalent is this in your sleep? FWIW, this information looks relevant to your therapy thread, and might explain why you did so much better with higher EPR.

[David Clark]

I haven't noticed a "flutter" but if it's something subtle I may not unless I was paying attention to it. The little peaks are there all night. Something I was reading was saying it could be triggered by having too high of a trigger setting..I don't know. I have mine on "high". I was thinking about changing it to "medium" for a night or two and see if the wave changes. What do you think? You said I did better with a higher EPR... Is there something in the setting you think I should adjust?

[Sleeprider]

I was using the wrong terminology, and should have said pressure support or PS. I don't think that there is necessarily anything to be done with this, especially if it is not noticeable in your sleep. Your tidal volume and respiratory statistics look fine except these little peaks are causing the machine to miscalculate expiratory time. Especially in these close-up zooms, you should show mask pressure instead of pressure so we can see how the bilevel is managing pressure during expiration. Are trigger and cycle on medium?

[SarcasticDave94]

To clarify, if your left panel info is correct and you're using a VAuto, you will not find EPR. The VAuto is a BPAP and has instead Pressure Support. PS and EPR do the same thing on ResMed devices, it's just that EPR is a limited range of pressure selection versus PS having a wider range of pressure selection.

[David Clark]

I was using the wrong terminology, and should have said pressure support or PS.  I don't think that there is necessarily anything to be done with this, especially if it is not noticeable in your sleep. Your tidal volume and respiratory statistics look fine except these little peaks are causing the machine to miscalculate expiratory time.  Especially in these close-up zooms, you should show mask pressure instead of pressure so we can see how the bilevel is managing pressure during expiration.  Are trigger and cycle on medium?

I'll reposition the graphs so it shows mask pressure when I get home. The trigger and cycle are both on high. I was thinking of changing them to medium to see what difference it makes, if any.

[Gideon]

Dave, Why did you set Trigger and Cycle to high?

[David Clark]

Dave, Why did you set Trigger and Cycle to high?

I am brand new to using a pap so I am going through the "get used to it" phase. It felt like the breaths were a little more 'natural' that way...not forced. I don't know if that explains why or not but I am going to change them back to medium, where they were when I got the machine, which I assume is default.