Stop Breathing event with CPAP - help

[Sleeprider]

If the event was what I'm looking at at 04:55, then my advise is to move minimum pressure to 8.0 and I see no reason not to change EPR to 2 or 3. The event came out of nowhere and there is nothing to suggest a respiratory issue before you suddenly started hyperventilating. A higher minimum pressure and higher EPR will help avoid the pressure fluctuations and sense of expiratory resistance.

[SarcasticDave94]

For myself I would rather focus on one data set of info. It should be well known that the phone app isn't nearly as accurate as OSCAR. CPAP like this AutoSet isn't a ventilator, so it can let you not breathe. It's not designed to induce a breath or be life sustaining breath support.

The OSCAR chart above shows several times of large leaks, don't just focus on the flagged sections, but all the areas of leak spikes above 24L/min on ResMed. Some of this appears to me to be mask leaks some might be mouth leaks. Importance? During high leaks, the ability for the PAP to treat and report properly are reduced proportional to the severity of the leak. More leaks equal less accurate reporting and therapy until the tipping point where the PAP can't do anything to help.

[neils]

Thanks to both of you !! Even though I am in Montreal, if ever either of you open an apnea clinic or paying apnea consultation business, I would sign up for it (these days of remote work from home via Teams means it is a viable business). Thanks for your valuable advice.

I did notice the mask leaks being greater on the 13th than a normal night. I forgot to attach last night for reference to compare.

As for the timeline, I usually go to bed around 11:00PM maybe 12:00, yet my wife reminded me that Sat night we went to bed super late, I think it was a back to back Netflix night. Plus we moved the clocks 1 hour ahead (DST), so 3:00 AM was actually 2:00 AM but the machine seemed to have advanced the hour already at this point.

3:32 AM - 3:59 AM
4:01 AM - 11:59 AM


My other guess based on the 2 time stamps above is that I probably ended up ripping my mask off to gasp for air at 3:59, and oddly enough put back on the mask only 2 min later (maybe thinking the air will help me breath better once I caught myself). So that would mean my event probably happened at the 3:59 mark (leading up to it), even though the actual time is wrong.

Attaching some additional charts which seems to suggest that 3:59 is the time of attack. Hoping these additional charts, and more precise time of attack, can paint a better picture for you experts that know how to read this data better than I can.

Thanks again guys, board members are lucky to have guys like you interested in other people's apnea problems/issues !!

Neil

   

[SarcasticDave94]

I'll probably open up a sleep and coffee clinic. You're welcome to visit.

On the timing, maybe the PAP clock has drifted off some. Just be careful in editing the PAP clock, believe it or not but that can mess up the works. I think for some reason probably due to a PAP "day" starting and ending at noon that 2 PM is supposed to be OK to try editing. Don't take just my word though, I don't have working PAP therapy right now, between machines. And I've not cared what time the PAP said since I'm disabled retired.

[neils]

Sorry, updated my reply above, wife walked in and reminded me 3 things, one that we went to bed super late (Netflix night), two that the clocks moved ahead by 1 hour that night (DST), and three it was the weekend and not a weeknight.

I think my mind needs more fixing at this point, or the lack of air from Sat night affected my memory.

Neil

[SarcasticDave94]

It's OK. Just proof that you're still normal like the rest of us.

[neils]

So I guess based on these additional charts here, and the fact that I am now able to determine the attack event happened leading up to the 3:59 mark on the graphs, with spikes everywhere, the conclusion seems to be the following, based on your feedback so far

* Mask leak (20.4-34.8) prior to loss of breath event  may have been part of the problem
* Hypopnea event (3:57:32) & Obstructive event (3:58:57) may have led to breathing issues
* Events above may have been due to mask leak or possibly obstructive sleep position
* Other concerning stats from the charts leading up to loss of breath event @ 3:59 :
       Tidal volume peak (2006), 
       Resp Rate peak (50), 
       Minute Vent peak (29.80), 
       Flow Rate (-120 to +120)

Your thoughts or own analysis of these additional charts around the 3:55-3:59 mark ??

Thanks again !!

   

[Sleeprider]

You know you could just zoom into the approximately 5 minutes of the event and what led up to it. We are still looking at a chat that covers nearly 8-hours, and you want to analyze just the event. Use the zoom function at the bottom of the Events table or just click repeatedly on the event until the zoom centers on it and you can see the breath by breath wave form.

[neils]

Thanks Sleeprider,

Have done the zoom and looking at the data now. I guess at some point I have to do my homework and read up on what some of this data means, and if it is above the norm, try to understand why. From the bit of reading I did on the various parameters based on info on this board, some data seems more critical than others, and sometimes it's a combination of several data points together that gives better indicators.

It's like trying to become a data analyst overnight, trying my best to make sense of it.

Thanks again for all the great insight !!

Neil

[neils]

Sorry, but have another question as I try to dig into the data analysis prior to my inability to breath and waking in fear of a heart attack. I  zoomed in on the graphs, and noticed something particular on the Flow Rate (which I initially misunderstood as the flow of air from the machine, and now understand as my inhale and exhale flow rates. Prior to my attack, the flow rate is flat line from 3:58:43 to 3:58:57. Can I translate this as no breathing (or very little for a period of 14 seconds ?)


Timed with that, I had a HO prior to the flat line at 3:57:32 and then right at the end of the flat line flow rate an OA at 3:58:57.

So of course my question is how do you interpret this sequence of events ? Could the HO preceding have caused the flat line flow rate, which then somehow ended with the OA which finished with me waking and ripping off my mask gasping for air ??

I often worry that a CA was not picked up and is the cause of these type of extreme series of events.

I also noticed that the mask pressure hovered around 5.0-5.5 between this time period, only peaking at 8.19 around the time of the OA leading up to the breathing event immediately after. So why is that, why would the machine not push the pressure to max 16 (preset) if it saw I was flat line in my breathing ?? Does not make sense to me (assuming I am interpreting the data correctly of course).

Finally, I included a zoom out view which shows a very regular flow rate when I drifted off to sleep, then all of a sudden at 3:55:25 mark my breathing goes irregular and extreme on both ends for about 2-3 min until my HA at 3:57:32 leading to the breathing event at 3:59:21.

Your thoughts, would appreciate to hear from the experts again please.

Thanks !!
Neil