Errant readings, breath control, cardiac stuff, etc

[mralaska]

Greetings all - Things have been topsy turvy these days and I have not been around much but I am wondering if the charts below can be attributed to some errant machine readings for some reason or just a loose nut strapped to the mask. I have seen short periods of wave-forms resembling these but never extended like last night. I was hard pressed to find more than 30 seconds in a row that resembled "normal" for me. The full page is my last night's overview, the focused capture is the first half hour of turning on the machine.




Last night I was trying out a breath pacing app set for an hour. I am not sure how long it actually took me to drift off to sleep but I should have been awake during the highlighted time. If I was awake and the OA and CA events were a result of the machine trying to interpret my breathing exercises, which seem plausible or maybe likely, then I wonder if the other clusters may have been myself trying to control my breathing while sleeping? I found nothing on the wave-form that resembles any normal sleep patterns that I have been accustomed to over the last year (today marks one year on xPAP machine) and my AHI ended up about 15 times more than normal. The only other time it has surpassed AHI of 6 was an equipment related problem. Even then the wave-forms made sense to me but most of the time AHI is around 0-2.

Using the breath pacing app is an experiment to hopefully help control palpitations that started a couple weeks ago. When I went into ER they did not say much about the palpitations but they kept me a few days trying to get my BP down. They finally released me when they were able to keep the BP reasonable for several hours but the medication they prescribed me is not helping much even though it has been doubled since then. They would not let me use xPAP while I was there because it was not prescribed by a doctor, which I do understand, but after I was released I started back on the machine and my nightly readout looked normal until last night. During my stay my O2 stayed within specs and the staff tell me I did not snore which they said keeping the head of the bed partially elevated seems to help alleviate such breathing issues. I only mention all this extraneous stuff as an overview in case it might be related.

On the bright side I finally have a primary care physician for the first time in twenty some odd years. I have not met her yet but I have an appointment for tomorrow. First priority is getting the blood pressure under control, which spends most of its time fluctuating between "urgency" and "emergency" status, so it might take a while before we can address the sleep issues. In the meantime I am hoping the community can help provide some insights to help maintain a stable status on the sleep front. I am sure similar situations are old hat to some people but it is all new to me and more than a little overwhelming as well as unsettling. Thanks!

[robysue]

Last night I was trying out a breath pacing app set for an hour. I am not sure how long it actually took me to drift off to sleep but I should have been awake during the highlighted time. If I was awake and the OA and CA events were a result of the machine trying to interpret my breathing exercises, which seem plausible

Can you describe the breath pacing app/exercise? If it involves any kind of "slowing" your breath down, particularly by pausing between the exhalation and the inhalation, then it's possible that the breathing done with the breath pacing app might look like sleep disordered breathing to the machine.

You could test that hypothesis by breathing with the breath pacing app for 30-40 minutes during the daytime while using the machine and then comparing the known wake+breathing app pattern to this one.

or maybe likely, then I wonder if the other clusters may have been myself trying to control my breathing while sleeping?

I have no idea how plausible this theory is. When you are sound asleep, the autonomous nervous system is in charge of your breathing. When you are awake, the voluntary nervous system controls the breathing. And it sounds like the app is designed for helping you to consciously control your breathing while awake.

[mralaska]

Thanks Robysue - the exercises were more designed to take deeper breaths more than slow them down but the deep inhalation and exhalation led to a much slower than normal breathing. When I am sleeping I usually get around 15 breaths per minute. When I finally got a pattern for the exercise that felt like it was in sync and comfortable to breathe deep it was closer to 2-3 breaths per minute but there was a second or two of pause between each inhale & exhale. When I pause breathing while drifting off to sleep I can often feel the pressure pulse but perhaps I need to be super relaxed to be aware of it.

I agree that I should have reverted to normal breathing upon falling asleep. I was just trying to make sense of something that makes no sense to me yet.

[rick blaine]

Devices such as RESPeRATE and Kinetik, and various breathing exercise sequences such as 'breathe into the abdomen ... and breathe in for a count of two, breathe out for a count of four, hold on empty for a count of four' are all designed to retain CO2 and normalize blood gasses.

A related instruction is to 'aim for 12 or fewer breaths per minute. Eight is fine.'

Such deliberate breathing leads to an increase in parasympathetic activity, and thus (it is hoped) to the lessening of many symptoms - including a reduction in blood pressure.

Do not, repeat, do not do these exercises while on XPAP - and while trying to get off to sleep, or while still dozing half-awake in the morning - unless you want to get crazy-looking and/ or unexpected results. XPAP machines such as the PR S1 561 will categorize and record this kind of breathing as centrals.

These bp-reducing devices and exercises may have a place during the daytime, whilst under wakeful control - and for not more than 10 minutes at a time - and done not more than five times a day. But done while on XPAP what they do is muddy up the waters.

[mralaska]

Thanks rick blaine - that all makes sense and confirms my limited experience. I don't think paced breathing is a solution for me! The night before last, which I posted about, I had the training app set to run maximum length. I am harboring the belief that the clusters after I fell asleep were the result of waking up barely conscious and trying to re-sync with the app's audio prompts.

Last night was slightly different. I recovered an old playlist I recorded from a CD of an obscure Asian artist which for some reason resonates with me as the most relaxing music I have ever heard. Listening to that while hypnotizing myself on Winamp's visualization plugin I was able to get some sleep despite some physical discomfort. Before drifting off I was deep breathing out of habit from the night before (I tend to form bad habits very rapidly) and true to form I had a large cluster of recorded events right at the beginning of the session but it led to a much more restful night after that with a normal sleeping waveform.

On a side note since I brought it up: if anyone can identify this artist I would love to know if it is possible to track down more of her music or even find out what she is singing about (gotta be about love, I suppose). The Asian girls said she was Thai but nobody knew her name and the few Thai people I met were not literate in their native tongue so they were unable to translate anything or even confirm if the language on the jacket is actually Thai. THe links below are scans of the CD cover and a sample of kinda what she sounds like (afraid the optimized upload sounds a bit rough on the stream).

CD front jacket inside and outside: http://i.imgur.com/El9csmk.png
CD rear jacket: http://i.imgur.com/IS4SBPJ.png
CD front: http://i.imgur.com/llEB7R1.png?1
MP3 of first track: http://picosong.com/KRcs

[Sir NoddinOff]

I've used Steven Halpern's music, consisting of binaural beats and drone components, to help me sleep. Since you use Winamp, you might get free Audacity audio editing software and mix whatever sounds you like. Audacity allows you to easily 'cut and paste' to make MP3 tracks as long as you like.

https://en.wikipedia.org/wiki/Binaural_beats

https://www.amazon.com/gp/product/B0011 ... go-ffsb-20

http://www.audacityteam.org/

Here's some other sounds that some people like:

https://www.amazon.com/Schumanns-Resona ... KW6KCAR8G1

Sometimes I get tired of the binaural beats etc and just play MP3s of some bird songs, babbling brooks, wind in the trees... all available free on Youtube and elsewhere. I use a Naxos CD player that supports a large SD card which holds all my edited music/sounds. As a bonus, all this stuff helps mask traffic noise, barking dogs, radios playing etc.