Need some help (data review)

[avi123]

Still no show. Can you go back to this graph and change the time duration from 5 hours to one minute and pick one central apnea and show the graphs?

https://docs.google.com/document/d/14fl ... t?hl=en_US#

[justbreathe]

Here is another wave

[BrianinTN]

These aren't showing up for the rest of us. I think the problem is that you're using Google Documents, but somehow either don't have open sharing on, or aren't sharing the "right" part.

If you can't fix it with Google Documents, you might consider using another service like Photobucket (sucks IMO) or Dropbox (awesome IMO).

[justbreathe]

I put them in dropbox. Here is the link
Wave1 http://dl.dropbox.com/u/7264454/Wave1.doc
Wave2 http://dl.dropbox.com/u/7264454/wave2.doc

Can you read them now?

[BrianinTN]

Yup, that works!

[JohnBFisher]

I put them in dropbox. Here is the link
Wave1 http://dl.dropbox.com/u/7264454/Wave1.doc
Wave2 http://dl.dropbox.com/u/7264454/wave2.doc

Can you read them now?

Yup! Definitely centrals. And it appears you have some periodic breathing going on as well. It's shows a classic pattern of waxing and waning (growing stronger and then fainter). I suspect that, combined with the centrals may have convinced your doctor that an ASV would be a good thing to try.

Here's hoping it helps you get better sleep. You would have to knock me out and then pry my ASV machine out of my fingers before I would give it up! But then, there's no doubt in my mind. No ASV unit = no sleep for me! Not fun.

Keep us updated!

[avi123]

I am not sure if it's Cheyne Stokes, but as Ben Fisher suggested that it might be periodic breathing.

Your graph #2 is a more indicative of Cheyne-Stokes possibility between the two graphs linked to the e dropbox. These graphs you took from your S9 Elite CPAP with the ResScan software.

It would be interesting if your titration on next Sunday would validate the Periodic Breathing seen in the following graph. After the 26 sec of central apnea the hyperpnea continued for 52 more sec for a total cycle time of 78 sec. Such a complex is often connected to CSR.



Good luck with the titration on Sunday!

[BrianinTN]

What? No. There's nothing at all (yet) to point to high pressures being the likely outcome. Also, the existence of centrals while on CPAP is not the same thing as CSR.

[justbreathe]

Here is another example that does not look like cheyne stokes.
http://dl.dropbox.com/u/7264454/wave3.doc

[ozij]

justbreathe, if you use the upper of the two charts to show longer periods, and the bottom chart to focus on a shorter time period, you'll get two blue line on the top chart showing you what period you're focusing on. Clicking on the upper chart will period you want to see in detail on the bottom, and show you 2 blue line in the upper chart delineatign that time period.

Try 5 hours on the top, 10 minutes on the bottom, scroll to an interesting spot on the top. click, and you'll get the details of that period on the bottom. Play around with time periods, the lager always on top, to get a sense of the info.

[avi123]

Here is another example that does not look like cheyne stokes.
http://dl.dropbox.com/u/7264454/wave3.doc

It seems to me that you're correct that there is no CSR flow formation in this segment of time.

As Ozi suggested, I first click on the upper panel at a time segment within an 8 hours period of sleep that is of interest to me and next make the lower panel larger at a 5 to one minute scale and scan the Flow trace, horizontally.

But, you have been doing it correctly to get your last graphs results. Notice that during the 5 min period your total central apneas added to 148 seconds. Meaning that you have not been breathing for half the time. An ASV would probably try to make up for this lack of breathing, in someway.

[DaveLP]

The giveaway on the apnea bars is that the center of the circle at the top of the bar is white, indicating central apnea. Had they been obstructive, the circle at the top would have been red, regardless of the bar color.

Central apnea, according to the descriptions I've read, simply means that you took more than 10 seconds to inhale after exhaling. It's an indication that your brain isn't calling for inhale as soon as it should, based on your average. A slow number of breaths per minute could mean that your oxygen levels are sufficient or that the machine is sensing that occasionally you pause between breaths, which could be an issue if it's too long. A higher respiration rate indicates a higher need for oxygen intake. Any time you pause abnormally, your CO2 levels rise and O2 levels fall.

Does that make sense to anyone else? I'm thinking that the machine is comparing normal inspiration rate to actual rates for the patient's pattern. Sleeping aids can cause this type of breathing abnormality. A doctor may be able to shed some light on the graph.

[justbreathe]

Thank you all for the input and help with using the software. From reading the past experience of others on this forum I am happy that I am moving along quickly toward my ASV titration. I am sure that if it was not for what I have learned and requested from the DME and my Dr. I would not even know I am having any centrals an unusual AHI for someone on CPAP therapy.

If it helps it will be a blessing but if it does not and I can't use it then I will be happy to continue with my current treatment. I have moved from moderate apnea at 24.7 AHI to mild apnea with treatment averaging 14 AHI. If the ASV does not work for me then I will be interested in getting an O2 monitor to see how low am am going during my sleep on a regular basis. my lowest 02 on sleep study was 81%.

[justbreathe]

I just downloaded my card again and have the results of my first 30 days use of CPAP. The only night I have missed using my CPAP is when I went for the ASV Titration. So in reality I am 100% compliant. I was curious if things would change once I get used to the therapy and my centrals would calm down. But it did not happen. I have the same periodic breathing pattern that results in apnea events all night.

I am feeling much better than I did before PAP therapy but that is because my night time breathing is 63% better than before. I am still waiting for the results of my ASV titration on 7/31. I should hear from my doctor today. I am convinced that a few of us from this board could run a sleep clinic and help people better than what they are doing at my sleep clinic.

[JohnBFisher]

... I am still waiting for the results of my ASV titration on 7/31. I should hear from my doctor today. ...[/quote
Here's hoping the results will be clear and lead to better sleep!

... I am convinced that a few of us from this board could run a sleep clinic and help people better than what they are doing at my sleep clinic. ...

LOL! When I searched for a sleep center, I did the unusual step of interviewing the head of the sleep clinic. I *insisted* they have an experienced sleep tech help me with my sleep study. I then explained my situation and why it was needed. But by then I had six sleep studies "under my belt". And I had two more to go (one on BiPAP and one on ASV).

When I showed up at the sleep center the sleep tech was polite, but said "My manager thought you could just about run your sleep study yourself". I laughed and explained my situation. She decided experience did make a difference.

At this point, I've been a patient in the sleep medicine industry longer than most of the professionals. And yes, experience actually does matter! I don't pretend to be a professional. But I've had the chance to learn by cold, hard experience things that few professionals experience.