Collection of Oddball Flow Graphs

jnk suggested that someone start a thread on oddball graphs, so I'm obliging him.

This here graph looks like what -SWS described as "breath stacking". Maybe some of you can confirm or correct that appellation. There's a nice French word so brain_trust will drool instead of being irritated. Note the flow graph at the bottom. During the inhale phase, there are two peaks with a zero between and no exhale, so I think it is breath stacking. And for those of you not used to reading my charts (why, that would be everybody but me), this occurred right at the start of the first REM period for the night. (See the Tidal Volume for REM identification. Don't need no stinking Zeo with a chart this clear.)




If you have an example like that, or another oddball graph, post it.

LoQ wrote:During the inhale phase, there are two peaks with a zero between and no exhale, so I think it is breath stacking.

I agree with your breath stacking interpretation, LoQ. Thanks for sharing that!

Below is my own S9 oddball mystery. The left-most inhale and exhale humps are my "normal". Then commencing around 05:01:25 I have about 3 inhalations with very little exhalation for a while... Then finally one long exhalation commencing around 05:01:35. Interestingly there were no recorded A, H, or FL during that time---and no recorded leaks either. Perhaps that was acid-refluxing on my part, perhaps an event similar to breath stacking, perhaps expiratory obstruction, or...

...

And while this is not at all a common morning for me, it's what happens when I repeatedly try to doze off, then wake, then doze, then wake, then doze, then wake, etc.:



Here's the likely explanation with all that early-morning wake-to-sleep central instability on my part: Ventilation is unstable during drowsiness before sleep onset. The bottom flow graph reflects periodic breathing ("central instability") BEFORE I start presenting a dense cluster of central apneas----amidst my wake/sleep/wake/sleep/wake/sleep early-morning transitions.

Moral of the story: just get up and stay up!

-SWS wrote:Below is my own S9 oddball mystery. The left-most inhale and exhale humps are my "normal". Then commencing around 05:01:25 I have about 3 inhalations with very little exhalation for a while... Then finally one long exhalation commencing around 05:01:35. Interestingly there were no recorded A, H, or FL during that time---and no recorded leaks either. Perhaps that was acid-refluxing on my part, perhaps an event similar to breath stacking, perhaps expiratory obstruction, or...

Alright, now what is expiratory obstruction? When I suggested that I have that, you called it a "leak." Heh.

I have my own collections similar to that. Looks like a two-year-old grabbed the marker for a bit and went to town, then gave it back. A lot of mixed up breathing. I have always assumed it was associated with coughing, clearing the throat, or other normal but not regular breathing phenomena.

-SWS wrote:And while this is not at all a common morning for me, it's what happens when I repeatedly try to doze off, then wake, then doze, then wake, then doze, then wake, etc.:

Whoa! Those clusters of apneas are wicked looking! It's scary to look at that.

What kind of machine do you use?

Here's another of mine. I'm calling it exhale stacking:



Annotated and color-coded for your viewing pleasure.

I call this one "Man's Inhumanity to Man".

brain_cloud wrote:I call this one "Man's Inhumanity to Man".

And I call it Brain_Cloud's Big Fraud. Heh.

LoQ wrote:

brain_cloud wrote:I call this one "Man's Inhumanity to Man".

And I call it Brain_Cloud's Big Fraud. Heh.

Dude, why so cynical? I'm hurt.

Here's one FROM WHEN I'M ACTUALLY ASLEEP that shows variations on breath stacking. As a bonus, I'm showing you a baby apnea, often misidentified as a hypopnea. Heh.



OK, -SWS, does that look like leaking to you? If not, please comment on whether you think the area under the curve for the red circled "breath," if you can call it a breath, is equal to the stuff above the line. (Part of the exhale is out of the oval to the right.) Not hardly looking like that to me. Not looking like those things you called leaks, either.

One good thing, this chart seems to have more incisors than molars in it. Or maybe that's just wishful thinking on my part.

LoQ wrote: OK, -SWS, does that look like leaking to you? If not, please comment on whether you think the area under the curve for the red circled "breath," if you can call it a breath, is equal to the stuff above the line. (Part of the exhale is out of the oval to the right.) Not hardly looking like that to me. Not looking like those things you called leaks, either.

Tough telling when there are only a couple inhalations IMO... However, at 15 nearly-identical breaths or better yet 15x15, I think guessing becomes a little easier.

LoQ wrote:

-SWS wrote:And while this is not at all a common morning for me, it's what happens when I repeatedly try to doze off, then wake, then doze, then wake, then doze, then wake, etc.:

Whoa! Those clusters of apneas are wicked looking! It's scary to look at that.

What kind of machine do you use?

That was my first reaction when I saw a somewhat rare central-apnea morning like that in my data collection. I use an S9 AutoSet, so it will not raise pressure on those central apneas by design. The ASV type algorithms would treat those. My doctor wrote a script for an ASV trial---and if the hours, frequency, or density of those horrendous-looking central-apnea mornings pick up, I'll probably at least trial an ASV.

I'll also point out that most heart attacks occur between the hours of 4am and 10am. So I'm watching and trying to avoid those crazy wake/sleep/wake/sleep/wake mornings. Thank goodness they're kind of rare so far...

This looks like a central hypopnea to me:



Note that the flow limitation was 1.00 (no limitation) or nearly 1.00 throughout the hypopnea; you can find the hypopnea on the Flow graph. However, the minute ventilation plummets from 10.75 to 4.13 during the hypopnea, consistent with the decreased flow. No flow limitation, but dramatic drop in ventilation. Interesting, no?