What exactly is unstable breathing??

[grumpygirl]

Hello again- I have been seeing in some posts a reference to unstable breathing and I cannot really find a suitable definition of what it is and how to know if you are experiencing it and how to remedy the problem. I am wondering if I may be having such a problem and it is causing my pap usage to be less effective. How does it show up in your data? I do not have any software so that may make my situation more difficult to diagnose. Thanks- GG

[Slinky]

What PAP are you using?

[JohnBFisher]

Unstable breathing essentially means that it becomes .. well .. unstable. It's not predictable. Not regular. This frequently occurs during the transition to and from sleep. During this time our breathing becomes unstable as we move from one mechanism that controls breathing to another. When we are asleep the acidity of our blood triggers breathing. When we are awake our autonomic nervous system and voluntary nervous system allows us to control our breathing. The hand off between these mechanisms to control breathing is not always smooth. That can lead to "unstable" breathing.

Here's an article that discusses how central sleep apneas occur during sleep transition:

Ventilation is unstable during drowsiness before sleep onset
http://jap.physiology.org/cgi/reprint/99/5/2036

[Slartybartfast]

When you're sleeping well your breathing rate and the volume you take with each breath will be very steady. When you are in REM sleep or when you are disturbed in some way, those characteristics vary. Unstable breathing might have another definition, but that's how I've seen it used on this forum.

Here's an example of regular breathing:



Below are two images of unstable breathing. The top one shows 8 hours. The blue trace is the Minute Variation chart which shows changes in flow over time. You can see four or five periods where the blue line becomes very irregular. Those are likely periods of REM sleep, which are characterized by irregular breathing. The bottom half of that image, at 1 minute scale, shows a hypopnea. Breathing tapers away to almost nothing, then resumes its regular pattern, which the machine evidently thought indicated flow limitation and responded by ramping up the pressure. Most events occur during periods of REM sleep. This one occurred at 02:24 where the vertical light blue line is located. Note there were two hypopneas that night, and they both occurred during periods of irregular breathing, as evidenced by the Minute Variation chart.



Did that answer your question?

[patrissimo]

Wow, my breathing never looks anything like as rounded as that first graph! Here's an example of a period with relatively good (for me) breathing before and after relatively restricted breathing:



I'm curious what other people's breath waveforms look like.

[chunkyfrog]

I'm just happy to be breathing, period.