Very Strange Breathing Pattern

[upsman]

I have had a couple of "different" nights of sleep lately. Two days ago, my AHI shot up to 4.5, and the following day it was much higher than normal at 2.9. Then last night it was back down to near normal at .99, but there were several CA detected at over 30 seconds each. I think the longest I've ever noticed in the past has been around 15 seconds. 

Now, I do have COPD and when I use my maintenance inhaler I'm supposed to hold my breath for at least 10 seconds for the medication to be absorbed. Most times I can do this with little problem, but occasionally it's very difficult. So how in the world am I not breathing for over 30 seconds at a time on several occasions during the night? 

Could this be a one-off type thing with the machine....or my breathing? I should probably drag out my Contec O2 monitor and use it for a couple of nights and see if there are any significant O2 desats.

[Gideon]

It never hurts to monitor your oxygen overnight though in this case I don't think it will show anything alarming.

Those look like fairly normal centrals.

Why are you using EPR=1. Do try EPR=2 and see if you feel better. I suspect your good flow limits will lower a little, but I'd also want to closely watch what happens to your centrals as they could, not will, go up.

[upsman]

Thanks Gideon. 

I lowered my EPR to 1 cm a while back as a suggestion to lower my centrals, but it didn't really change much. 
I suppose I could raise it by 1 again and see if it affects anything. I really don't need it for the exhale pressure for comfort, though. 

I almost always have nothing but central apneas on a daily basis. I suspect most of them aren't true centrals though. My average AHI is below .6 and I rarely have anything but a few hypopneas and the rare RERA.

Overall, I'm happy with my therapy, but this anomaly seemed worth looking into. Do you think I was actually not breathing for that length of time? Normally, my central events are no longer than 10-15 seconds.

[Gideon]

Very clearly yes.