Examples of baseline "flow rate" stat?

[usernamenumber]

I've been using various CPAP and BiPAP machines for years, but sadly I am not one of those for whom the treatment has worked wonders. Part of the problem is that I have some combination of obstructive apnea (which the CPAP seems to treat alright), and central apnea and/or, if I'm understanding my doctor right, some other weird thing that basically boils down to "your brain is really dumb about breathing, especially when you're asleep". My AHI is actually pretty low, sometimes even zero, even on days where I wake up a total zombie, exhausted all day long. It's getting old. :\

Anyway, I was going over my SleepyHead logs with my doc, and he said that for me the thing indicates the real problem is my "flow rate" graph, and that if we can get it to look "less like a bottle brush" it might solve a lot of my problems, though so far we haven't had much luck in doing that.

Looking over my logs got me wondering what a baseline looks like, so I'm wondering if there are people here who:
1) Use a CPAP, and have found it to make a big difference for them
2) Track their data in sleepyhead
3) Wouldn't mind sharing representative examples of what their flow rate graphs look like, or at least whether mine makes them go "whoa...".

I am of course also open to suggestions. I've attached my log from last night, which looks more-or-less like most nights for me. It doesn't look *so* bad to me, but then I don't really have a frame of reference for judging that. Hence this thread.

I guess I'm looking for confirmation (or denial) that my stats are as weird as I'm led to believe they are before I go hanging too much hope on them being the key to making some progress here.

[Sleeprider]

Maybe by "bottle brush" your doctor was talking about your flow chart needing to be zoomed in to show what is really going on. Open sleepyhead and zoom in on the flow rate line by clicking repeatedly until the time narrows, or use CTRL+ or the up-scroll on your mouse to zoom in.

The bottle brush should become a wave-form that shows the inhale and exhale of each breath cycle. You can click on the left margin of the flow chart and select Dotted Lines/Zero. Adding the zero dotted line marks the point where there is no flow. Kind of like slack tide, this is where inhale begins (above zero), and exhale ends (below zero). A typical waveform shows the inhale flow rate rising to a peak and falling to zero flow where an exhale begins. The exhale is usually a bit longer in time (x-axis), than the inhale, and may be at zero flow for a short fraction of a second before the inhale begins again.

That is in the ideal world. I have this kind of regular pattern, and it is mixed in with some really bizzare and disturbed looking breathing. But this is the ideal.

[Sleeprider]

If you want to give your doctor something he is accustomed to seeing and understanding, download EncoreBasic from the forum at this link. http://www.apneaboard.com/forums/Thread-...hines-only

EncoreBasic is not as much fun for you to use, but it produces its reports in Acrobat (PDF) format, including a full-night of waveform like the above. It will take quite a few pages to print, or you can provide it electronically. But THAT is what he is expecting to see.

[car54]

What does your respiratory rate graph look like? My is very erratic and it concerns me. I will be talking to my doc about it. If you get a few more posts in you could post your graphs.

Thanks.

[usernamenumber]

Thanks everyone for the quick replies!

SleepRider: Hmm.. well, when you zoom in my flow rate definitely doesn't look like yours, though I'm not really sure what to make of the differences. I'm attaching a few more screenshots, showing zoomed in versions of places where the rate is relatively consistent, and where it's... not. Any thoughts?

car54 (where aaaare you?): I've also attached my resp rate graph which, now that you've got me looking at it, is kinda freaking me out as well.

[usernamenumber]

Oh, and I couldn't get the zero line to show up. I'm using v0.9.6 on a Mac, and clicking, right-clicking, and anything else I could think of on the left margin doesn't seem to do anything. Hmm.

[Sleeprider]

Thanks everyone for the quick replies!

SleepRider: Hmm.. well, when you zoom in my flow rate definitely doesn't look like yours, though I'm not really sure what to make of the differences. I'm attaching a few more screenshots, showing zoomed in versions of places where the rate is relatively consistent, and where it's... not. Any thoughts?

car54 (where aaaare you?): I've also attached my resp rate graph which, now that you've got me looking at it, is kinda freaking me out as well.

Well, i said that was "ideal. Typical looks quite different. Anyway, the point was that your doctor is expecting to see a flow chart with that kind of resolution, and Encore can print a full night of wave-form...line after line so he can see it in a format he understands.

Add the dotted zero line into the graph, as it makes it much easier to understand. Based on the examples you showed, you Tidal Volume would not look very good (look at the summary data on the left of what I posted). That looks like a hypopnea, and if it wasn't flagged, it's because it is not a reduction in flow volume from the previous minutes of data.

[usernamenumber]

Unfortunately, I haven't been able to figure out how to make the zero line appear (see #6).

As for the tidal volume issue... what can I do about that? Is it a matter of adjusting the pressure? If I recall correctly, my doc told me I'd need to talk to the CPAP company, not him, about getting adjustments of that kind made, but I'm not even sure what to tell them (I realize I could probably also do it myself, but same problem).

If it's any use, I'm attaching a screenshot of the tidal volume graph (zoomed out for the whole night).

[Sleeprider]

Take a look at EncoreBasic I linked earlier. The point of this was to share a meaningful waveform with your doctor so he doesn't have to deal with the "bottlebrush" chart. Since you're using a Mac computer, I can't help with software issues or differences. It works here on Windows.

[car54]

Here is about a minute of my flow rate,
[attachment=1990]

A screen shot showing how ragged my respiratory rate is over the night.
[attachment=1991]
I want to talk to the doc about this. I have asthma and that may be why it looks that way. If you notice in the statistics my Insp. time is 2.00 and my Exp. time is 1.30. From what I understand the exhale time should be longer then the inhale. My is reversed. It may be due to my lung congestion. I don't know how my doctor will like me asking questions. He is new to me.

Brad(car 54). I used to be an amateur raise car driver. My car # was 54. I was on a hot lap going for a track record. I spun out landing in some brush. The corner workers could not seem me and radio in to central control "Car 54 where are you"