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12-16-2024, 02:30 PM (This post was last modified: 12-16-2024, 02:31 PM by arch.)
REM Predominant/Low REM
I'm a CPAP user with REM predominate sleep apnea. I was wondering if anyone has any insight into what is going on with my choppy breathing and REM ending early at 5:28. It appears to end in what is reported as a central. I have a Garmin watch I wear and night that correlates this period of choppy breathing with REM. This was my 4th REM 'session' in the night pictured and it ended prematurely after only 15 minutes. My research has said that closer to 45 minutes would be expected.
My current settings are CPAP mode 12 with EPR 3. Mask worn was the ResMed F40 with a soft cervical collar (positional apnea had been suspected in previous posts from me).
12-18-2024, 04:07 PM (This post was last modified: 12-18-2024, 04:08 PM by arch.)
RE: REM Predominant/Low REM
(12-16-2024, 03:50 PM)gainerfull Wrote: That choppiness is a position change followed my a significant flow limitation followed by another position change and a breath hold (normal).
Thank you for the reply! So it sounds like in the screenshot I posted things look fine at the pressure I have set?
I have a new question about a weird flow rate chart I had last night (picture is attached). Have you ever seen this pattern before? It lasted about 25 minutes then returned to my normal breathing pattern.
I did some reading on the wiki and think I think I've identified it as a form of expiatory mouth breathing. I am already using a full face mask, which seems to be the go to consensus for treatment on the few threads I've been able to find with similar waveforms. I did see one reply somewhere that noted if the flatish line is on a negative number for these breaths, it is likely to be exhale puffing. They also said if the flat line is on 0, then it's likely palatal prolapse. I looked through these wave forms more closely, and what I think I am seeing is exhale puffing leading to palatal prolapse followed by an arousal. Where I'm getting stuck is treatment for this. Exhale pulling seem to sometimes be a sign of too high pressure. Palatal prolapse seems to be best treated with higher nasal pressure, and no EPR, but apparently isn't very well treated by CPAP. For last night I changed my settings from CPAP 12 with EPR 3 to APAP 9-14 with EPR 0. I can see the same waveform pattern starting last night at varying pressures, all the way from 9 up to 11.5. I definitely slept better with these new settings than the night before, but I'm not sure if I should stick with this for now, or try CPAP starting at a lower pressure then titrate higher to see if I can find a pressure that treats these conditions. I guess I can't tell if my pressure is too high which leads to exhale puffing, which causes the rest. Or if my pressure is too low, allowing for palatal prolapse. Or just live with the exhale puffing and a full face mask.
If anyone has seen this before, and has any experience treating it, I'm all ears. I'd be happy to hear if any of my assumptions are incorrect. Am I tilting at windmills?
