Can anything be done about my Periodic Breathing?

[DBBCPAP]

I have been using a CPAP for over 3 years and have generally been happy with the results - most of my AHI are below 1.0.  I live at 7500' elevation and find that I do not need my CPAP at sea level (as proved by a sleep study).  Because I spend 5-6 months of the year at sea level (wintertime), I do not use my CPAP continuously.  Additionally, I do not use it while traveling especially if the altitude is lower than 7500'.

Generally throughout those 3 years of use I have had bouts of periodic breathing - probably more than not.  I just had a bout where my AHI was 7.55 with over 6% of the time in periodic breathing.  My own diagnosis says that it is periodic breathing rather than Cheyne-Stokes because there are attempts to breath during the apneic phase.  Here are some results from OSCAR:

           

How concerned should I be?

Thanks for any help.

Doug

[Sleeprider]

The larger pattern appears to be alternating between hyperventilation and hypoventilation, characteristic of CSR, however if there are attempts to breathe in the apneic phase, then that would be a view worth seeing. If we see increasing flow limitation (flattening of the inspiratory wave) moving towards apnea, then this is more likely positional apnea and has a relatively easy solution. http://www.apneaboard.com/wiki/index.php...onal_Apnea

[DBBCPAP]

 if there are attempts to breathe in the apneic phase, then that would be a view worth seeing.  

Thanks for the reply!  Are there not attempts to breath in the apneic phase evident in this view (on the right side of the window just prior to the beginning of another cycle)?

   

[DBBCPAP]

  If we see increasing flow limitation (flattening of the inspiratory wave) moving towards apnea, then this is more likely positional apnea and has a relatively easy solution.

Is the previous screenshot I showed evidence of "increasing flow limitation (flattening of the inspiratory wave) moving towards apnea"?

Is this condition something that I should talk to my Doctor about in your opinion?

[Sleeprider]

I see a lot of flow limitation. There are a number of possible causes for this, but I suspect you have increasing flow limitation due to chin-tucking. As discussed in the wiki linked earlier, you can simulate this by relaxing in a chair and letting your chin drop to the chest and feel the inspiratory resistance. The solutions may be to just avoid that position by using fewer pillows, a soft cervical collar or other sleep position adjustments. Normally, I would expect to see a strong arousal and recovery breathing at the end of the apnea. We're going to need some additional views to see the progression of the events, but the clustering strongly suggests positional apnea.

We really need to lose that monthly calendar to see more respiratory statistics and settings.

[DBBCPAP]

  We're going to need some additional views to see the progression of the events

We really need to lose that monthly calendar to see more respiratory statistics and settings.

What additional views would you like?

Sorry about the data presentation - I know there is a sticky that says how the data should be presented to the forum, but I cannot find it.  I will at least remove the calendar.

[Sleeprider]

Well the sticky is in every post I make, how to organize your Oscar Charts http://www.apneaboard.com/wiki/index.php...ganization

I'm just looking for any random image of your flow rate while asleep that shows the individual wave-forms. There are examples and instruction in the wiki.

[DBBCPAP]

Well the sticky is in every post I make

I'm just looking for any random image of your flow rate while asleep that shows the individual wave-forms.

Sorry, I was looking in the forum posts for a sticky before you responded.

Here's a random sample of the flow detail during a good night.