Periodic breathing during REM

[ShadowGallery]

Hi guys.

I've noticed that I have constant waxing and waning breathing patterns during my REM sleep. This isn't 100%, and I have no EEG to prove that it is really REM, but Fitbit fitness watch that I am using and data it produces during sleep perfectly matches these patterns. In other words, when Fitbit claims I was in REM, in Sleepyhead I can see this periodic breathing, and I've noticed this correlation on every day I compared.

Here is what it looks like when I am not in REM



And here are several instances when I am in REM:









I have many more examples, but hopefully these are enough to give you the idea.

Has anyone else noticed this?

FYI I am currently on fixed 5cmH20, no EPR. The value is low because I am looking for my ideal pressure. I don't think any of that is affecting it, which is why I am asking for your opinion. I also do understand that REM breathing is expected to be a bit irregular, but this seems borderline chayne-stokeish to me in some areas.

[ShadowGallery]

Today I compared the data and noticed I had the same patterns last night. They matched the Fitbit graph to a minute and had the same breathing patterns that would start and end at nearly exact times.

For the sake of the discussion, here is what the Fitbit graph looks like:



As you can see, I can hover over certain areas, and see at which time span they happened. Then, when I look at Sleepyhead data, I can see that those breathing patterns match almost perfectly.

Is there any sleep doctor that can verify this? Also, is this normal?

[Pugsy]

Could you post just the ordinary detailed view of the night in question?
The one that shows the basics like in this thread.

viewtopic/t158560/How-to-post-images-for-review.html

PB isn't usually alarming unless there is an awful lot of it and it has a large number of centrals in it.
What you show here isn't anywhere near considered a large number of centrals.

[ShadowGallery]

Here you go. Note that for some reason the date in Sleepyhead is one day behind the one on the Fitbit chart. But, they are the same nights.




You can see this crazy cluster between 10:05 - 10:30. This is also supposed to be REM according to the Fitbit chart above, but has a lot more CAs and Hs. Here is a closeup:

[Pugsy]

I don't see any PB/CSR breathing flagged on this report.
So your mention of PB must be from what your eye sees? Is this correct?
In the future if you post anymore detailed reports lose the snore graph and make the events graph larger. The snore graph isn't particularly useful but the events graph is. No need to redo this image though.

While there may be a little waxing and waning of the flow rate it isn't enough to earn a flag.

Here's the deal...even if this was flagged as CSR it's in such a small amount that most doctors would just shrug their shoulders and tell you not to worry about it.
You need to be talking to your doctor about this breathing pattern if it bugs you too much.
You have what appears to me to be some arousal breathing happening too which would mean a false positive flag on some of those events.
At any rate not nearly enough of anything to be much of a concern IMHO. That first cluster of CAs at the beginning of the night I would bet money that you were awake/semi awake when they got flagged.
You might watch the videos here to help you figure out awake/arousal breathing vs asleep breathing.
http://freecpapadvice.com/sleepyhead-free-software

Here's what CSR looks like when it is real and it's a worry.

[ShadowGallery]

I don't see any PB/CSR breathing flagged on this report.

So your mention of PB must be from what your eye sees? Is this correct?

Correct. I noticed the pattern and realized that there is a strong chance it is associated with REM stage. I assumed this is what "Periodic breathing" looks like, so called it like that. I wasn't aware that the machine can mark these for you.

In the future if you post anymore detailed reports lose the snore graph and make the events graph larger. The snore graph isn't particularly useful but the events graph is. No need to redo this image though.

Gotcha.

While there may be a little waxing and waning of the flow rate it isn't enough to earn a flag.

Here's the deal...even if this was flagged as CSR it's in such a small amount that most doctors would just shrug their shoulders and tell you not to worry about it.
You need to be talking to your doctor about this breathing pattern if it bugs you too much.

I was a little concerned because I noticed a correlation. But the way you explain it makes much sense.

You have what appears to me to be some arousal breathing happening too which would mean a false positive flag on some of those events.
At any rate not nearly enough of anything to be much of a concern IMHO. That first cluster of CAs at the beginning of the night I would bet money that you were awake/semi awake when they got flagged.
You might watch the videos here to help you figure out awake/arousal breathing vs asleep breathing.
http://freecpapadvice.com/sleepyhead-free-software

Yeah, you're right. Thanks!

Here's what CSR looks like when it is real and it's a worry.

Wow, these are REALLY uniform. Thanks for the images.

So all in all, you are saying that some waxing and waning, even though it happens on every REM stage (provided the data is accurate), is nothing to be worried about? This is perfectly normal for REM?

[Pugsy]

So all in all, you are saying that some waxing and waning, even though it happens on every REM stage (provided the data is accurate), is nothing to be worried about? This is perfectly normal for REM?

Yeah, pretty much.

We breathe a little differently sometimes in REM...maybe with a dream or something and you are just seeing breathing that looks a little different. Some of it might be awake/semi awake/arousal breathing and if that's the case totally ignored.
And it doesn't have to be in REM....it can be in the other stages too. You just happen to have more of it in REM (assuming the FitBit is correct).

Whatever you are seeing and whenever it is happening...not enough of it to be a concern.IMHO I wouldn't be giving it a second thought if it were my report.

[mrcrayola]

Hey SG, if you think that one segment of your graph is "crazy," I'll spare you showing what mine looks like. It would qualify as a horror movie. And I'd take your AHI any day. After six-plus months of CPAP usage, I rarely get anywhere near that low of an AHI.

Finally, I also believe that Fitbit tracks very closely with SleepyHead. I look at both every day. While the FB data is more generalized, I find it more reliable in reflecting the quality of the sleep, i.e., if I wake up rested and refreshed, there's nearly a one-to-one corollary to a FB report showing 65+ deep sleep, even if the SH AHI chart looks like a roller coaster track.

Cheers,

MC

[ShadowGallery]

Thank you, guys!

Yeah, I realize my AHI is quite low, but what I can't figure out is why am I being so fatigued on many days. The day you see in the graphs above (yesterday), I could swear I slept nearly perfectly, but I felt like a "Zombie" (in Sleepyhead terms) all the way until I took a VERY long nap later in the day.

Then, the next day (today) I slept like c*ap but I feel completely fine! It makes no sense and is it's kinda driving me nuts.

Low AHI or not, I still can not crack what is causing this fatigue. All I know is that I DO feel better since using CPAP, and on the days I feel terrible, I DO feel better after taking a nap. So it's got to have something to do with sleep. At least I think it does.

[Pugsy]

When we don't feel the good numbers like we would expect....
There's a list of stuff to look at first.

Hours of sleep.
Are those hours of sleep fragmented with a lot of wake ups.
Take any meds that might cause fatigue or poor sleep quality.
Any other potential health issues that could be a factor.

And then google "causes of fatigue" and start going down a very long list of potential culprits. Not everything is related to sleep apnea or how we breathe and thus cannot be fixed by the machine no matter how much we might want it to.