Is this real CSR or periodic breathing? Should I be worried?

[Jonkier]

Hey all

Resmed 10 auto flagged about 15 mins of CSR lastnight. 

Terrible sleep as is usual for me. Aerophagia and lots of arousals/awakenings with burping. 

I had fallen asleep on my left side, which I never do. Pretty sure this period coincides with being on left side, but not certain. 

Settings were fixed at 9cmH20 EPR 3 fulltime. FFM f20. 

Should Ibe worried?

[Narcil]

i don't really know much about CSR but i think you need to zoom in further on a 2-3 mins timeframe inside the CSR events so we can see more.

[OpalRose]

ResMed labels Periodic Breathing as CSR. It usually isn't CSR.

I've looked over some of your data in your other thread, and didn't see this pattern on any of the graphs you posted.

Is this just a one time occurrence? If you know that you don't have any heart issues, then I wouldn't be overly concerned. If you start to see this pattern more often, then you should touch base with your doctor, just to rule out anything.

I did however notice that you don't get much sleep time in. Most of your charts show 2-3 hours total sleep. Are you sleeping without Cpap for part of the night?

[Sleeprider]

Your flow rate labeled as CSR is periodic breathing caused by a pattern of apnea that is not Cheyne-Stokes. In my opinion, you should change settings to the following:
Mode: Autoset
Minimum pressure 6.0
Maximum pressure 9.0
EPR: On Full-Time
EPR setting: 2

You will find this more comfortable and I think it will resolve your problems here.

[Jonkier]

Thank you so much for all of the replies. 

I don't have any known heart issues, and haven't seen this periodic breathing before, at least not to this extent. I do tend to get more CA's and A's and H's though. 

@Opalrose exactly, I see sleep most of the night without the mask on. I always wake up and take it off. My dream is to fall asleep and have the therapy effective enough to keep me asleep. 

Attached is last night. Min 7 max 9 EPR fulltime 3. I actually tried the BMC nasal pillow for the start of the night, but took it off due to nose discomfort. I think I had the straps too tight. Put the FFM Resmed f20 back on and managed about 90mins. Woke, took it off. Then put it back on after midnight and managed another 90mins. 

No really burping in the night lastnight, which was nice. I was a bit bloated and burpy after getting up but it was totally tolerable. 

@sleeprider thanks so much for the pressure recommendations. I'll try them and report back.

[Jonkier]

Okay so tried Sleepriders settings lastnight...

Mode: Autoset
Minimum pressure 6.0
Maximum pressure 9.0
EPR: On Full-Time
EPR setting: 2

Probably the most comfortable I've been with therapy so far. Little bit of burping but not too bad at all. Wore nasal pillow again for about 20mins then took it off due to painful nose. Went back to FFM and managed a couple of stints of 2.5 hours. 

17 centrals and 12 H's. 
Subjectively...same as usual, terrible nights sleep with lots of waking, tossing and turning. I probably did feel a little less lethargic and foggy today though. 
Light on the horizon and I'm determined to get this working. 

Would I be correct in thinkin I need to bring up the min EPAP to control the H's, and EPR 3 to reduce flow limitations? 

I have attached a zoomed in image of my breathing from a section of the night where there are no events. My thinking is, even when the machine does not flag and event, I have crazy shapes to the flow rate waveform with lots of large spikes that look like recovery breaths. My breathing just never gets into the nice rounded shape.

As always, any help greatly appreciated. 

Will make a donation to the site.

Best,

Jon

[Narcil]

Could it be positional apnea? your events are very clustered together. Since you said you move around a lot maybe you kink your airway at some point, or land on your back.
I would suggest reading  https://www.apneaboard.com/wiki/index.ph...onal_Apnea

[BigWing]

Pretty sure this period coincides with being on left side, but not certain. 

SomnoPose would answer this question definitively. I started using it on my iPhone a few weeks ago and the data it gives is fascinating.

[Jonkier]

Thanks o much for the link. I'll check this out for sure. 

My flowrate is shocking all night. Whether events are flagged or not my breathing seems to be very disordered. When there are periods of the flow rate that look okay, the pressure isn't always high for the night, leading me to believe it's likely I have some positional apnea going on. 

Thanks again.

[Jonkier]

Have attached past 2 nights. 

Nothing new for me. Terrible sleep, lots of waking, lots or burping. 

There is a nice section on the 23.5.24 where the top of the flow rate looks fairly consistent. Would be nice to know what position I am in here. Will definitely try the app mentioned above.