Central sleep apnea periodic breathing

[richb]

Doc isn't ready to go there yet. My guess is that I will end up with an ASV machine, medication or both. He still wants to rule out a faulty machine. I think my original sleep study was misread.

I'd agree with Sleeprider, who knows more than I.

Also, it's a 'long shot' that your study was misread AND your machine is faulty. Chances are 'pretty slim' for those two things happening.

I seriously doubt that the machine is faulty. I will find out in a couple of days.

Rich

So that may only leave your sleep study in question, but if your sleep study conformed to review procedures, the RAW data was reviewed by three professionals- your sleep technologist, a supervisory sleep technologist, and by a board-certified sleep doctor who supposedly writes a separate report with doc's findings.

p.s. Please use the 'Reply with Quote' button when doing so, rich.

I don't think they looked at the waveforms very well.

[richb]

I'd agree with Sleeprider, who knows more than I.

Also, it's a 'long shot' that your study was misread AND your machine is faulty. Chances are 'pretty slim' for those two things happening.

I seriously doubt that the machine is faulty. I will find out in a couple of days.

Rich

So that may only leave your sleep study in question, but if your sleep study conformed to review procedures, the RAW data was reviewed by three professionals- your sleep technologist, a supervisory sleep technologist, and by a board-certified sleep doctor who supposedly writes a separate report with doc's findings.

p.s. Please use the 'Reply with Quote' button when doing so, rich.

I don't think they looked at the waveforms very well.

When I visited with the Tech last week I brought printouts from my SleepyHead reports. They had some pages from ResMed but never referred to them. They are having trouble believing the data from over a month of machine use. I will be using a replacement machine starting on Sunday.

[tedburnsIII]

Best wishes!

Sincerely,

[mollete]

Met with my sleep doc (Pulmonologist/Internist) yesterday. He said this breathing pattern is not Cheyne-Stokes.

The pattern we are referring to mimics Cheyne Stokes breathing but the period peak to peak is usually not as long as Cheyne Stokes. Cheyne Stokes is usually associated with congestive heart failure and the peak to peak is usually about a minute or more.

So trying to follow this.

Are not swwalden1's peak to peak times about a minute, therefore this IS CSR?

swwalden1, can you post the 30 minute block immediate prior to your original image?

Thanks.

[vsheline]

when you leave your card out, you get the exact same score, just not the highly detailed data. so, that night you really did have an AHI < 5.

If only that were true. I left the card out for 2 nights in a row, Both reported AHIs under 5. No CAs. The next night with the card in I had an AHI of 38 all CAs.

Hi richb,

I suppose it is possible some software bug in the machine causes the number of centrals to be misreported unless the SD card is installed but I think it far more likely this would somehow be only a SleepyHead bug.

However, if ResScan or the machine's screen also repeatedly report no centrals unless the SD card is installed, then I suggest you call ResMed Customer Service and report the bug.

I am confident the machine would not have been designed to behave like that. The machine should have no problem keeping a running total of how many central apneas have occurred during the current session even though the SD card is not installed.

But unless you see this behavior repeated a few more nights and shown in ResScan Statistical Summary (one night no card and no centrals, next night with card and lots of centrals, again one night no card and no centrals, next night with card and lots of centrals) I'm not sure ResMed would believe these coincidences prove the machine is misreporting the number of centrals unless the SD card is installed.

[quiescence at last]

richb reported that his machine did not score CAs when card was removed, but showed that when card was out there were CAs on his report, just not the same frequency. that just seems weird. But, maybe the new machine will act differently.


QAL

[swwalden1]

So trying to follow this.

Are not swwalden1's peak to peak times about a minute, therefore this IS CSR?

swwalden1, can you post the 30 minute block immediate prior to your original image?

Thanks.

Not sure why you are asking but here it is.

[tedburnsIII]

It may be a bug but it makes sense that more data is reported when SD card is inserted.

For example, my iCode displays data but when I use the SD card and review it there's more detail.

Perhaps richb machine only picks up a set minimum of data without SD inserted. If it were the other way around, one
might find it more problematic.

[vsheline]

Met with my sleep doc (Pulmonologist/Internist) yesterday. He said this breathing pattern is not Cheyne-Stokes.

The pattern we are referring to mimics Cheyne Stokes breathing but the period peak to peak is usually not as long as Cheyne Stokes. Cheyne Stokes is usually associated with congestive heart failure and the peak to peak is usually about a minute or more.

So trying to follow this.

Are not swwalden1's peak to peak times about a minute, therefore this IS CSR?

swwalden1, can you post the 30 minute block immediate prior to your original image?

Thanks.

In CSR, each cycle usually lasts between 30 seconds and 2 minutes.

From Wikipedia:
https://en.m.wikipedia.org/wiki/Cheyne-s...espiration

Cheyne–Stokes respiration /ˈtʃeɪnˈstoʊks/ is an abnormal pattern of breathing characterized by progressively deeper and sometimes faster breathing, followed by a gradual decrease that results in a temporary stop in breathing called an apnea. The pattern repeats, with each cycle usually taking 30 seconds to 2 minutes.[1] It is an oscillation of ventilation between apnea and hyperpnea with a crescendo-diminuendo pattern, and is associated with changing serum partial pressures of oxygen and carbon dioxide.[2]

References
[1] "Cheynes–Stokes Respiration". WebMD LLC. Retrieved 2010-10-05.
[2] "Cheyne–Stokes respiration". WrongDiagnosis.com. Health Grades Inc. Retrieved 2010-09-03

But I think the doctor may be saying CPAP treatment-caused CSR mimics true CSR, which in his understanding is disease-caused CSR.

[mollete]

Thanks.

I was curious to see if there were respiratory events that were missed by the machine. Indeed, there is a bit of periodic breathing (put http: in front of that):

//i79.photobucket.com/albums/j147/morbius10/apboard_zpsz5s1y8ze.jpg

In both periodic salvos, the trigger appears to be a arousal, suggesting a CompSAS type of thing. Yet those cycles are long, suggesting circulatory delay may be underfoot.