Excessive Periodic Breathing - Help....

[gregbe2000]

Thanks for the explanations of waxing and waning and EPR. I tried a static pressure of 5.4cm last night and didn't have success. Still a lot CAs and CSR. Even much of the flow that's not tagged CSR has the same waxing and waning form. I was hoping a lower pressure would remove the CAs and waxing and waning but it didn't. I'm not sure what to try next - maybe I shouldn't even use the CPAP until I can see my sleep doctor next as I'm not sure if this is helping or hurting me. I continue to feel very fatigued in the morning and function.

I've had my Oxygen tracked in my last sleep study in 2020, which was without a CPAP on. The min was 88% and mean was 97%. I wear a garmin watch to bed and that tracks it too, maybe not super reliable, but it states it was above 90% at all measurements last night. I'm sure I'll be getting another sleep study, hopefully soon, and I'll have it tracked for this. The last sleep study report says "No" to Cheyne Stokes breathing but has 18 central apneas with an index of 2.9 - I guess that wasn't considered material. I also had 46 PLMS events with an index of 7.4 - again, I guess not considered material.

In anyone has any suggestions I could sure use them...

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[robysue1]

I'm not sure what to try next - maybe I shouldn't even use the CPAP until I can see my sleep doctor next as I'm not sure if this is helping or hurting me. I continue to feel very fatigued in the morning and function.

What was your diagnostic AHI on the last sleep test without the CPAP on?

Because as soon as you quit using the CPAP, your obstructive apneas and obstructive hypopneas are going to come roaring back.

[gregbe2000]

My last sleep study had an AHI of 8.7 (composed of hypopneas 5.8 and central 2.9).
My RDI was 21 (due to RERAs of 12.3).

So not that bad - this was characterized as moderate sleep apnea. I've assumed my sleep quality has been so bad due to the # of arousals (31.7/hour) that were brought upon by apnea. My first sleep study in 2008 had an AHI of 37 and RDI of 38. I had a sleep surgery that didn't work, but later had my deviated septum fixed and that improved things in terms of the #'s (but not my perceived sleep quality). I've always had a high number of arousals/awakenings. None of my sleep studies found CSR - so maybe CPAP has made my condition worse and more complex.

[gregbe2000]

Update.

I thought I was only a side sleeper, but I video'd my sleep and I sleep on my back 50% of the time. I correlated this to my oscar data and the CSR stuff was only flagged when I was on my back. I slept with a backpack on last night to force side sleeping. While me sleep was horrible, CSR wasn't flagged. However, the waxing and waning of my respiration at certain times of the night was still there. I have an appointment with my sleep doctor early next week. I'm also going to get scheduled for a CPAP titration sleep study. Hopefully they can see the waxing and waning in my respiration. I didn't have a titration study 4 years ago due to COVID. I also wonder if my waxing and waning would show up if I wasn't wearing a CPAP. It wasn't flagged in my sleep study 4 years ago, or the ones I did in 2008. The report I got doesn't show the respiration flow charts.

See the chart below - I have periods where my respiration looks even (normal), but I have periods like this that aren't flagged for CSR (and I see some incorrect flagging for hypopneas) that have the waxing and waning flow. I assume that's not normal even if these don't technically meet the requirements for CSR.

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