Is this cheyne stokes breathing?

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WildMtnHoney
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Is this cheyne stokes breathing?

Post by WildMtnHoney » Sun Mar 29, 2015 9:20 am

Image
(hope I did the screen shot ok!)

I had 24 total clear airway events last night, with 12 obstructive, and 3 large leaks (I think my mouth popped open, I remember some chipmunk cheeks). This breathing pattern is present several times, but this is the best, and you can see several clear airway events happened in a row at this time.

When I was first diagnosed, it was considered NOS and I was put on O2. Later they changed it to OSA, and I got the CPAP just 2 days ago. I didn't snore during either sleep lab study, and my husband has never reported snoring. I don't want them to be missing something. I don't see my GP until mid/late April, so I'll have more data by then. My neurologist is also interested in this, to see if it helps my morning headaches, so I will take any data to her as well, when I see her in May.

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WildMtnHoney
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Re: Is this cheyne stokes breathing?

Post by WildMtnHoney » Sun Mar 29, 2015 9:22 am

OMG it's huge! I'm sorry, someone tell me how to resize!!

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WildMtnHoney
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Re: Is this cheyne stokes breathing?

Post by WildMtnHoney » Sun Mar 29, 2015 9:28 am

Here's a different area of the same time frame, smaller pic:

Image

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Pugsy
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Re: Is this cheyne stokes breathing?

Post by Pugsy » Sun Mar 29, 2015 9:36 am

Here's a little hint for using imgur...
look on the bottom below the box of addresses and click on "Large thumbnail" and that changes the addresses that you copy just a little...then copy the last (bottom) box of the addresses and paste that code in the body of your post here.
That last code will give a slightly smaller viewing image that we can then click on and see the full image easily.

To answer your question. No, that doesn't look like CSR to me. Not enough waxing and waning (rounding) of the air flow.
See this image...and I did the "large thumbnail" linked BBC code (bottom line) so you can see how it works.

Image

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palerider
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Re: Is this cheyne stokes breathing?

Post by palerider » Sun Mar 29, 2015 9:48 am

WildMtnHoney wrote:OMG it's huge! I'm sorry, someone tell me how to resize!!
it's better when it's huge, then we can right click and 'view image' and see the whole thing, without details being reduced to fuzzyness.

also... preview button.

but best to do what pugsy said about large thumbnails, and the bottom link on imgur.

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WildMtnHoney
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Re: Is this cheyne stokes breathing?

Post by WildMtnHoney » Sun Mar 29, 2015 10:00 am

Thanks!!

Follow up question - what, if any, concern is there that my respiration rate is so high for much of the night?

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Pugsy
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Re: Is this cheyne stokes breathing?

Post by Pugsy » Sun Mar 29, 2015 10:14 am

Your overall respiration rate is within normal limits.
What makes you think it is "high for much of the night"?
Is it that high maximum? That could easily just be related to a dream (good or bad) or it might possibly be short term result of that cluster of events.

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Re: Is this cheyne stokes breathing?

Post by WildMtnHoney » Sun Mar 29, 2015 10:27 am

Ok, better question, what is a normal respiration rate at night?

During that cluster of apneas, the respiration chart shows I was near 50 for several minutes. For most of the night I hovered closer to 20-25+ than what I was "normal" for sleep which was 12-18?

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palerider
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Re: Is this cheyne stokes breathing?

Post by palerider » Sun Mar 29, 2015 10:37 am

WildMtnHoney wrote:Ok, better question, what is a normal respiration rate at night?

During that cluster of apneas, the respiration chart shows I was near 50 for several minutes. For most of the night I hovered closer to 20-25+ than what I was "normal" for sleep which was 12-18?
http://lmgtfy.com/?q=what+is+a+normal+r ... e+at+night

though, this might be easier:

http://lmgtfy.com/?q=what+is+normal+respiration+rate

in other words, don't forget there are other sources where you can repeatedly ask the same question

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Pugsy
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Re: Is this cheyne stokes breathing?

Post by Pugsy » Sun Mar 29, 2015 10:43 am

Normal respiration can vary widely and can depend on various factors and where you look
http://en.wikipedia.org/wiki/Respiratory_rate

The 95% number is not a number where you were at for 95% of the night...by definition it is where you were at OR BELOW for 95% of the night. People tend to forget the "or below" part of the definition and assume it is an overall average and it isn't.
It's the same definition whether we are talking about pressure or leak or whatever and it is easily skewed by any number of factors so I don't put it up on a pedestal.

Brief periods of a really high rate (like that 50) could easily be related to apnea events themselves (if you see the rate associated with a cluster of apnea events then it like is related) or it could just be dream related. Ever had a bad dream and wake up with pulse racing? I know I have.

Typically respiration does slow with sleep but there's still a wide range of normal and it all starts with the awake respiration rate.
If your normal daytime awake respiration rate is on the high side of normal then I wouldn't be surprised to find the asleep rate also on the high side of normal.

If this concerns you (and you don't think that you have any known lung issues which might explain the respiration rate) then by all means discuss it with your doctor to see if he is concerned.

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WildMtnHoney
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Re: Is this cheyne stokes breathing?

Post by WildMtnHoney » Sun Mar 29, 2015 10:46 am

Thanks, pugsy.

I don't mean to be difficult, but I know I am - I'm sorry.

I *did* google it.

