Periodic Breathing

[Johnboy]

Hi - its been a while since i last posted and i am hope you are all well. I have been receiving treatment for 2 years now and my AHI is always inder 2 and periodic breathing 0-2%. This is at a pressure of min 14 and my 90% is usually 15.5-16.5. I was convinced that my sleep apnea was to a large degree positional. Therefore, having taught myself to not sleep on my back (tennis ball and t shrit) i decided last night to turn the pressure setting down to the minimum of 4 and see what that recorded. I found that my AHI was 10, which is much lower than when i was diagnosed with 52, and wasnt a great surprise (although i know it is still above normal). However, my periodic breathing was 11% - is this something that i should worry about?. In the past o have read that i high PB reading can suggest heart issues - however i have absolutley no other signs of heart problems and i am generally fit. Does this reading suggest that i have a problem with central apneas that might need a different treatment? Any advise welcome. My sleepyhead readings were off the charts with snoring activity etc.

Secondly, has anyone experienced nose cuts using the Amara View? Last week i recalled that during my sleep that there was what i thought was a bit of moisture in my mask. When i got up in the morning the pillow looked like something for the Godfather ie covered in blood that had been exhausted out of the mask. Just under the bridge of my nose had a cut which surprised me as the silicone is very soft.

[Sleeprider]

With the pressure turned down to 4-cm, you not only increase obstructive AHI, but the airway was destabilized resulting in the fluctuating flow rates or "periodic breathing" the machine flagged. It does not infer a central breathing issue. I'm sure you can zoom in on the flow rate and easily see it yourself. Looking closely, you will probably see the flat-topped or downward sloping inspiratory peaks in the wave-form that are diagnostic of obstruction or airway resistance. The fact they occur in a periodic pattern is not significant nor suggestive of central apnea.

4-cm is not untreated, but it is, in your case, inadequate, so it is not reflective of your diagnostic sleep test. Your test confirms that the pressures and positional techniques you have been using are effective compared to low pressure, and is nothing to be concerned with. I'm not an Amara user, so that's all I have.

[srlevine1]

 i decided last night to turn the pressure setting down to the minimum of 4 and see what that recorded. I found that my AHI was 10, which is much lower than when i was diagnosed with 52, and wasnt a great surprise (although i know it is still above normal). However, my periodic breathing was 11% - is this something that i should worry about?. In the past o have read that i high PB reading can suggest heart issues - however i have absolutley no other signs of heart problems and i am generally fit. 

With your pressured deliberately dialed down to 4 from your normal settings, I would suggest that you are not getting the therapy you need. As for relying on a single night's numbers, this is often counterproductive as it is a trend you want to observe before changing therapy parameters to eliminate the randomness factor.

While Periodic Breathing has been associated with CHF (Chronic Heart Failure -- the backup of fluid in the heart and lungs due to arrhythmias or pumping insufficiencies), you might wish to ask for an echocardiogram to rule out underlying heart issues that may not be reflected on a standard EKG.

[Johnboy]

Thanks for the reply. It was only an experiment and not something that intended to continue. I simply wanted to find out what my AHI was whilst not sleeping on my back.

[Johnboy]

Thanks Sleeprider. It amazes me how you guys know so much about this. I wouldn’t have a clue what the flow rate was telling me lol.

[sleepyzzz]

than kyou