questions about flow rate waveform

[sheepless]

questions about flow rate waveform.  I think the attachments show examples of what I'm asking about.

1.  is the pattern I think I'm seeing really a pattern? it looks like centrals are generally just at or slightly above the 0 flow line while obstructives are generally below the 0 flow line. not sure why this would be so, though, if not-breathing is by definition equal to the 0 flow line; unless apnea isn't necessarily a full 100% cessation of breathing...?

2.  I see quite a few flows that look like apnea but are shorter than 10 seconds.  is it fair to say that shorter 'events' - and the more of them you have - are as bad or almost as bad as an apnea meeting the clinical definition? it looks like sleepyhead has an option to track user defined events. is a proactive doctor likely to take shorter events into account if I bring them to his/her attention or are their actions limited to the 10+ second rule? 

3.  I see quite a bit of uneven breathing, especially before and after an event.  should we expect that if therapy resolves the apparently-associated events, the apparently-associated ragged breathing would resolve as well?  or is uneven breathing something different? and is that treatable?

thanks.

[tedvpap]

Your data looks normal for a person whose treatment is not as effective as it should be.  Your zoomed in data is what apnea (and near apnea) events look like.  
Your AHI is too high.  You need to work with your doctor or learn how to improve your treatment.

[sheepless]

good advice tedvpap. I totally agree. but in this thread I'm not asking about efficacy. just trying to understand waveform structure and patterns. posted data are intended to show examples of the things I'm asking about. hoping for additional info in response to specific questions.

[sheepless]

Your data looks normal for a person whose treatment is not as effective as it should be.  Your zoomed in data is what apnea (and near apnea) events look like.  
Your AHI is too high.  You need to work with your doctor or learn how to improve your treatment.

that's why I'm here asking questions and looking for answers!  

[jaswilliams]

Your AHI is still over 5 in this session the majority was OA's clustered so may be positional and a soft cervical collar may help. I went back searching your other threads and I see you generally have an element CA's in your stats... An APAP/CPAP will not treat that, a bilevel with a backup rate or ASV would be required, you need to go back to your medical team and discuss treatment however your figures willl be considered borderline and you will need to be an advocate for your own treatment and be a squeaky wheel.

[gwc2795]

sleepless hope this chart helps

[sheepless]

thanks!, gwc2795, for being the first to take a stab at answering my questions. it's really good info that I refer to often but still maybe not exactly what I was looking for. no matter. I surely don't mean to put anyone / everyone on the spot so I'm okay letting it go.

and thanks jaswilliams for a clear response, not to my questions but to my general therapy status indicated by my charts here in other threads. above and beyond to search my other posts. other advice has been a little ambivalent (properly so, I expect) so I haven't understood whether I might or might not benefit from bilevel or asv.

[fwg1947]

1.  is the pattern I think I'm seeing really a pattern? it looks like centrals are generally just at or slightly above the 0 flow line while obstructives are generally below the 0 flow line. not sure why this would be so, though, if not-breathing is by definition equal to the 0 flow line; unless apnea isn't necessarily a full 100% cessation of breathing...?

The Philips Respironics Provider Manual states that "An apnea is detected when there is an 80% reduction in airflow from baseline for at least 10 seconds or if there is no airflow detected for 10 seconds" and that "A hypopnea is detected when there is an approximately 40% reduction in airflow from baseline for at least 10 seconds."

[tedvpap]

thanks!, gwc2795, for being the first to take a stab at answering my questions.  it's really good info that I refer to often but still maybe not exactly what I was looking for.  no matter.  I surely don't mean to put anyone / everyone on the spot so I'm okay letting it go.  

and thanks jaswilliams for a clear response, not to my questions but to my general therapy status indicated by my charts here in other threads.  above and beyond to search my other posts.  other advice has been a little ambivalent (properly so, I expect) so I haven't understood whether I might or might not benefit from bilevel or asv.

I did try to answer your question in post #2 as I gave you a general response. You did not ask for clarification so I thought you understood.  I will go back and give you specific responses.

[sheepless]

thanks tedvpap. no slight intended. you have given me good info in other threads. if feels a bit like maybe my questions are tough or unclear, so as I indicated I'm willing to drop them and keep searching on my own. I won't be unhappy if there are no more-direct responses forthcoming. on the other hand, I won't be unhappy to hear your thoughts on the matter either if you so decide!