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It's been a few months since I posted my nightly data on here but recently things have changed according to the data my CPAP machine is showing me. Where before my AHI's were consistently high even with 100% compliance at a fixed pressure of 13, now they are staying more normal; even some in the 2-3 range and some not much over 5 or 6. But last night my Periodic Breathing % was at 21% and that threw me for a loop. And with all of the fear and anxiety I've been feeling since the coronavirus has turned everyone's world upside down I'm starting to think, "Is there a relation of my sleep numbers and data to possibly the coronavirus?" Being already in the high risk group - over 65 with several health conditions including COPD, GERD and of course OSA I have anxiety through the roof.
If anyone can help make sense of some of my latest numbers and either give me reason for concern, or put my mind at ease a bit I would appreciate it. Thanks.
I will try to post last night's and Tuesday night's data (4/21/20 and 4/20/20)
Second set will follow in a minute.
Some more data from previous post...this is some data from April 21st for comparison. I can post data from earlier of this week if that helps. The number that really concerns me is that 21% periodic breathing and whether it can indicate possible Covid 19, heart failure, stroke or something else. I have always been 100% compliant with my CPAP use but unfortunately during these trying times I cannot get in to my sleep doctor to get a new machine or equipment, I have been using this Philips Respironics System One since April 1, 2015.
Jennie, on the chart for 4/22, go to the area around 7:15. Zoom in so that there's a total of just two minutes showing -- that will be screenshot #1. Then pick a nearby area and zoom in so there are five minutes showing -- that will be screenshot #2. Then Bonjour will be able to tell you more about what seems to be going on.
You say to zoom in on the 7:15 for 2 minutes - what part of my charts do I do this on? I just tried on the top where it says Event Flags. If that's not right, let me know.
The zoom function will zoom all the graphs, but the key graph here will be the flow rate. Be sure that is visible. Also, the zooms you just posted are for multiple hours, rather than 2 minutes or 5 minutes. You can read the times off the bottom of each graph.
Wow! Flow limits. When you update and upgrade your CPAP be sure to get a Resmed that at least gives you EPR and preferably move to the Aircurve 10 Vauto bilevel. Believe it or not, there is a Resmed Aircurve 10 Vauto on the Louisville Craigslist for $300 A greqt deal if you want some better sleep and therapy. Reading between the lines on the Craigslist ad, the user had to upgrade to ASV by order of the pulmonologist. Based on the kinds of RERA, Hypopnea, snores and uneven respiration resulting from what appears to be airway restriction that I'm seeing with your System One CPAP, the Vauto will feel like a miracle. Please give it consideration. I would buy it if I was closer.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
So from your most recent reply to my data what should I be worried about? How bad is what you are seeing from my charts and what could it mean about my health? I am doing a telehealth appt with my sleep doctor tomorrow afternoon- what should I bring up or discuss with him? Now I am very worried, especially since you began your last reply to me with “Wow”
Jennie, what I see during the period flagged as periodic breathing is a pretty high level of flow limitation. Notice how squashed the inspiratory wave is on the flow chart? That means that there is probably a significant amount of upper respiratory resistance that is limiting flow. I suspect this is a common feature with your therapy because you have so much RERA and hypopnea. So what is flow limitation? It is an inhale that increases on flow rate normally at first, but as resistance increases with flow, the flow rate stalls or even decreases. This means you are expending a lot of effort to inhale, like sucking through a straw that is too small. The effort can cause a respiratory effort related arousal (RERA) and since it reduces the volume of air you can take in, it also is a lot like hypopnea, and can even cause a lower oxygen saturation. It has a very bad effect on sleep.
Why bilevel? With a bilevel positive air pressure device, the inhale pressure can be increased to make breathing easier, while at the same time, the exhale pressure is lower. This makes therapy more comfortable, and it also does part of the work for you and so you expend less effort, get more air flow, and things just normalize. Let's talk about this chart a bit focusing on flow rate. At 07:15:00 you're sucking in air and expending a lot of effort. The tops of the inspiratory peaks are flattened and might even have a snore at the top. At 07:15:35 we see really big flow amplitude with a strong exhale, and that is you arousing from a deeper level of sleep because of the respiratory effort. The machine loses track of the zero-flow crossover and the whole curve rises and drops back to another RERA. This is recovery breathing, just like you exercised. It settles down into more flow-limited breathing and then another arousal and recovery breathing at 07:19:00. This is why periodic breathing is being flagged. You are fluctuating between flow limited respiration and recovery breathing, and it must feel terrible! Your fixed-pressure CPAP is not going to change or get better. An auto CPAP would increase pressure, but a bilevel would assist you in getting a normal breath and all of this would just go away.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
