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[Treatment] Central Apneas and Periodic Breathing
#1
Central Apneas and Periodic Breathing
Hi All,

I'm fairly new to CPAP, but I feel like I've had Sleep Apnea for a while.

2 months ago I had a sleep study and was diagnosed with moderate sleep apnea (24 AHI).

I've had mixed results with my CPAP usage but still frequently wake up every night and don't feel well rested in the morning.
My monthly AHI results vary between 1.7 to 11.7.

My recent OSCAR results have been predominantly or exclusively Central Apneas and the shape is making me worried that I have CSR happening, at the very least periodic breathing.
The average period length between apneas is 30 to 35 seconds.

My results are always worse when on my back, I also feel I may be chin tucking while I sleep.
I sometimes get the feeling I'm breathing shallow or not exhaling while falling asleep and sometime get this feeling while awake but overly sleepy the next day.

My sleep doctor did not give me any detailed results so I'm not sure if the sleep study showed OSA, CSA or complex.
My next sleep appointment isn't until December but was hoping for some input on my results to see if I need to chase a faster appointment time.

Thanks in advance.

Pat


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#2
RE: Central Apneas and Periodic Breathing
Welcome! That rash of CAs doesn't look at all like CSR to me. The tops and bottoms of the flow rate patterns for CSR have a sinusoidal shape to them, and the time interval for waxing plus waning is generally around one minute.

You got into a segment of unstable breathing, with CA followed by recovery breathing, which triggered another CA, which was followed by recovery breathing, etc. This coincided with a period of leaks and, due to a few OAs, pressure increases. You were probably sleeping only fitfully.

How frequently do you have nights with an AHI of over 3? Over 5? -- If these aren't frequent occurrences, you could hold off on asking for an earlier doctor's appointment to see whether the CAs start settling down some, which they may do on their own. Whenever you see the doctor, ask for information about the breakdown of your AHI during your sleep test. In the U.S., you're entitled to a copy of your sleep report; see if you can get a copy of yours.

In the meantime, I'd suggest that you lower your EPR to 2, which may reduce the frequency of the CAs. I'm also wondering whether your sleep posture might account for an ugly period like the one you had starting around 4:12 a.m. Try using a single pillow, low and firm, and try as best you can to sleep on your sides. If you tend to tuck your chin down toward your chest, try keeping your neck in a straighter alignment. (Some people benefit from using a soft cervical collar for this purpose.)

Finally, I have a couple of questions. You had six breaks in machine usage during the night. Is that typical? What caused those interruptions? And you were using the machine for only 6 hours and 19 minutes. Is that typical? Can you work toward using the machine for more like 8 hours?
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