Link between pressure setting and periodic breathing?

[daryl314]

Is there any link between the periodic breathing percentage reported and the pressure setting? I have a Phillips DreamStation and I’ve tried increasing the minimum pressure lately because I’ve been having trouble since getting COVID in January. I’ve noticed an upward trend in periodic breathing and have wondered if the two are connected

I originally posted this on Reddit, and the advice I got was to try posting here.

Thanks,
Daryl

[OpalRose]

Welcome to Apnea Board!
A high pressure could trigger period breathing.  I've also noticed the use of AFlex, especially set to 3 sometimes coincides with PB.  There could be other reasons, but we would be guessing without seeing some data.  

Could you post a Screenshot of the daily page in OSCAR?  There's a link in my signature line on organizing your chart.  Use the Attachment Feature to post a chart here.

[daryl314]

Thanks OpalRose.  See attached for an example of a "typical bad night" and also the worst night I've seen lately.

   

   

[OpalRose]

Daryl,
How long have you been on Cpap?  I am curious if the Clear Airway events are typical.
Can you post a "Statistics Page" from OSCAR?  That would show us some history of settings and events.

Also, it would be helpful if you have a copy if your sleep study and post it here, redacted of personal information.

Thanks!

[daryl314]

I've been on CPAP just over 2 years, and I've seen my reported periodic breathing % increase over the last few months.  Clear airway event frequency doesn't seem to be out of the range of normal.  Unfortunately I never got a copy of my sleep study.  My doctor told me that I have mild sleep apnea, and I'm exhausted all the time even when I am using my CPAP.

   

[OpalRose]

Your charts mostly show Hypopnea and Reras. You could try to move your minimum pressure up to 9cm to try and keep ahead of that. Keep AFlex at 2.

The Reras are known to cause mini arousals all night, even if you don't remember.

There is also evidence of "Positional Apnea". See your graph where the events are clumped together. Can you tell us how you sleep? If on your back, try to sleep on your side, preferably the right side.

What may be happening is that you are tucking your chin/neck into your chest.
This could cut off your air supply, and may be a cause of the Periodic Breathing.

A " soft" cervical collar has helped many overcome this. Also, using a thinner pillow helps.

http://www.apneaboard.com/wiki/index.php...cal_Collar

[daryl314]

Thank you so much for the suggestions - I really appreciate it. I haven't known what to look for with the OSCAR data, and it's been a struggle for years to figure out why I struggle to wake up feeling rested.

I try to sleep on my side, but sometimes end up on my back. I started having trouble with acid reflux during the pandemic so I've been sleeping on a wedge. I'll try experimenting with wedge vs no wedge, cervical collar, and pillow type and see what happens. I frequently have clumped events so I'll see if I can figure out what's going on with that. I've thought about pointing a camera at myself at night so I can go back and see what was happening when I had events.

[OpalRose]

I've thought about pointing a camera at myself at night so I can go back and see what was happening when I had events.

That's not a bad idea. Others have done it. I think it would be an eye opener.