Determining true CSRs on AirCurve VAuto

[JoyD.]

I recently switched from using AirSense10 AutoSet - to - AirCurve VAuto. I've been wondering why I haven't seen any CSRs reported since I've had the AirCurve for almost a month. After last night, however, I assume the AirCurve10, unlike the AirSense10, does not report CSRs/PBs.

Up until last night on the AirCurve, I've had AHIs mostly under 1 (max 1.75), with periodic breathing scattered throughout (usually NOT with events) due to my Persistent AFIB which is only rate controlled. (Zooming in on the breaths, all or almost all of the reported events were preceded by SWJ, so the true AHI has been closer to zero.)

Last night, for the first time, I had an AHI reported as 3.91 with a block of what looks like CSRs between 5:40-6:30am consisting of sinusoidal breaths with CAs at the nadirs. Involved were about 20 CAs & 4 OAs/CAs?. (It was during Core Sleep, NOT REM per my Apple Watch). Note: With the AirSense10 I was seeing reported CSRs looking like this about 8-9 X monthly.)

What should I make of this? Having AFIB, do I need to be concerned as long as this doesn't occur on a regular basis: what-looks-like-CSRs with lots of associated sinusoidal CAs at the nadirs? (In contrast, the "usual" periodic breathing that I see "nightly" is scattered throughout the night, but NOT associated with events . . . and I attribute this to the AFIB which is documented in the medical literature as going hand-in-hand with Sleep Apnea.)

By the way, even though I'm not needing much PS, I find that with my new bilevel (trigger at high), I'm getting much lower AHIs with my AirCurve settings as I did when using the AirSense10.

Thanks, in advance, for any insights into these occasional CSR-looking blocks in my reports on the AirCurve VAuto.

Joy

[PeaceLoveAndPizza]

Let’s see a 2-3 minute zoom on the CA’s that look like CSR’s. Difficult to tell from the wider view.

CPAP machines cannot determine a true CSR, as that is the brain not telling the body to breathe. Most events flagged as CSR are periodic breathing. In your case with heart issues it is possibly a true CSR, but those with experience will want to see a better zoomed image to review.

https://www.apneaboard.com/wiki/index.ph..._Breathing

[JoyD.]

The second screen shot in my reply above shows the sinusoidal breaths with CAs at the nadir. I used this shot to show the beginning and end of the PB. More zooming would really not add any more needed info., only a closer view of the sinusoidal breaths.

However, below are two increasingly zoomed in attachments . . .

[Jay51]

Thank you for posting the close up Joy.  Like PeaceLoveAndPizza said, most CSR flagged are false.  Yours do look like the real thing here with the sinusoidal pattern.  The good thing is that it lasts for a very quick short period of time.  Most people with CSR have bouts like this all night long for long periods of time.  

A good plan IMO would be to show these chart to your PCP (and Cardiologist and/or Pulmonologist if you have them).  They could then advise on the next steps to take if this is indeed real CSR.