Questions about clear airway and cheyne stokes

I'm still trying to learn more about OSA and other kinds of apneas. I noticed that my data consistently has flagged events that sound closer to mixed apnea or central apnea. I was diagnosed with mild OSA, another doctor though diagnosed me with UARS. I've been concerned though because lately i've been complaining to my doctor that I'm having more moments where I feel too tired to breathe.

The Cheyne Stokes Respiration and clear air way concerns me the most. Am I worrying for nothing? How does one know if their respiratory problems switch from OSA/UARS to Central or Mixed apnea?



My past sleep studies showed central apneas in normal range. Hypopneas and RERAS that put me in moderate index. no Obstructive apneas.

Also there is this huge gap in the cpap data. It looks like I wasnt wearing the machine but I dont remember taking off the mask or turning it off in the middle of the night. Why did that happen?

Thanks,
Linda

Your CAs are insignificant....your hypopneas may be able to be reduced by raising your pressure. Try 8 or 8.5 for a few days.

So CA and the Cheyne Strokes are not a sign of central or mixed apneas? I had three sleep studies done and they all had central apneas but I was still diagnozed with OSA not central. I'll bump the pressure back to 8

lindalam89 wrote:So CA and the Cheyne Strokes are not a sign of central or mixed apneas? I had three sleep studies done and they all had central apneas but I was still diagnozed with OSA not central. I'll bump the pressure back to 8

your machine doesn't flag CSR, that's a misclassification in that version of sleepyhead.

I thought I downloaded the latest SleepyHead. Where did you hear it was a misclassication?

Thanks,
Linda

Please read Pugsy's post about CSR here: viewtopic/t103877/Visual-appearance-of- ... ml#p977997

There are periodic breathing patterns that are not CSR but are still identified in that event category in Sleepyhead.
CSR is characterized by a crescendo-decrescendo alteration in tidal volume (shallow breaths building to deep breaths then back down to shallow) separated by periods of apnea or hypopnea. It has a very definite look. Unless you have CHF, I wouldn't be concerned. Also the number of CA's like LSAT said do not appear to be a concern at this time.

Thanks for referring me to the link where Pugsy demystified the Cheyne Stokes issue. I feel a little bit better now but maybe I should post a few images of the zoomed in Cheyne stokes events:



Sorry if I sound like a worry wort. Just want to make sure it isnt something I should bring up to my doctor. And I'm guessing the Clear airway and hypopneas showing up doesnt necessarily indicate I have central or mixed apneas?
I'm trying to be extra careful about my data since i'm in a very tight situation with my doctors. They are fed up with my complaining but if I never gotten a second opinion from Stanford, I would have never known I have respiratory events in the first place. So I've kind of been overly cautious about my sleep data interpretation since then.

I wouldn't worry, in these pictures you don't have the crescendo-decrescendo with 20 sec apneas picture like was in Pugsy's link. To me it looks like irregular breathing we all have at times.

lindalam89 wrote:I thought I downloaded the latest SleepyHead. Where did you hear it was a misclassication?

I didn't hear it anywhere, I work with the developer, and know that when the new resmeds came out with a flag that DOES represent CSR, he used the same term for the respironics machines, which do NOT flag csr, they flag a more generic 'periodic breathing'.

the next version of sleepyhead has a separate flag for each machine, so the confusion will be eliminated.

Thanks for the responses. I got more concerned about Cheyne Stokes Respiration because each day I have a small percentage flagged at CSR. I hope it is really just periodic breathing. I asked my doctor about it and he said the machine is not sensitive enough to actually catch CSR.

True CSR has a definite pattern to it and will usually have flagged events associated with it and most often it will be centrals/Clear Airway events. Even true CSR is not normally a huge concern unless it is very frequent and very prolonged.
Periodic Breathing may or may not have flagged events associated with it.
You can zoom in on the flagged green area up close and look and the air flow/waveform pattern.

Here is what true CSR looks like.


And here is an example of plain ordinary periodic breathing and I suspect that yours will look more like this of mine