Unusual ResScan Obstructive Pattern

[idamtnboy]

Sorry, but I don't see in my detailed graphs any FOTs spikes every couple of minuts clicking in the EVENT or FLOW graphs.

Here's what the FOT looks like.

[Bandnuts]

Thank you all for your comments.

I bumped up the air flow last night to 13.6 and there was no change in the patterns. I get some nice lines until about 1:00 AM, then I go into those rolling trends or possible Cheyne-Stokes. I would love to have some opinions on the S9 before I talk with my Dr tomorrow.

I wonder if I could request some help in understanding the S9 "Auto" vs "non-Auto", as it relates to this breathing trend. So the question. IYHOs, would an S9 Auto-set (or even a totally different machine) help the condition displayed or does the auto-set feature not really address this issue and I'm fine with what I have?

I just got my machine last Sunday and if I'm going to push my Dr. for a change, now would be the time to do so. I've torn the internet apart looking for a specific opinion, but nothing direct is showing up.

Any help and info would be appreciated.

Thanks,

Band...

[Lizistired]

I think your doctor would be the one to evaluate that breathing pattern. Just make sure you get some answers.

btw notmuffy, thanks for your insight

[NotMuffy]

In the endless list of possibilities, he could have also had his titration at ~sea level, but resides in the mountains, and the Periodic Breathing is due to elevation.

[avi123]

Sorry, but I don't see in my detailed graphs any FOTs spikes every couple of minuts clicking in the EVENT or FLOW graphs.

Here's what the FOT looks like.

Hi, even going down to 10 Second scale I don't see FOT pulses in the Flow and pressure curves of the S9 Elite machine.
Let me try and enter a photo of a graph here proving my point.

Besides, notice here that the CSAD (Central Sleep Apnea Detection ) was designed by Resmed to be included only in the APAP S9 Autoset:


Excerpt:

Two previous ResMed APAP devices have utilized FOT technology
to determine the state of the airway during apneas:
the AutoSet Clinical and AutoSet Portable PII+ [3]. These
devices were designed for the sleep laboratory rather than
home use. Recent advances in motor and microprocessor
technology have enabled what was once relatively expensive
and complicated equipment to be used in a home
APAP device such as the S9 AutoSet.

Source:

http://www.resmed.com/us/assets/documen ... -paper.pdf

Besides, since the S9 Elite is a plain CPAP it is not capable raising pressure automatically in response to an Obstructive airway as the S9 AutoSet does. So installing a FOT technique in the S9 Elite would be a waste of money. It would offer only showing the existence of a Central apnea but not delivering treatment pressure as does the S9 AutoSet in cases of closed airways that are determined to be Central and not Obstructive.


As is written in the above mentioned report:

CSAD also serves an
important role in fixed CPAP in reporting the state of the
apneas that have occurred during therapy which may assist
with therapy reviews.

[avi123]

Bandnuts, I (We?) don't know what kind of ailment you got. So I can't comment what CPAP machine, if any, is appropriate for you . If your problem is b/c of a Cheyne-Stokes respiration. {This type of central sleep apnea is most commonly associated with congestive heart failure or stroke, and it is characterized by a rhythmic, gradual increase and then decrease in breathing effort and airflow. During the weakest breathing effort, a total lack of airflow (central apneas) can occur] then who knows if other respirators are better for you such as:

■ Adaptive servo-ventilation (ASV). This newer airflow device is designed to treat central sleep apnea and complex sleep apnea. The device monitors your normal breathing pattern and stores the information in a built-in computer. After you fall asleep, the machine uses pressure to regulate your breathing pattern and prevent pauses in your breathing.

I would look to be checked by a specialist such as:

1) Neurologist MD
2) Cardiologist MD
3) a sleep DOC, i doubt!

[NotMuffy]

Hi, even going down to 10 Second scale I don't see FOT pulses in the Flow and pressure curves of the S9 Elite machine.

You need to find an apnea (it starts at about 5 seconds without flow) so see it.

[Lizistired]

avi123, maybe you need to stretch the parameters of your flow graph.

[avi123]

See the FOT in the last Flow graph:


https://docs.google.com/viewer?a=v&pid= ... vxlw&pli=1

[AMUW]

Bandnuts,
I won't try to compete with the experts' posts.
But before you get unduly worried of a potentially serious problem:
you're just starting CPAP and your system has a lot to adjust to. I wonder whether the CPAP titration night also generated such "hard to classify" events, occurring very regularly with an apnea in the middle.
I also had them; the CPAP titration report mentioned "PAP-induced central apneas ... typically transient in nature ... result of relative hyperventilation".
And I also saw them in my home CPAP flow curves over the first 3 months... at sleep onset or upon nasal congestion buildup during the night. I still don't know why they would be hyperventilation, when in may case they'd go on maybe 20-30 of them at regular 1.5 min duration. But lately they slowly faded away... and my total sleep quality feel improved.
It is possible that your doctor may just tell you to go home and try to relax when you go to sleep ... even give you some tablets ...

[idamtnboy]

Besides, notice here that the CSAD (Central Sleep Apnea Detection ) was designed by Resmed to be included only in the APAP S9 Autoset:


Excerpt:

Two previous ResMed APAP devices have utilized FOT technology
to determine the state of the airway during apneas:
the AutoSet Clinical and AutoSet Portable PII+ [3]. These
devices were designed for the sleep laboratory rather than
home use. Recent advances in motor and microprocessor
technology have enabled what was once relatively expensive
and complicated equipment to be used in a home
APAP device such as the S9 AutoSet.

Source:

http://www.resmed.com/us/assets/documen ... -paper.pdf

Besides, since the S9 Elite is a plain CPAP it is not capable raising pressure automatically in response to an Obstructive airway as the S9 AutoSet does. So installing a FOT technique in the S9 Elite would be a waste of money. It would offer only showing the existence of a Central apnea but not delivering treatment pressure as does the S9 AutoSet in cases of closed airways that are determined to be Central and not Obstructive.


As is written in the above mentioned report:

CSAD also serves an
important role in fixed CPAP in reporting the state of the
apneas that have occurred during therapy which may assist
with therapy reviews.

The above is contradictory to another Resmed document at http://www.resmed.com/us/products/s9_se ... nc=dealers
which states:

CSA detection

CSA detection is now available in both the S9 AutoSet and S9 Elite.

It uses the forced oscillation technique (FOT) to determine the state of the airway during an apnea. When an apnea is detected, small oscillations are added to the pressure to measure airway patency. The CSA algorithm uses the resulting flow and pressure to measure airway patency and differentiate central and obstructive events.

If you cannot see the FOT during an apnea recording then maybe your machine is defective. Is your machine segregating centrals from obstructives? If so then it must be using FOT.

[Lizistired]

avi123, You need the "FLOW" graph. Do you check the detailed sessions box when you download?

[avi123]

del

[idamtnboy]

Thanks, I read it too but I don't see the FOTs and don't know why it's needed in the S9 Elite?

That is the methodology the S9 Elite and Autoset use to differentiate between central apneas and obstructive apneas.

You are looking at the Flow graph for the apnea time span, right? How about posting a copy of what you're looking at.

[NotMuffy]

...I don't see the FOTs and don't know why it's needed in the S9 Elite?

Can you upload your ResMed data file to a third-party server?