afib and sleep apnea

[jaswilliams]

Sleeprider...

Can you possibly explain for me why these events are triggered, as seen up close on these graphs, when my SpO2 level is very good (95%), and the heart rate is less volatile in range than we've seen previously...

...the "23.28.42 (62)" is indicating the end of the Apnea (obviously)...

...but that 'event' seems to trigger further activity of a disturbing sleep nature (Hs and UAs) when previous to its happening, almost 1hr 25min had been slept peacefully, and in blissful ignorance of my body's recovery process...

...is the norm, for others too?

Is Central or Obstructive apnea 'simply' the answer?

i'd like to try and understand how to interpret what I'm seeing, a little better...if that's at all possible on my limited education (as compared obviously, with yours and other Forum Board advisors).

Cheers...poppypete 

Pete 

it might make it easier to understand what’s going on with an ASV if you replace the pressure graph (which is a low resolution graph) with the mask pressure graph. The mask pressure graph will show how your ASV is working to attempt to maintain the air volume and breathing rate to the last 3 minute rolling average your ASV was giving it all it had (25 cm’s of pressure)during this time but it was not sufficient. I would not worry about this low level of events, but as an education I see it as worthwhile question to ask and be answered.


I if you look at these apnea with mask pressure you will see the ASV is responding on a breath by breath basis attempting to encourage you to take a breath by boosting pressure support to the max but you do not breath yourself so an apnea is scored.



Jason

[Sleeprider]

In terms of SpO2 you're doing great. Your AHI is not bad. The pattern of obstruction appears like positional apnea and events seem to be confined to a fairly short period(s) of time. If you are still using the c-collar, just try to keep that positioned properly, and maybe we should expect that your AHI of 2-4 is just okay as long as you are feeling pretty good. Your heart rate is not spiking and you no longer have O2 issues, so this treatment is helping you to heal, and we probably need to give that time.

The "answer" lies not in the numbers but how you subjectively feel.

[poppypete]

Thanks to both of you...

...I now better understand.

re: "If you are still using the c-collar, just try to keep that positioned properly"

Sleeprider...

I did enquire about one of these, but have never acquired one...so maybe it's time I did?

My partner does tell me I spend considerable time in the supine position when I'm asleep, and I admit that I find it 'luxurious' when I'm resting.

Is it better on the heart to be on one's side???

Thanks again...poppypete 

[poppypete]

In terms of SpO2 you're doing great.  Your AHI is not bad. The pattern of obstruction appears like positional apnea and events seem to be confined to a fairly short period(s) of time.  If you are still using the c-collar, just try to keep that positioned properly, and maybe we should expect that your AHI of 2-4 is just okay as long as you are feeling pretty good.  Your heart rate is not spiking and you no longer have O2 issues, so this treatment is helping you to heal, and we probably need to give that time.

The "answer" lies not in the numbers but how you subjectively feel.

Jason: "The mask pressure graph will show how your ASV is working to attempt to maintain the air volume and breathing rate to the last 3 minute rolling average your ASV was giving it all it had (25 cm’s of pressure)during this time but it was not sufficient. I would not worry about this low level of events, but as an education I see it as worthwhile question to ask and be answered.

I if you look at these apnea with mask pressure you will see the ASV is responding on a breath by breath basis attempting to encourage you to take a breath by boosting pressure support to the max but you do not breath yourself so an apnea is scored."

Sleeprider and Jason...

Combining the thoughts in these two replies from you both, and reflecting on my experience these past couple of months:

Last night:
I had 4hr 50min in my first session, mask on at 8.40pm...waking at 1.30am.
At 10.10pm (90min sleep), the mask pressure does reveal more...as hypopneas commence (questioning myself: have I gone over onto my back, or is this another sleep phase change happening?).
The second session commenced 5 minutes later @1.35am.
Again the mask pressure reveals change after 2.30am, but sufficient to only reveal 2H and a 17s apnea before I recall waking...but I did not rise this morning, choosing to recline and rest in lieu...until 4.4.48am.

Now given all my past experiences and to consider again the question I first raised related principally to what was happening to me back then; what occurred to me during my first oximetry reading 'test'; and what caused my hospital visit...the 'activity' I see today on my graph between 4am and 4.48am suggests strongly to me now, that the supine position (when I'm 'positional breathing' differently to when I'm on my side), gives me rise to think this may well be the final piece in my personal jigsaw.

So as Sleeprider so eloquently suggests: "The "answer" lies not in the numbers but how you subjectively feel.", my answer is that I did feel on waking, that my chest had had a workout (again)...however, far less severe than previously when I visited Emergency in concern.

When my partner later rises, I'm sure she'll add some comment to what no doubt disturbed her a little, after 4am...but in the meantime, would you two too, like to see anything more than this full graph of last night's results?

Cheers...and thanks again...poppypete

[Sleeprider]

Pete, I don't know why hypopnea seems to be so prevalent when pressure support is strongly working to remedy it. Early in this thread, i suggested reducing your minimum PS from 3 to 1, and I think I'd like to take that back to 2-cm PS min.

I have to say your ASV results are like tuning an old analog TV and moving the antenna "just so" to reduce interference.. (Old guy humor).

[poppypete]

Sleeprider...

I'll reduce the PS min down to 2-cm tonight.

re: "c-collar"

Can you confirm please, that by 'c-collar' you mean one of these:


...as in my previous comments, I was referring to one of these (quite expensive gadgets):



Cheers...poppypete 

[poppypete]

Sleeprider...

Just went to machine for adjustment, and lo...

...last (and previous) night PS min has been on 1-cm, so do you want me to go down to nil for tonight???

Cheers...poppypete  

[Sleeprider]

Peter, that image is of a soft cervical collar.  There was a thread on the forum recently that suggested a couple brands as being pretty good and one of those was the Dr Dakota Stop Snoring collar.

Yes, minimum PS of 2. 

Check out the review of the Dr Dakota Snoring Stop on YouTube. Search video l1rM5XIje6M by Lanky Lefty. 11-1/2 minutes of entertaining comments that I think are worth your time.

[poppypete]

Peter, that image is of a soft cervical collar.  There was a thread on the forum recently that suggested a couple brands as being pretty good and one of those was the Dr Dakota Stop Snoring collar.

Yes, minimum PS of 2. 

Check out the review of the Dr Dakota Snoring Stop on YouTube. Search video  l1rM5XIje6M by Lanky Lefty.  11-1/2 minutes of entertaining comments that I think are worth your time.

Sleeprider...

Will go to PS of 2 tonight. 

[from last night's results, the decrease option (refer my last post...going down from the previous setting of 1)... wasn't the way to go. Your latest advice/reply coming to me too late (in my time @ 10.45pm). Lesson: go to machine to adjust next time, in your time (when advice first received)...not mine! Procrastination: the thief of time!]

Thanks for the clues about the thread and Dr Dakota...I'll 'keep you posted' (as the modern young ones say!).

Thanks again...poppypete  

[poppypete]

Pete, I don't know why hypopnea seems to be so prevalent when pressure support is strongly working to remedy it.  Early in this thread, i suggested reducing your minimum PS from 3 to 1, and I think I'd like to take that back to 2-cm PS min.

I have to say your ASV results are like tuning an old analog TV and moving the antenna "just so" to reduce interference.. (Old guy humor).

Sleeprider...

Re-reading this advice post of yours again, I now see how I mis-understood.

Old guy ageing...poppypete