I don't WANT to be sick dang nabbit.

I want someone to tell me that they've got this diagnosis all wrong, that I don't have to sleep with a dang mask that is causing me sores all night for the rest of my life, and I can go back to just the O2 that had I just finally gotten used to after 2 years. I don't snore. They couldn't even hear it on my two different sleep lab tests!

I want a paddle to get me up the river of de'nile, I guess.

<end pout>

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Pugsy
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Re: Is this cheyne stokes breathing?

Post by Pugsy » Sun Mar 29, 2015 11:09 am

Sorry...I am fresh out of paddles for that canoe going up the DeNile River.

I think I see where you are going with the respiration thing...hoping that there is something else going on but the spike to 50 if you saw it at the same time as a reduction in airflow and any flagged events...that's probably OSA related..and not what you wanted to hear.

Also can I add something about O2 being added at night and a person has OSA....if that airway is collapsed and no air is going through...then that added O2 isn't going through either. So just remember that little tidbit.

I don't know all your history or all the specifics to your diagnosis or situation but if you had enough apnea events to earn a machine then that's pretty cut and dry.
I do understand that sleeping with all this crap attached to us probably isn't number one on our life's bucket list but I always felt that it is what it is and I deal with it. Would I really rather sleep without this stuff...you bettcha I would rather not but with time this alternate does normally get less intrusive and less annoying.
Without this therapy my O2 drops to 73% which is scarey low and my throat/airway totally closes off and no amount of added O2 can get through the blockage. With this therapy my O2 doesn't ever drop below what are the minor normal drops that we can have in sleep. No where ever needing adding O2 for my night breathing.

If you were hoping for a more central sleep apnea diagnosis (like the CSR stuff) so that you could maybe just use O2 (which I know that sometimes that is done)....I don't see it here. If your diagnosis is predominately obstructive related...the machine is still the first choice for therapy. If for some reason you simply cannot or will not use the machine then added O2 might help keep the desats limited because it might help bring up the O2 levels after the airway opens back up but it's a bandaid on a wound that needs a better solution IMHO.

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WildMtnHoney
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Re: Is this cheyne stokes breathing?

Post by WildMtnHoney » Sun Mar 29, 2015 11:36 am

Well darn it, they don't sell those types of paddles at REI either

OK, I was wrong, they *did* hear snoring on the last sleep lab study (I coulda swore the tech told me she didn't - oh well!)

Here's the only results I have:

Image

So I guess that means that I do need the dang CPAP, huh?

I'll give it a few more nights -- ok ok, I'll give it a few WEEKS. It's only been TWO full nights, I'm not even giving it a fighting chance. My husband is now concerned that I may need PAP with O2, though. Maybe I'll invest in an oximeter with usb that talks to sleephead. le sigh.

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Re: Is this cheyne stokes breathing?

Post by Pugsy » Sun Mar 29, 2015 12:13 pm

WildMtnHoney wrote: So I guess that means that I do need the dang CPAP, huh?
Yep...and especially when sleeping on your back and especially when in REM sleep (which is quite common and I have the same thing where my OSA is much worse in REM sleep). If it weren't for the REM sleep thing you could maybe consider totally side sleeping (though that's often easier said than done) but you have no control over REM sleep so no sense in looking for that paddle for the canoe trip.

Instead of expending time and energy on the search for the paddle for the canoe trip up the DeNile River how about we expend that time and energy on figuring out how to make this whole cpap process easier and less annoying?
It will get easier with time but sometimes it takes some work to get there.

What in particular about the mask and machine seems annoying to you right now that we could maybe improve on or make less annoying?

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WildMtnHoney
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Re: Is this cheyne stokes breathing?

Post by WildMtnHoney » Sun Mar 29, 2015 12:31 pm

Pugsy wrote:What in particular about the mask and machine seems annoying to you right now that we could maybe improve on or make less annoying?
1) The sore on my nose. It did just like the last one - puffed up into a huge cyst/zit, got 5+ little white heads on it by evening yesterday, oozed, and when I took a shower and gently washed, still became a mostly open sore by bedtime. I didn't go to the store and find Lanisoh yet (bad) but I did put some of my mostly beeswax lipbalm on my nose instead last night (hope that's ok for the mask!) and that helped the sore not get bigger, and it scabbed over by this morning. I'll get lanisoh today.

2) Dry mouth and chipmunk cheeks. They seem to go hand in hand. I get chimpmunk cheeks, which wake me up with a puffy face, I open my lips to let the air out, and I notice my mouth is dry. I read around on here that biotene helps. I can get some when I'm out today.

Other things that I've already sorta worked out:
3)The hose was getting tangled, but there is a gap between our headboard and the wall, so I draped the hose over the headboard last night, and that helped a lot.

4)My nose gets dry, and I woke with bloody boogers the first morning. I have Ayr that I used the first year with O2, so I pulled it out and shoved it up my nose last night - no bloody boogers this morning. Question though - would turning up the humidity help? It's currently at 4, but I live in arid CO.

5) I have a had a DVT in the past, and my valves in my veins are shot in my left leg, so I sleep with a ramp pillow to keep my legs elevated at night, meaning back sleeping most of the time. However I'm learning to adjust to sleep on my side and still keep my legs up.

I don't think I've said it yet - so THANK YOU!! You've been very patient with me, and I really appreciate all your help.

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