flow rate and central apnea questions

Hi, all. I'm a few months into CPAP treatment, but I'm not noticing any improvement in terms of my fatigue. I suspect there's something else besides sleep apnea going and I'm using Sleepyhead to figure out as much as I can. I have an S9 CPAP with a nasal mask, am compliant, and most nights my AHI hovers around 4 or 5, and unintentional leaks for the most of the night are typically below 20 (medians under 10).

I've been using sleepyhead to track this stuff over the last couple of months and only reading some of the other threads yesterday did I realize that there's still a lot I don't know and could check out.

1 - I observe that most of the events that are flagged are clear-airway at this point. When I zoomed in on a sample of these instances over different nights, I can see that they sometimes happen at about the same time as a change in leakage. While this makes sense when leak goes from lower to higher, I also noticed it's picking up events when a leak goes down or disappears altogether. Any insight as to what that could be or to improve on that?

2 - I was reading about the more obscure breathing patterns that could be abnormal, and I wanted to attach a few small samples of what mine looks like under ideal conditions (i.e., no events, no leaks) at varying times of different nights, but I wasn't sure how. I'll resort to describing the pattern on the flow rate graph for now. In one minute it seems I take about 16 breaths. The waves usually go from around -20 to +20 (sometimes +/-15, sometimes +/-30 but the amplitudes are steady in the one-minute samples). The tops and bottoms of the waves are sort of v-shaped, with the bottoms being a bit more pointy and not quite as low as the tops are high. The graph then wraps tightly around zero before the next breath. The time spent around zero is almost as long as the wave part. Does this sound like the right frequency/amplitude/shape?


Thanks for any help.

You can use the snip tool or other to post graphical information. Theres a tutorial on it. Can you describe your fatigue specifically? Do you awaken refreshed but feel physically tired later. Do you awaken sleepy? Are there other correlated issues--antihistamine use, alcohol of any kinds, prescription meds, health or heart issues? Any history of cheyes stokes?

awakeinnj wrote: 1 - I observe that most of the events that are flagged are clear-airway at this point. When I zoomed in on a sample of these instances over different nights, I can see that they sometimes happen at about the same time as a change in leakage. While this makes sense when leak goes from lower to higher, I also noticed it's picking up events when a leak goes down or disappears altogether. Any insight as to what that could be or to improve on that?

I was going to post a question regarding all the centrals my machine has been recording when I read your post. Turns out my centrals were mostly at the same time as a change in leakage too!

It could be that we are awake during that time and is tossing + turning in bed, causing temporary leaks. I did notice that when I wake up or go back to sleep (e.g. during a toilet break), centrals would be recorded.

My worse unintentional leaks are just 1.20 median and 2.40 95% L/min however.

Cpaptalk com

Here are the graphs. Hopefully I'm doing this right...

http://s1265.photobucket.com/user/awake ... sort=3&o=0

Thanks.

Does anyone have any insight? Thanks.

awakeinnj wrote:Here are the graphs. Hopefully I'm doing this right...

http://s1265.photobucket.com/user/awake ... sort=3&o=0

Thanks.

I see what looks like it might be snoring here and there, or maybe you've got a pug dog like pugsy that has a breathing problem too...

I actually don't have any audible snoring (and it only registers lightly on sleepyhead,occasionally) -- plus I could only wish I had a dog lol

awakeinnj wrote:I actually don't have any audible snoring (and it only registers lightly on sleepyhead,occasionally) -- plus I could only wish I had a dog lol

generally the sawtoothed squiggles at the tops of the peaks are snores, but you've got a lot of them at other places too... maybe moving around and rubbing the hose??

Interesting. These were samples of my regular breathing pattern during sleep - no leaks, no incidents. I don't move around all that much. I wonder if I distorted the graph when I played with the dimensions and resolution to get it right for the upload. I'll see if I can get another sample or two.[edited - here's the link:]

http://s1265.photobucket.com/user/awake ... 2.png.html


An aside: my home study, which wasn't completely helpful, didn't pick up any snoring issues. And during the in-lab titration study, I slept just enough for the dr to say that yes, I did have moderate sleep apnea. It wasn't useful for much else. I'm trying to look at everything, though, but something tells me my problem goes beyond sleep.