Understanding Flow Rate (ASV)

[Uncle Flapp]

Things with my sleep have been relatively uneventful (no pun intended) for months but I recently observed a pattern that has me scratching my head. I am hoping y'all can help me understand the data.

The snippet here shows me awake and drifting off:


This is my normal sleep pattern and what I see throughout most of the night. Wave form is pretty regular:


A couple of times per night, some weird stuff happens. This is where I could use some help. I'm not sure what causes this.
I see a series of short breaths followed by large breaths. The series repeats for about 15 or 20 minutes before returning to normal:


Back to normal again:


And then more weird activity including some CAs with PB before returning to normal.


I've seem this pattern for the last several nights. Not sure why. Any ideas? My CA and OA index for the night remains <1.0 but I would like to better understand those anomalies.

Thanks for your input!

- Flappy

[Sleeprider]

I get the same thing occasionally. It is periodic breathing or Cheyne Stokes Respirations. You don't want to see a lot of that. It can be a component of central apnea and indicates a waxing and waning of respiratory effort.

Here is my version from last night...not good, but probably SWJ.

[Uncle Flapp]

Thanks for sharing, Sleeprider. Makes sense now that you call it out.
My second episode lasted 8 minutes but only the last 3 were flagged by the machine. The first was not flagged at all. Is that normal? I may have to review some old data to see if I can find other examples.

In thinking aloud, I wonder what causes my periodic breathing. I had an EKG a few months ago and everything appeared normal. Perhaps another trip to the cardiologist is in order.

- Flappy

[palerider]

Perhaps another trip to the cardiologist is in order.

I don't have an opinion on what you've posted, if it's just a few minutes here or there... I dunno...

but this is one view of congestive heart failure:

[Sleeprider]

Really the intermittent stuff like you and I posted is as likely to be 'sleep/wake junk as anything real. If it's not a routine part of your sleep then nothing to worry about. Last night mine was definitely swj and if you look at the time, I was probably half awake. I didn't do myself any favors by drinking a bit more than I should the night before.

Pale, that is a graph I hope never to see first-hand. My dad died of CHF. Had oxygen but no ventilation.

[palerider]

Pale, that is a graph I hope never to see first-hand. My dad died of CHF. Had oxygen but no ventilation.

that's from a friend of mine, I saw that and my immediate response was "holy shit"... and I started frantically learning as much as I could, decided he needed an asv, stumbled across one on craigslist, bought it, said "here, use this, AND GO TO YOUR DOCTOR AND DEMAND A REFERRAL TO A CARDIO"

he ain't ded yet

[Uncle Flapp]

Really the intermittent stuff like you and I posted is as likely to be 'sleep/wake junk as anything real. If it's not a routine part of your sleep then nothing to worry about. Last night mine was definitely swj and if you look at the time, I was probably half awake. I didn't do myself any favors by drinking a bit more than I should the night before.

Could be swj, I dunno... I got more questions than answers. I see similar spells almost nightly but they are usually HYP clusters and don't always include CAs. I previously assumed it was just the PRS1 being overly sensitive.

After seeing Pale Rider's screenshot, I am not going to worry too much and just keep an eye on things. That graph is nasty. PR, best of luck to your friend.

- Flappy

[Uncle Flapp]

A call from work woke me early so I decided to take a quick look at last night's data. There were two more instances of this weird behavior. The second has no flags at all:



Is that periodic breathing? More swj? A dream where the dog and I are chasing rabbits? My OCD is having a difficult time letting this one go.

- Flappy

[Pesser]

Things with my sleep have been relatively uneventful (no pun intended) for months but I recently observed a pattern that has me scratching my head. I am hoping y'all can help me understand the data.

The snippet here shows me awake and drifting off:


This is my normal sleep pattern and what I see throughout most of the night. Wave form is pretty regular:


A couple of times per night, some weird stuff happens. This is where I could use some help. I'm not sure what causes this.
I see a series of short breaths followed by large breaths. The series repeats for about 15 or 20 minutes before returning to normal:


Back to normal again:


And then more weird activity including some CAs with PB before returning to normal.


I've seem this pattern for the last several nights. Not sure why. Any ideas? My CA and OA index for the night remains <1.0 but I would like to better understand those anomalies.

Thanks for your input!

- Flappy

I certainly am not qualified to give an opinion on your graphs but I have a question for you. I have seen myself, in my graphs, breathing in and not out. I can see that in yours. Is it possible that you are exhausting air through your mask while you FFM is a little to the side of your face? I use a nasal pillow and I do exhale from my mouth a little. This only happens when I am on my back.

[Uncle Flapp]

I certainly am not qualified to give an opinion on your graphs but I have a question for you. I have seen myself, in my graphs, breathing in and not out. I can see that in yours. Is it possible that you are exhausting air through your mask while you FFM is a little to the side of your face? I use a nasal pillow and I do exhale from my mouth a little. This only happens when I am on my back.

Thanks for the reply, Pesser. I'm not an expert either and welcome all opinions. Anything is possible and I am a FFM side sleeper.

For this event:

Sleepy Head reports a gradual leak rate rise from 0L/min to 4L/min and back down again. Total leak ranged from 34L/min to 38L/min and back. Coincidence or not, it does seem to correlate with the event. On the other hand, I did have an equally large leak rate in other areas and the graphs appear normal. Most of the time Leak Rate is 0 and Total Leak well within normal parameters. In the other two graph examples from my earlier post, Leak Rate remained 0 and Total Leak just under 40L/min.

It's a good theory but I am still not sure what to think.

- Flappy

[-SWS]

I've seem this pattern for the last several nights. Not sure why. Any ideas? My CA and OA index for the night remains <1.0 but I would like to better understand those anomalies.

Here is my version from last night...not good, but probably SWJ.

Sleeprider is probably right about sleep-wake junk in the flow waveform.
http://www.ncbi.nlm.nih.gov/pubmed/16024516

[Jay Aitchsee]

And here's another I found interesting referenced at the address provided by -SWS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3378217/

[Uncle Flapp]

Thanks for all the responses.

I see a more telling picture when I enable the Timed Breath flag and think this is likely just part of my complex apnea. PTBs range from 50% - 85% on any given night so I usually keep the flag off to avoid the extra clutter.


I suppose it could be sleep-wake junk or, more likely, the reason I am on ASV in the first place.

[Sleeprider]

Your machine is capable of dealing with that issue. Do you have timed breaths enabled?

[grayghost4]

I get patterns like that every night .. first one is usually about 90 min into the night and then they repeat through out the night ..... "REM" sleep.