CPAPtalk.com

Had four of these episodes last night. Two lasted about 15 min; the others 6 or 7. Forgot about the oximeter last night; will try again tonight.

Looks kinda familiar.

FWIW I went back to the auto BiPAP three nights ago using the previous best prescription, and averaged less than 0.9 AHI since.

My overall AHI was lower: 3.7. Better than the 6 I have been averaging over the last couple weeks but being exhausted last night, I slept two hours longer than normal. That extra time likely lowered the overall score. As usual, AHI consisted of almost all HYPs that occurred during those goofy episodes. Since starting ASV, my OA and CA index have remained <1 and are sometimes 0.

Sleeprider wrote:FWIW I went back to the auto BiPAP three nights ago using the previous best prescription, and averaged less than 0.9 AHI since.

Very nice! I'd be there too if I can figure out these strange breathing patterns...

I had a thought (as dangerous as that is). For one specific episode, Morbius believed it was caused by several spontaneous arousals followed by overcompensation from the ASV. If that is true, might a sleep aid help with this problem? Think there is any validity to this theory and is it worth a shot?

- Flappy

A 40% improvement is nothing to sneeze at. Let it go another night. Sleep aids may allow you to sleep through these episodes, and would probably be approved by a doctor based on your state of exhaustion. I would still try to work through it. This is positive progress, and it might be worth seeing where it goes...one night benefit or a trend. At some point, your efforts to relieve the conditions will work in your behalf to argue for intervention, or support that you've improved things by trial and error.

Speaking of which, be prepared that this approach may include some error, but so far so good.

Uncle Flapp wrote:If that is true, might a sleep aid help with this problem?

Like what?

Sleeprider wrote:Morbius seemed to have some ideas on the breath timing before, but was too cryptic for me to understand the point.

I dunno. Seemed clear enough to me.

Morbius wrote:

Uncle Flapp wrote:If that is true, might a sleep aid help with this problem?

Like what?

If these episodes are created by multiple spontaneous arousals resulting in the machine overcompensating/forcing unnecessary breaths, would a sedative help eliminate the arousals thus prevent the cycle from even starting?

Here is a copy of an episode from last night with Sp02

Sleeprider wrote:A 40% improvement is nothing to sneeze at. Let it go another night...

Sleeprider, I am still skeptical that the increase in EPAP is helping things but I can't argue with good results. AHI last night was 2.57 - best it has been in a while. It could be coincidence, the increase in pressure, or the fact that I have been double-lining the mask in an effort to mitigate leaks. Either way, I ain't changin' nuthin' since the numbers are where they need to be.

- Flappy

Uncle Flapp wrote:

Morbius wrote:

Uncle Flapp wrote:If that is true, might a sleep aid help with this problem?

Like what?

If these episodes are created by multiple spontaneous arousals resulting in the machine overcompensating/forcing unnecessary breaths, would a sedative help eliminate the arousals thus prevent the cycle from even starting?

Yeah, I got that, but which specific one do you plan on using? Are you treating insomnia (SWJ, or more appropriately, WJ) or changing arousal threshold (CompSAS)?

Uncle Flapp wrote:AHI last night was 2.57...

I think your AHI is a heckuva lot higher than 2.57 (OTOH, even if it doubled, it's still only 5.14. Everything is relative).

Whatchoo calling a hypopnea? 30% flow reduction? 50% flow reduction? 3% desaturation? 4% desaturation? Resultant arousal?

The most recent submission has chain (cyclical) characteristics, as well as now being able to reveal a pattern of desaturations (although the initial event is a supersaturation, initiating the chain):



Therefore, if you have flow reduction and desatuation (known), arousal (suspected) and central apnea (the ASV Fallacy - if the machine is driving in breaths, then that means you are not breathing, and that is a central apnea, no matter what the machine is generating to make it look like it isn't), then you got events, and I figure you need to add 9 more to that segment.

Morbius wrote:Yeah, I got that, but which specific one do you plan on using? Are you treating insomnia (SWJ, or more appropriately, WJ) or changing arousal threshold (CompSAS)?

My first thought was zolpidem.

Sleeprider wrote:A 40% improvement is nothing to sneeze at. Let it go another night. Sleep aids may allow you to sleep through these episodes, and would probably be approved by a doctor based on your state of exhaustion. I would still try to work through it. This is positive progress, and it might be worth seeing where it goes...one night benefit or a trend. At some point, your efforts to relieve the conditions will work in your behalf to argue for intervention, or support that you've improved things by trial and error.

Speaking of which, be prepared that this approach may include some error, but so far so good.

Sleeprider, just a quick note of thanks for your suggestions. I'm not quite there yet but the number of episodes have decreased along with the total AHI when using the slightly higher pressure. I may bump the EPAP another 1/2 point in a few days to see if they continue to decline.

Thanks again.

- Flappy

Flappy,

Do you have insomnia as well as frequent awakenings ? And CSA ?

I have Idiopathic CSA and was diagnosed 2 1/2 years ago. I am using a Respironics Bipap w/ auto SV Advanced machine. I'm still struggling to get proper sleep. One problem that I have is that if and when I do get to sleep, I wake up every 30 - 75 minutes during the night. I've been to 4 sleep neurologists and DME sleep advisor and cannot get any answers. All of the above seem to circumvent my problem as if they don't have an answer.


Does anyone have any thoughts on this situation ?

Dreamless