Periodic Breathing - Printable Version

Periodic Breathing - Printable Version

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Periodic Breathing - jonathan richardson - 09-18-2017

I have a concern about periodic breathing. Unfortunately I am still struggling to adapt, and therefore the most I have gotten so far is around 2 hours of consecutive sleep. Although I did my best to read the instructions, I was not sure at what level would be required to zoom in, so I took the liberty of providing the tightened waveform along with a narrower timeframe. I have read about the sinusoidal waveforms being CSR. I was going to increase the pressure a bit tonight, as I have had it within a tight range, trying to get used to it and prevent centrals. thank you for any input you can provide. Will sleepyhead flag potential CSR with my machine or does it always have to be analyzed by a human. I noticed that there was an event type in the settings of SleepyHead (same or similar color), but these are being flagged as periodic breathing.

As a new user my images were rejected. here are the obfuscated links.

I really appreciate your help/input.

imgur_com/oxzoWRu
imgur_com/1K467U4
imgur_com/rZKQuQX
imgur_com/zGGgYlm

RE: Periodic Breathing - Sleeprider - 09-18-2017

(09-18-2017, 07:38 PM)jonathan richardson Wrote: I have a concern about periodic breathing. Unfortunately I am still struggling to adapt, and therefore the most I have gotten so far is around 2 hours of consecutive sleep. Although I did my best to read the instructions, I was not sure at what level would be required to zoom in, so I took the liberty of providing the tightened waveform along with a narrower timeframe. I have read about the sinusoidal waveforms being CSR. I was going to increase the pressure a bit tonight, as I have had it within a tight range, trying to get used to it and prevent centrals. thank you for any input you can provide. Will sleepyhead flag potential CSR with my machine or does it always have to be analyzed by a human. I noticed that there was an event type in the settings of SleepyHead (same or similar color), but these are being flagged as periodic breathing.

As a new user my images were rejected. here are the obfuscated links.

I really appreciate your help/input.

imgur_com/oxzoWRu
imgur_com/1K467U4
imgur_com/rZKQuQX
imgur_com/zGGgYlm

Image assist:

[Image: oxzoWRu.png]

RE: Periodic Breathing - Sleeprider - 09-18-2017

Analysis: You are using an auto CPAPat 9.0 to 9.5 fixed CPAP. Your AHI is acceptable for a new user, but might be improved by changing to Auto mode on your machine. Events are predominately obstructive and the periodic breathing is an artifact of adapting to CPAP use and will shortly disappear...trust me. There is nothing seriously wrong in any of these charts. If I was asked for suggestions, I would recommend changing to Auto mode, with minimum pressure at 8.0 and maximum pressure at 12. I would change ramp settings which are clearly causing some respiratory distress (note the wide amplitude flow in chart 3) to a minimum pressure of 7.0 with a Ramp duration of 10 minutes.

Seriously, the periodic breathing in these charts is of very short duration and not of a type to be concerned about. Results are pretty good, and you might feel more relaxed if the pressure changed automatically as needed as you change sleep position and your needs change with sleep stage. Leak rate is good and there is nothing here that suggests the sleep disturbance problems cannot be improved with better comfort settings.

RE: Periodic Breathing - jonathan richardson - 09-18-2017

Thank you very much for your response. In another thread, I had mentioned my issue with the pressure pulses which almost made me abandon treatment altogether. I know how important it is to be patient and adapt. Almost, every time that I am about to fall asleep, the quick pulse would wake me up and it was an endless cycle. Since the machine thought I was having centrals and all kinds of events (sleep/wake junk) it would quickly increase the pressure to max, i.e. 12 and I found it even more difficult to fall asleep, all along pumping all the pulses. I seem to breathe very slowly and calmly as I am trying to fall asleep and the fear of the pulse coming on makes me speed up my breathing unnaturally when trying to fall asleep. By setting the ramp longer and starting lower, it seemed to let me fall asleep and the puffs of air aren't as high (or at least don't seem as strong). Maybe I've just adapted and by relaxing and getting a better fit with my mask I'm getting less event pulses. Anyway, by limiting within a range, it lessened the hunt and peck that was happening as well during the period of me falling asleep - that in combination of the pulses was driving me crazy.

regardless I will take your advice and will set it to 8 min and 12 max. I will increase the ramp to 7.

I was a bit concerned over the periodic breathing so you have put my mind to rest for now, and for that I am very thankful.

RE: Periodic Breathing - Sleeprider - 09-19-2017

Thanks for the explanation. That sounds like something I would recommend for someone disturbed by the pressure pulses and variable pressure. Smile

I guess my memory is failing. http://www.apneaboard.com/forums/Thread-Pressure-pulses?pid=216704#pid216704

RE: Periodic Breathing - trish6hundred - 09-19-2017

Hi jonathan richardson,
WELCOME! to the forum.!
Good luck with CPAP therapy and also with getting used to it.

RE: Periodic Breathing - jonathan richardson - 09-19-2017

Hi Sleeprider:

I had about 3 hours where I couldn't fall asleep - I cut what portions I believe were not junk throughout my several sessions of sleep. However, this is the most sleep I've ever obtained thus far with the machine.

No major periodic breathing issues so that is a good thing. Do you think I should raise my minimum from 8 to 9? I like (and am obviously more comfortable) having it at 8, but if I'm ending up having events because of it, I should probably notch it up. Some of these spikes I believe were due to me waking up slightly and being uncomfortable with the mask and adjusting. I might need to keep working at it and hopefully getting a full night of data.

I'm using the nasal pillows and find them to be obtrusive - the inside flanges seem to be hard to adjust. I've tried all three sizes and struggle to get it just right. Additionally the straps lay directly on my face causing marks for hours when I wake up (along with making it uncomfortable to sleep - note I have purchased covers but that just makes it even bulkier). I see you use a nasal pillow too, and wonder if I should switch to another brand. anyway, any input on these charts would be beneficial. If you believe I should have branched this off to another thread now that the periodic breathing issue is moot, let me know. I'm a newbie and don't mind the criticism, but did want to get back to you with the new data.

yeah - charts posted! thank you Trish for the warm welcome. I never thought I'd adjust, and now almost 60 days later, things are looking up. Stuff that used to bother me, I rarely notice now.

RE: Periodic Breathing - Sleeprider - 09-19-2017

Your best sleep and best results seem to be related to lower pressure, not higher pressure. How would you feel about trying fixed pressure at 8.0 and turning off the Flex?

RE: Periodic Breathing - jonathan richardson - 09-19-2017

I'll do that! I love the recommendation. I also noticed that most of the events last night were hypopneas vs. the obstructives you noticed prior. As a side note as it may be relevant to you, I have non-allergic rhinitis, one collapsed nasal valve (but the ENT did not want to operate). I had read that some feel that may contribute to the hypopneas. I am even doing saline rinses at night and throughout the day.

Thank you again. I'll report back tomorrow.

RE: Periodic Breathing - jonathan richardson - 09-20-2017

Hi Sleeprider:

I got about 3 hours of useful data. I didn't cut out the end of chart 1, but I believe it was just me waking up/junk. I turned off the Aflex and set to 8 min 8 max as you'll see in the chart. No periodic breathing. I do seem to have more RERA's at the lower pressure but maybe not enough info. the one chart I turned off I was up the entire time.

Your comments are appreciated.