What the &*!@# is this?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Darth Lady
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What the &*!@# is this?

Post by Darth Lady » Tue May 26, 2015 3:09 pm

I've had milder versions of this kind of breathing all along, but it's been getting more extreme, and last night I had a spate of this, several times (although mostly without the hypopneas) :

Image

I can't complain about my AHI; this is actually high for me. But it sure doesn't look like I'm getting very good rest here.

Would setting PS min to some number >0 help to keep this from swinging so wildly, perhaps?

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Julie
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Re: What the &*!@# is this?

Post by Julie » Tue May 26, 2015 3:22 pm

Did you inadvertently end up on your back for much longer than usual?

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Re: What the &*!@# is this?

Post by Darth Lady » Tue May 26, 2015 3:26 pm

No idea, Julie. I sometimes do sleep on my back, but unless I wake up that way, or Sweetieboo sees me, I can't associate it with any particular period of time.

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Re: What the &*!@# is this?

Post by grayghost4 » Tue May 26, 2015 5:41 pm

Sweetieboo

If "THE WIFE" called me that I think I would %@*)!@#
If you're not part of the solution you're just scumming up the bottom of the beaker!

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Re: What the &*!@# is this?

Post by poppi2 » Tue May 26, 2015 5:46 pm

I thought she was referring to her pet.

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Re: What the &*!@# is this?

Post by Darth Lady » Tue May 26, 2015 6:30 pm

My pet husband! Who has bravely attempted to sleep through four in-lab sleep studies with me (for religious reasons, I couldn't be alone with a male tech, which is all the lab had)!

That's spousal dedication. And it's his birthday today, so play nice .

Now, as he'd much prefer it if I kept breathing for a few more years, anyone got an idea what the @$!*& in my Sleepyhead report is?

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Julie
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Re: What the &*!@# is this?

Post by Julie » Tue May 26, 2015 6:34 pm

Could you have had your head scrunched down, narrowing your airway (and calling for a cervical collar)?

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Re: What the &*!@# is this?

Post by Darth Lady » Tue May 26, 2015 6:45 pm

Julie wrote:Could you have had your head scrunched down, narrowing your airway (and calling for a cervical collar)?
All I can say is I didn't wake up that way, at least that I remember. The one wake that I remember, I was on my side, with my head in a normal position. Also, that chin-jamming position tends to make me snore, and there isn't any of that recorded.

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Re: What the &*!@# is this?

Post by ChicagoGranny » Tue May 26, 2015 8:06 pm

Are you just worried about data or did you feel excess sleepiness and low energy the next day?

Show the machine pressure graph. There are no sensors that measure the mask pressure.

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Re: What the &*!@# is this?

Post by Darth Lady » Tue May 26, 2015 8:36 pm

New and improved. Since we've got a closeup, I've squished it a bit to show a bit over 15 minutes of the grossness.

Image

In answer to Granny's question, yeah, I'd like to know whether this phenomenon (which is increasing) is something to be concerned about, or just shrug-worthy. My sleep hasn't changed that much since I started therapy. The one improvement to my sleep I've noticed lately (and yes, it's an improvement) is that I remember fewer wakeups at night, so I may have somewhat better sleep efficiency. Or not. I still feel pretty tired days, although I make an effort, not always successful, not to nap. I'd call today an average day, not too energetic, but "muscling through."

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Re: What the &*!@# is this?

Post by palerider » Tue May 26, 2015 8:59 pm

ChicagoGranny wrote:Show the machine pressure graph. There are no sensors that measure the mask pressure.
it is technically correct that modern machines don't have a sensor that directly measures the mask pressure.

however, the mask pressure chart is the reading from the pressure sensor, corrected to included the mask and tubing resistance, so it is a functional measured pressure trace, whereas the 'pressure' chart is a commanded pressure readout.

for an ASV, the mask pressure trace is much more informative of the performance and behavior because it shows the breath by breath activity of the ASV, whereas the pressure trace does not.

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Re: What the &*!@# is this?

Post by Darth Lady » Wed May 27, 2015 6:42 am

Thanks for the clarification, PR - I'm always glad to learn new things about this complicated creature that sits on my bedside table

Now, for last night's offering, complete with that thing that SleepyHead calls "CSR"
Image

Actually, I've been getting nailed for "CSR" periodic breathing more nights than not lately - again, that's new. At what point is it a problem?

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Re: What the &*!@# is this?

Post by ChicagoGranny » Wed May 27, 2015 7:21 am

Darth Lady wrote: I still feel pretty tired days
I see you posted this a few months back ->
I too am not a fan of prescription meds, and sadly, I've gone from 0 to about five of them because of one illness, for which sleep apnea may even have been the root problem!
What's the situation today?

And sorry I don't know, but why were you prescribed ASV?

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Re: What the &*!@# is this?

Post by robysue » Wed May 27, 2015 8:29 am

Darth Lady wrote: Now, for last night's offering, complete with that thing that SleepyHead calls "CSR"
Image
Actually, I've been getting nailed for "CSR" periodic breathing more nights than not lately - again, that's new. At what point is it a problem?
Darth Lady,

I'm not an expert on ASV machines, and I do wish that Morbius would stop by and offer his views of what's going on.

For what it's worth: The mask pressure graph is showing that your machine is stepping in an increasing the IPAP pressure a in an effort to "stabilize" the breathing in some way---i.e. the whole thing about periodic breathing is that it can indicate that there's a problem of a CO2 undershoot/overshoot cycle developing. These CO2 undershoot/overshoot cycles often occur with central sleep apnea and the whole idea behind ASV therapy is that the machine can/will respond to the subtle shifts in breathing that indicates there's a potential for going into a CO2 overshoot/undershoot cycle; and the way the machine responds is by increasing the IPAP appropriately to prevent the undershoot part of the cycle from developing.

Also for what it's worth: Sleepy Head mislabels "Periodic Breathing" (as scored by the PR System One machines) as "CSR". Cheney-Stokes Respiration is one type of periodic breathing, but there's a lot of periodic breathing out there that is not really CSR. Whether yours is real CSR or not is an important question. To my very NON-expert eyes, I'd say it doesn't quite look like full blown, real CSR.

Could you remind us why you were put on an ASV machine in the first place? Was your original diagnosis central sleep apnea? Or did you develop problems with centrals after you started xPAP for OSA and then were switched when the centrals didn't resolve themselves after a few weeks?

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Re: What the &*!@# is this?

Post by palerider » Wed May 27, 2015 8:39 am

Darth Lady wrote:Thanks for the clarification, PR - I'm always glad to learn new things about this complicated creature that sits on my bedside table

Now, for last night's offering, complete with that thing that SleepyHead calls "CSR"
put your eyeballs back in their sockets

sleepyhead is *wrong*. the prs1 machines have a flag for "Periodic Breathing".

the new resmeds have a flag for CSR. when mark was updating sleepyhead for that, he ended up mistakenly labeling the Periodic breathing flag the same.

you can go into the settings and relabel that chart to say periodic Breathing.

csr is a specific type of periodic breathing... but your machine does not check for that specifically.

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