I'll try to answer each question:
@Pugsy;
Is your doctor aware of these periods of Cheyne Stokes Respiration?
Yes
@Miss Emerita:
Make an appointment with your doctor soon, and show him or her several samples of these flagged waxing/waning episodes. Print them or take your laptop. The level of zooming in the one you posted is just right. Be sure to tell him or her roughly how many minutes per night you spend with these episodes.
I have shown OSCAR charts and similar zoomed sections to both my Sleep doc and my cardiologist as well as my PCP
@Miss Emerita:
have these episodes cropped up since the time of your last sleep study?
I've observed them sporadically after I started with CPAP two years ago, and they have continued sporadically up to and after my last sleep study a year ago, Neither my original sleep study in 2020, nor my sleep study in 2022 reported any CSR or periodic breathing pattern.
@Miss Emerita:
You may need a referral to a pulmonologist or a neurologist.
My sleep doc is a Pulmonologist,
@ozij:
So you have a cardiologist. How long has he been treating you? Known the details of you heart's condition? What do you mean by "pointed out"?
I've been seeing this cardiologist or his partners at least annually for 27 years. Principle reason I decided I needed a cardiologist was because of my family history. Both parents died of heart attacks, both brothers have had heart attacks. I've had stress test and echocardiography in the past 18 months in preparation for other surgeries (eye and colonoscopy). By pointed out I mean that I showed him OSCAR charts that are similar in pattern to the one I posted . He intimated that since he knew nothing about this 'strange software' nor what the reliability of the Resmed machine he was skeptical of applying much weight to it, He left me with the impression unless the pattern is reported and analyzed on "his hospital's" equipment he considered it (OSCAR and Resmed) a consumer toy, much like a smart watch reporting oxygen and sleep stages. (
briefly argued that Resmed is not a "toy" it is FDA approved, his counter was that FDA approves it for safety, but FDA makes no claim that home based machines are reliable medical diagnostic tools - they are treatment tools not diagnostic. I realized that I was in over my head, and did not push this any farther)
@ozij:
Did the home sleep studies study your breathing while you were on CPAP?
I seem to recall that the 2020 home sleep study had a nasal cannula, but there may have been some doubt about it accuracy because I tend to mouth breath when really relaxed. I know for a fact the the home sleep study done Dec 2022 did not have anything to measure my breathing/air flow (no mask, no cannula)
@ozij:
The sleep doctor who put you on an APAP can't seriously distrust ResMed's ability to track you breath flow.
The sleep doctor (pulmonologist) seems to have no problem "believing" the AHI values that HE gets from Resmed's cloud (or I should say that's where I "think" he gets them) He told me that none of the data that he gets from Resmed's Airview say anything about "pattern breathing" or CSR. (So, apparently his view is if the data doesn't come from Resmed Airview, it is suspicious)
@ozij:
your breathing system has to get used to regulating CPAP supported breath and the problem will disappear
I would sure hope that after two+ years of CPAP use (at 98% compliance) my system would have become used to CPAP.
@Rubicon
Evaluate for TECSA instead.
What is TECSA? Is that some thing I should press my cardiologist for or press my pulmonologist?
Thanks to all for your help and may you have a Merry Christmas .
