Variable Breathing always 60%+ - Concerned

Hello,
I have severe osa and purchased an auto m-series and with J. Skinners program my variable breathing is 98% of the time over 55% up to 75%. I have tried auto and cpap mode and cflex 1,2,3 and off and still high. I noticed if I take 1/4 mg of Klonopin a couple hours before bed the VB drops to 25%. I have no known breathing disorders other than OSA with an AHI at the PSG over 100. I went to a cheesy sleep lab last time and was titrated at 15 but I wonder if they missed something and if I should go to a better lab instead of the cheesy one? Could I need a special machine? My AHI remains 5-10 if I set the machine 10-15 11-15 12-15 13-15 straight 14 or straight 15 and if I go over 15 I really fill with air in the tummy. I don't fall asleep during the day anymore but I don't feel right. I wonder if it could be related to antidepressant use or BP meds? Should I just ignore the VB or go to a better clinic.

Thanks

We recently had a very long thread in regard to one person who had very erratic respiration (VB) and also took medication before going to sleep.

VB on the Respironics is detected as an erratic rate of breathing and it is considered to be a problem for the AUTO's algorithm (it destabilises it) so the AUTO takes this approach to trying to reduce VB - reverse pressure in 0.5 CMs increments - that is revers from the last direction it was moving in before the VB was detected)
IIRC, It does this adjustment every 2 mins but if after a couple of tries the VB has not reduced it reverses pressure direction again & tries for a few goes. If that fails it locks the pressure for 15 mins.

In effect (in regard to erratic breathing (VB)) the machine is mostly concerned with if its recent pressure adjustments caused erratic breathing. It can't specifically fix erratic breathing but it can try to go back to a pressure that causes the least amount of it.

VB is when someone breathes at different speeds in an erratic fashion - it can be caused by medication or by some other disorder.

DSM

Browser, are you a guy or a gal?

Do you have the results of your sleep study?

What medications are you taking?

You seem to have something in common with dsm up there, at least statistically.

98% of the time he is 55-75% wrong.

SAG

StillAnotherGuest wrote:Browser, are you a guy or a gal?

Do you have the results of your sleep study?

What medications are you taking?

You seem to have something in common with dsm up there, at least statistically.

98% of the time he is 55-75% wrong.

SAG

SAG

Instead of just making an ass of yourself, just politely point out what is incorrect & do it in words people can make sense of then we may actually learn from you rather than always be wondering what your point is & why you come here.

Cheers

DSM

Now if I want to watch the 3 stooges, I prefer to do it from their old TV shows - not here

That was funny. If you look at his picture he is very distinguished looking. I can't believe he is wrong that often. I have read many of his posts and he seems very intelligent. I am a male 6ft 250lbs. I take an antidepressant(SSRI) and BP med and nose spray(Steroid). I feel anxious often during the day and I read a post here about breath holding and I have noticed since I was a kid that I do that often when changing positions watching tv or after I wake up in bed - don't know why but I have always done it. I have my study results.
73 minutes to fall asleep (Noisey lab where they kept a cold fan running in my room to try and drown out all the noise they made-their words)
Slept just over 4 hours
Sleep efficiency 61% (Due to lab conditions-my opinion)
Some slow wave delta sleep was seen in later part of the night once cpap was applied
Onset to initial REM sleep was normal but a decreased proportion of overall rem sleep was seen
No PLM
During initial 3.5 hours of the night he slept for 2.2 hours for a sleep efficiency of 64%
During this time there was considerable disordered breathing seen with 185 OA and 52 HA
Repetitive arteial O2 desaturation as low as 78% in REM sleep with frequent episodes of desat below 90% from baseline of 94%
As a result of the frequency of apnea events there was prolonged sleep time below 90% SpO2.
Loud snoring was heard
Sleep ECG appeared normal
Cpap was applied and took just over an hour toresume sleep
Slept just over 109 minutes for a sleep effeciency of 58% of the remaining 3.1 hours in bed
During Cpap there was some consolidation of slow wave (delta) sleep seen and a reasonable amount of of REM sleep was evident
Minimal disordered breathing was seen with only 1 HA for an RDI of 0.6 per hour with treatment
O2 remained between 93 and 96%
Cpap was initiated at 7cm and he was unable to tolerate and it was raised to 10cm eventually this was raised to 15cm to overcome reidual snoring
He slept for 1.8 hours with no evidence of disordered breathing
Sleep stages - no treatment
Rem=13.5%
1=1.1%
2=85%
3=.4%
4=0%
Sleep stages with cpap
Rem=16.5%
1=4.6%
2=61%
3=17.9%
4=0%
Sa02 no treatment
Awake average = 94% With treatment = 96%
Lowest = 78% With treatment = 93%
Average desat = 8% With treatment = 4%
Lowest Sa02% = REM non-back 78% Non-rem Non-back 83% With treatment = Rem Back 94% Non-rem Non-Back 93%
Respiratory events=
OA = 184 Mixed = 1 Central = 0 Ha = 52 With treatment = OA 0 Mixed 0 Central 0 Ha 1
RDI = OA 83.0 Mixed 0.5 Central 0 Ha 23.5 With treatment = OA 0 Mixed 0 Central 0 Ha 0.6
Average duration OA 18.6 sec Mixed 13.5 sec Central 0 sec Hi 19.5 sec With treatment OA 0 Mixed 0 Central 0 Ha 29.4
Longest duration Total apnea = 36.6 sec Ha = 50.9 sec With treatment Ha 29.4
Number in NREM Oa = 169 Mixed = 1 Ha = 44 With treatment OA 0 Ha 1
Number in REM Oa = 15 Ha = 8 With treatment Oa 0 Ha 0
NON TREATMENT Respiratory arousal index = REM = 0 NON_REM = 45.7
Average HR = 71
Average HR assoc with AHI = 71
ARO RES - Rem = 0 Non-rem = 45.7
ARO Spont - REM = 8.2 Non-rem = 6.3
ARO Limb - O across the board
RERA - 0 Across the board
Snore 0.3 in Non-rem
Cpap - 10 12minutes - No events
Cpap - 12 20minutes - 1 Ha
Cpap - 15 79minutes - No events
Epworth score = 16
Note- Gained 10 pounds since study approx 2 years ago
Thanks

