[Diagnosis] More Periodic Breathing

[CarlW]

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Joined the forum a few minutes ago and immediately found Dr. Nefario's Long Episode of Periodic Breathing.  Unlike him, I do not have underlying health problems other than lifelong excessive daytime sleepiness from birth.

I have multiple clusters of periodic breathing nearly every night.  Many of them, but not all are coterminous with large leak periods.  I selected and expanded this cluster because it is not associated with a large leak period and displays good periodicity and uniform waveform.  I had to crop the pressure and leak graphs to limit the file size.  The pressure graph is a straight line at 9 cm(?).  The leak rate is relatively steady at about 26 - 42.

This cluster is about 20 minutes long.  The longest cluster I have examined is about 77 minutes.  The longest apnea in this cluster is 45 sec.  The longest apnea I have found is 61 secs.  The highest flow rates, not in this cluster, are +103 & - 120.  Is it possible that the large leak rates are a mis-reading of the high flow rates as large leaks?

At this time, I interpret these events as central apneas and at some point the apnea is interrupted by a panic signal from the O2 or CO2 monitor "breath or die."   This response then decays exponentially to the zero flow point set by the central apnea.  My docs are focused on O2 levels and in my tests I did not desaturate below 89%.  Is it possible that the number of arousals would be more important in my case?

I am currently doing several things: I forwarded copies of the graphs to the sleep clinic to be sure that they are looking at the detailed graphs and not just the AHI.  At my next appointment I will ask for my sleep study data.  I would like to know if periodic breathing occurred during the diagnostic and titration studies or if they developed subsequently.

I have two masks and they show the same periodic breathing, and for one of the masks I installed a new cushion.  I will review that data in a coupla days.  There are some pressure problems with the ResMed Air Curve 10 BiPAP and I am waiting for the vendor to troubleshoot this or replace the unit.

What else can I do in the meantime and what can the members of this forum tell me about periodic breathing?
TIA
Carl