RERAs -- OSA, central, unknown? Weird new breathing issue.

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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OSAHell
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Re: RERAs -- OSA, central, unknown? Weird new breathing issue.

Post by OSAHell » Tue Jul 07, 2015 5:27 am

Hi Sibbs,

The ZIP doesn't import in Sleephead... I think Sleepyhead need the whole card (meaning a zip of all the file structure on the card) to be able to do an import. Can you post again a screenshoot of Sleepyhead of your July 4 night but with a zoom in of the flow rate from 22:32 to 22:42?

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Sibbs
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Re: RERAs -- OSA, central, unknown? Weird new breathing issue.

Post by Sibbs » Tue Jul 07, 2015 7:13 am

Sibbs wrote:
musculus wrote:Maybe put the data in a shared folder or zoom in to show a typical RERA event in detail.
Two more screen caps below (RERAs followed by clear airways) and a link to the full CPAP card directory structure and files for importing here: https://dl.dropboxusercontent.com/u/177 ... Series.zip

Image
Image
Machine: Dreamstation auto BiPap
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OSAHell
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Re: RERAs -- OSA, central, unknown? Weird new breathing issue.

Post by OSAHell » Tue Jul 07, 2015 8:05 am

Thanks Sibbs for the zoom in graphs and the ZIP. I've been able to import it in Sleepyhead this time, I'll try to look at it today and come back to you with some comments.

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Re: RERAs -- OSA, central, unknown? Weird new breathing issue.

Post by Sibbs » Tue Jul 07, 2015 8:36 am

p.s. All of you kick @ss here. I get so much more usable, data informed tips here than I do from my doctor. So, all hail the CPAP / sleep tinkerers!

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Hang Fire
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Re: RERAs -- OSA, central, unknown? Weird new breathing issue.

Post by Hang Fire » Tue Jul 07, 2015 10:22 am

Sibbs wrote:All of you kick @ss here. I get so much more usable, data informed tips here
Well that is good to hear and it is the same experience most of us had when we found the forum.
Sibbs wrote:than I do from my doctor
We really can't expect doctors to delve into the details the way volunteers on the forum do. Doctors don't have the time and if they took the time, it would be very expensive.

Good luck in getting everything optimized.

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avi123
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Re: RERAs -- OSA, central, unknown? Weird new breathing issue.

Post by avi123 » Tue Jul 07, 2015 11:56 am

Sibbs wrote:Hi all -- Happy 4th!

Help me to troubleshoot some new sleep events?

Background-- started CPAP therapy about 9 months ago after sleep study demonstrated OSA. Use everynight and my average AHI is in the 4-5 range with an occasional mid 6. Down from 15. Has helped immensely.

Have recently had a new phenomenon pop up. During the first hour of going to sleep have the feeling that I can't breathe; wake up suddenly with the feeling like I'd forgotten to breathe. Repeats several times during this first hour and wakes me up repeatedly. Scary feeling. After the first hour, I sleep fine for the rest of the night. Sleepyhead sometimes shows a higher than usual AHI (6-7) sometimes not. Last night, a particularly bad night, I noticed that I had 16 RERAs and 7 clear airway events over about an 1:15 period at the beginning of the night. Few elsewhere in the night.
Tapentadol can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed


This is what happened to you. Ask your Doc to give you something else instead.

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Re: RERAs -- OSA, central, unknown? Weird new breathing issue.

Post by Sibbs » Tue Jul 07, 2015 3:16 pm

avi123 wrote:Tapentadol can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed
This is what happened to you. Ask your Doc to give you something else instead.
Maybe. But no effect on breathing during the daytime hours-- or the remainder of the night. And If, as this family of meds also do, it's just making OSA worse then I can work around that with pressures.

Looking to interpret the data before settling in on a cause. In part because my connective tissue disease is a complex one without a ton of alternative meds in the long-term.
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Re: RERAs -- OSA, central, unknown? Weird new breathing issue.

Post by musculus » Wed Jul 08, 2015 7:49 am

Sibbs wrote:
Sibbs wrote:
musculus wrote:Maybe put the data in a shared folder or zoom in to show a typical RERA event in detail.
Two more screen caps below (RERAs followed by clear airways) and a link to the full CPAP card directory structure and files for importing here: https://dl.dropboxusercontent.com/u/177 ... Series.zip

Image
Image
Sibbs, I checked your data: your airway is easily obstructed (very possibly at multiple level) and treatment is not effective at current pressure. Those RERA events are mostly partial airway obstruction. You should try a higher pressure for several days and evaluate the sleepyhead results and sleep quality.

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OSAHell
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Re: RERAs -- OSA, central, unknown? Weird new breathing issue.

Post by OSAHell » Sun Jul 12, 2015 12:35 pm

Hi Sibbs,

How things are going since your last post? Have your tried musculus suggestion?

I can assure you that your not the only one having bad or no info at all from there sleep doc, I just saw for the first time my third one last week and was amaze by his answers (not in a good way)...

I finally had the time to look into your data this morning, here my first impressions:

- Your compliance is really great since the end of November
- CAs where present basically right from the start of therapy
- RERAs, CSR, CAs look pretty much the same on average since November
- RERAs happened basically only in your first 2 hours of sleep. Do you have hard time falling asleep?
- CSR doesn't seem like a concerned, at least to me (low %)
- You virtually have no snoring (which might indicate more central than obstructive problems but it's not always true)
- Your leaks seem to be a bit higher since May (they don't look problematic and might be du to higher EPAP max and to be honest I'm really no expert in leaks)
- Since you started to open up your "EPAP max" your AHI seem to be a bit lower especially since EPAP max is at 12
- Higher "EPAP min" doesn't seem to help much (at least from the 3 days I see in your data)

Do you have a copy of your full report's sleep study? There might be good infos and worth a look by people here.

Also, I think your meds affect more your "CSA" than OSA. My "little" understanding of those meds is that they often cause more "central" problems in your breathing like opioid for example. Were you on your pain med (same dose) when you got your sleep study? If not, when did you start it (or up the dose)?

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Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: SleepyHead on Mac OSX, Resmed S9 VPAP Adapt (36037), EPAP 5 fixed, PS 4-10