Periodic breathing issues.

[Bigmike52]

In the past 10 days I have seen my periodic breathing increase to high levels. In the past I have had respiration issues as well as low Tidal Volume numbers. I have been on Cpap for two years and in 2019 I have been running <1.00 with occasional 0.00 each month. Last night I increased my minimum pressure from 10.0 to 10.5. I also turned off the flex per somebody else's advise. I have coronary artery disease as well as A-Fib. I am concerned about congestive heart failure especially due to the rapid increase in PB. On the attached charts you will notice a nightly break and when I return I usually turn on my left side and that's when my PB seems to be worse. I start each night out on my right side. Hopefully someone may have some advise for me as this really has me concerned. Thanks for your help.

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[Pugsy]

Can you zoom in on the flow rate so we can see the breaths better? Maybe 2 or 3 examples please....

This level of zooming please.



Does the bulk of your flagged PB look like the image above or does it look like this below with or without flagged events?

[Bigmike52]

Pugsy, let me know if this is what you wanted. They kinda look like both of them.

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[Pugsy]

You do seem to have both kinds it appears but you don't have a lot of PB showing with flagged events everywhere.
I don't know if any of this is important or not but considering your history and the apparent change (increase) in the amount of PB flagged breathing I think a chat with your heart doctor is probably in order.

If you were a family member of mine....I would be advising a chat with the heart doctor. May not be anything important but given your history and the fact that this is a change in what you normally see and the change is significant....I am thinking it's best to talk it over with the doctor and see what he/she has to say.
Heart doctor and/or maybe the sleep doctor too if you have one.

[Bigmike52]

Thank you for your review Pugsy. I agree with communicating both with my cardiologist and sleep doctor. Living in a state voted almost last( #49 or #50) in the US for healthcare I will be surprised just to get an answer. My cardiologist doesn't seem to return e-mails and my sleep doctor unfortunately is one of those that believes the AHI is all that matters. After retiring here to be closer to my kids, grandkids & great grandkids from Cleveland and leaving the best heart care in the US (Cleveland Clinic) has been quite the adjustment. Of course I knew that going in, but being by my family after 30 years apart I will endure whatever is in my future.

Last night I set my minimum pressure back to 10 as well as turn Flex back on and set at 1. I also used my P-10 instead of the FFM Airfit. I hadn't used the P-10 for some time as it was only good if I taped my mouth. I am not a fan of taping the mouth but I did it anyway. It amazes me the numbers can change so much just because of the mask. I still have a problem with PB's as well as low TD's and hopeful will get to speak with my doctors. Again thank you. You are truly an asset to this forum.

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[Pugsy]

Some people are just sensitive to the minor differences in the dead space in some masks over a different mask. Maybe you are one of those people and the dead space in a full face mask just upsets your breathing for some reason causing the PB. I dunno....big maybe.
It's a complicated thing that involves blood gases exchange and if you add that in to the YMMV thing there's just too many variables for me to understand it all.

With your history I can't help but say talk to the doctor about it. I don't know the answer and to be honest even if I thought I did I would still say talk to the doctor for confirmation. If I am going to err I always want it to be on the side of caution.

Last night's PB wasn't quite so pronounced or ugly looking though. I think I would stick with the P10 for a while and see what happens.
And unless mouth leaks wake you up a lot or are huge and prolonged...maybe not do the taping of the mouth for a little bit.

[Bigmike52]

I do plan on seeing if I get a response from my doctors. I won't hold my breath. (wait a minute, I don't think I have much breath to hold) The funny thing was the FFM F-20's worked great for the longest time and then in a course of a week went to hell in a handbasket. I did have some congestion in one nostril and maybe the FFM just doesn't clear it like a pillow does. I will let you know what the doctors say when they respond. Thanks Pugsy

[D.H.]

From what I've been told, "periodic breathing" is not dangerous. It might indicate underlying issues, but there is no medical benefit in suppressing it.

[zonker]

Last night I set my minimum pressure back to 10 as well as turn Flex back on and set at 1. I also used my P-10 instead of the FFM Airfit. I hadn't used the P-10 for some time as it was only good if I taped my mouth. I am not a fan of taping the mouth but I did it anyway. It amazes me the numbers can change so much just because of the mask.

pardon me if i've mentioned this to you already, but as an alternative to taping-

viewtopic/p1089718/viewtopic.php?f=1&t= ... s#p1086296

works a treat for me.

[Bigmike52]

Hey Thanks Zonker. I will check out the band.

[Bigmike52]

Just as I expected my sleep doctor didn't bother to answer any questions about periodic breathing, TD or high respiration rate. He had his RN send me a short message that he doesn't deal with heart problems and to contact my cardiologist. (she was the first one I contacted but unfortunately she did not respond.) I have made the decision to 86 the F20 mask and go back to the P10 and tape. I won't worry about the extremely low tidal volume. It was suggested I get a Resmed Airsense 10 so I ordered one last month but my DME has never returned my call. It must be a disease in this part of the country. Last night was the second day in a row with a 0.00 so hopefully I am making the right choice.

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