Joey's Mother: CPAP to ASV Therapy Thread

Joey's Mother: CPAP to ASV Therapy Thread - Printable Version

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Joey's Mother: CPAP to ASV Therapy Thread - JoeyWallaby - 11-19-2019

This is my mom's data, she has OSA... really good stats, very low AHI, FL, leak rate, etc. Only weird thing is these prolonged periods of shallow breathing on almost every night, occurring from once to up to five times a night.
Could it be caused by positional issues?

Settings are auto S9 min pressure 9, EPR 3
Once the shallow breathing ends, normal breathing reoccurs usually. I've cut off the preceding shallow breathing as it's too big.

9 minutes of shallow breathing
[Image: b8JdCTx.jpg]

11 minutes of shallow breathing
[Image: N11OO5B.jpg]

12 minutes of shallow breathing
[Image: 8cv3Gkk.jpg]

17 minutes of shallow breathing
[Image: k1tNQfo.jpg]

16 minutes of shallow breathing
[Image: 861H7R5.jpg]

15 minutes of shallow breathing
[Image: 5vnE58I.jpg]

13 minutes of shallow breathing
[Image: CfOeABk.jpg]

RE: What could be causing prolonged periods of shallow breathing? - Osiris357 - 11-19-2019

I could be wrong but that could just be her deep sleep rhythm. The others will correct me if I’m wrong. This is a screenshot of my shallow breathing before I got my settings right. The experts in this forum will definitely be able to guide you in the right direction

[attachment=17215]

RE: What could be causing prolonged periods of shallow breathing? - JoeyWallaby - 11-23-2019

bump

Tried taping mouth, still occurring.

RE: What could be causing prolonged periods of shallow breathing? - DeepBreathing - 11-23-2019

Need more information.

What's her age, general health, other complicating factors? Please post a full daily chart so we can see what else is going on during these periods - leaks, flow restriction etc. Her breathing is certainly shallow but also very rapid and some of the waveforms look somewhat strange to me. But let's see it all in context.

RE: What could be causing prolonged periods of shallow breathing? - mper6794 - 11-23-2019

.....complications factors....yes, ..... I think maybe it would important to know what medication she is on?
gl

RE: What could be causing prolonged periods of shallow breathing? - JoeyWallaby - 11-23-2019

(11-23-2019, 06:59 AM)DeepBreathing Wrote: Need more information.

What's her age, general health, other complicating factors? Please post a full daily chart so we can see what else is going on during these periods - leaks, flow restriction etc. Her breathing is certainly shallow but also very rapid and some of the waveforms look somewhat strange to me. But let's see it all in context.

50s, general health fine.

(11-23-2019, 08:01 AM)mper6794 Wrote: .....complications factors....yes, ..... I think maybe it would important to know what medication she is on?
gl

I was going to say... nothing that affects sleep but I remembered that she sometimes takes a low-dose benzodiazepine before bed.

I think the factors could be
1. medication (benzodiazepine)
2. too low EPAP (min pressure 9, EPR 3 = EPAP 6. with the shallow breathing, airway appears to gradually restrict more and more with each breath. she has significant flow limitation with EPR 1, haven't tested EPR 2)
3. positioning (usually sleeps on back... also might be chin tucking sometimes?)
4. mouth breathing (mouth taping seems to have improved breathing. she does sometimes drop mouth while sleeping, then inhales through nose and out through mouth)

This is the data from last night. Big gap in the middle is because she took mask off and turned machine off when sleeping subconsciously. She had her mouth taped but took it off when she woke up snoring and put the mask back on (second part of night).
Summary
[Image: 4sskTgl.jpg]

Events with mouth tape
[Image: umwdiTz.jpg]

Events without mouth tape
[Image: c8smbvg.jpg]

Shallow breathing with mouth tape
[Image: mVrSTYN.jpg]

Shallow breathing without mouth tape
[Image: qctICuU.jpg]

RE: What could be causing prolonged periods of shallow breathing? - JoeyWallaby - 11-23-2019

Normal waveforms with tape
[Image: 3Za3N1e.jpg]

Normal waveforms without tape
[Image: 8ZuoKHY.jpg]

RE: What could be causing prolonged periods of shallow breathing? - Gideon - 11-23-2019

The flagged events are seriously not a concern. Add minute Vent into your charts, and look at a period of time with reduced flow, 2 minute segments, (always include the overview of the reduced flow for context that you displayed here. I would suggest increased pressure support, but with EPR=3 you are maxed out

your numbers do not warrant getting a bilevel for apnea. Thus you would need to justify it another way. Is your sleep doctor a pulmonologist? It may be worthwhile seeing one and getting some help interpreting and resolving this.

RE: What could be causing prolonged periods of shallow breathing? - JoeyWallaby - 11-23-2019

Not me, my mother.

2 minute segment like this? Tidal volume and minute vent drop significantly in the shallow breathing parts while resp rate stays the same. Don't know what that means.
[Image: dVAWPpT.jpg]

RE: What could be causing prolonged periods of shallow breathing? - Gideon - 11-23-2019

That's 5 minutes, the idea is to really show the detail of the individual breaths during the reduced breathing. so modifying the y axis scale would also be helpful for this shot. The total duration for the night (you will have to manually add them) may have some interest.