dsm is making an importat point, SAG.
That statistical "joke" doesn't help anyone understand what you consider wrong in dsm's present analysis.
Not funny.

Edit: Above composed before Browser's response.
Added:
Not funny.
O.



-

What did I step in here? No worries people... I appreciate "ALL" comments on my post... I thought it sounded like the first comment was mean but funny the way it was presented and the reply was equally mean but also funny the way it was presented and maybe a deserved response to the first comment. It's all good. Now back to the comments please.

Thank You All !

obviously poor judgement on my part.

Snoredog

Aha, so we can blame you then

(actually I was going to beg you to do another 'Frequie' revenge number on our friend SAG but seeing as you are taking responsibility for him posting like he does I guess I can't proceed )

DSM

Browser wrote:What did I step in here? No worries people... I appreciate "ALL" comments on my post... I thought it sounded like the first comment was mean but funny the way it was presented and the reply was equally mean but also funny the way it was presented and maybe a deserved response to the first comment. It's all good. Now back to the comments please.

Thank You All !

SAG is the real life sleep pro on this forum - he has his own brand of humor - often very funny, and his frequent professional contibutions are a fantastic resource - make no mistake about it, Browser, you're in good hands.



O.

Me thinks they titrated you chasing snores.

Browser,
My humble apologies for getting sidetracked the way I was. This is your thread & your issue is the topic we need to focus on.

DSM

Snoredog wrote:I think he was kidding dsm, haven't you seen me and -SWS argue? He still hasn't learned how BPM mode works yet

I agree that was definitely a typical SAG witticism. However, about that second crack of yours: and what pray tell is wrong with my understanding of the BPM (blood pressure monitors) that are built into all these machines? Sometimes you make no sense...

Browser wrote:I noticed if I take 1/4 mg of Klonopin a couple hours before bed the VB drops to 25%.

Klonopin inhibits the central nervous system. That kind of touches on one of echo's grand unified theories. She has been unmercifully pestering others here regarding spontaneous arousals and variable breathing---quite possibly being linked to these fairly common neurologic traits: http://www.hsperson.com/index.html

Browser, if you happen to score positive on that self-test, echo is never going to let us hear the end of how she and her grand unified theory practically saved the whole universe.

So Browser, do you mind sharing how you scored on the HSP screening test in light of your Klonopin results? Please ignore this request if you'd rather not share that information. I also look forward to hearing SAG's professional analysis in response to your answers above.

dsm wrote:SAG

Instead of just making an ass of yourself <snipped>

Now, that was funny, considering who is saying what to whom.

I happen to agree with SAG's humorous assessment:

98% of the time he is 55-75% wrong.

Browser, ozij has given you a very good lead to follow, imho, when she wrote:

ozij wrote:SAG is the real life sleep pro on this forum - he has his own brand of humor - often very funny, and his frequent professional contibutions are a fantastic resource - make no mistake about it, Browser, you're in good hands.

O.

Browser, I'd suggest you not get sidetracked by what some of the well-meaning, eager helpers on this board start writing (and writing, and writing) and really concentrate on the direction SAG is heading to help you, starting with:

StillAnotherGuest wrote: Browser, are you a guy or a gal?

Do you have the results of your sleep study?

What medications are you taking?

In addition to SAG (a credentialed sleep professional), a very intelligent layperson on this board I'd pay attention to is -SWS. I always zero in on ozij's posts as well. There are other members I've been especially impressed with and have gotten very good information from. People like wulfman, kteague, Dream Stalker, Slinky, Hawthorne, bdp422, rooster, Jules, birdshell, snoregirl, and soooo many more.

Browser, I faced the same dilemma I think you may be in, when I first started trying over five years ago to educate myself on how to get the best treatment possible. It was on a different apnea message board back then (cpaptalk.com had not been created yet) -- but I still remember digging in to read every post I could, trying to sift through the confusion and figure out two things:

1. WHAT was being talked about? -- new lingo, new terms, new abbreviations.

2. WHO, of several that posted a LOT, seemed to really know what they were talking about? -- and who doesn't -- despite talking a good game. That (imho) can be the hardest part of the learning curve when a person first comes to a forum like this for help.

There can be a great deal of misinformation, misguided notions, and faulty conclusions presented as "fact" to sift through. There are also amazingly wonderful nuggets of gold to be found. Everyone, even the professionals, can be right sometimes, wrong sometimes.

What I looked for when I was getting started was,

"Who seems to be giving correct information most of the time?"

Only you can answer that for yourself.

Oh, and about this...

Browser wrote:What did I step in here?

Good question. Actually, all you stepped into is a message board where people have strong opinions, quirky senses of humor, lots of egos, and a strong desire to help in any way they can. Start sifting....

Yay !

Good ole RestedGal

Putting out fires with gasoline
Please remember whose thread it is !

DSM