Periodic Breathing 100% !!!

I have been on a Respironics BiPap Auto SV Advanced for 18 months. I have both severe central and obstructive apnea (untreated AHI is 55). Things have been going great over the past 6 months. The past 10 days I developed some abdominal pain which worsened the past 4 days. Not acute, but certainly uncomfortable when touched or pushed. Saw my internist and he has diagnosed diverticulitis. He put me on Cipro yesterday.

My concern is: until the past 2 days, my AHI has averaged less than 4. Patient triggered breaths were good at around 98%. Periodic breathing has always been zero. I just downloaded my data on on Thursday my AHI was 4.0 but my periodic breathing was 100%. Last night, my AHI went up to 9.0 and periodic breathing was at 49%.

Does it make sense for PB to go to 100% and my AHI to jump because of something like diverticulitis? How can I have a PB of 100% and an AHI of 4 ?? Seeing my pulmonologist on Tuesday for my quarterly check-up but this has me quite alarmed until then. Help !!!!!

I don't know what to say ... other than you are doing the right thing and discussing it with another doctor .. who should know .. your pulmonologist. It's possible it's not diverticulitis. Or it's possible the Cipro is causing an unusual reaction.

Keep us updated.

I agree with John, best to discuss all this with your Dr.

However I sometimes wonder if some of these out of the blue PB. is the machine we use. I also never have any P.B. episodes, however over the last 10 months using this machine they have shown up twice. The last time it was right after a bathroom break. Started right when I masked up and turned the machine back on, and lasted non stop until I woke up a little over an hour and a half later. This whole time I was supposedly having Periodic Breathing.



The one thing I do remember was forcing myself to sleep on my side, and thought maybe I was partially blocking the exhaust vent or something until I woke up. Since I never see this kind of thing on my data and felt fine, I disregarded it on those two occasions. Although for you to have it 100% all night long is a little strange to say the least. I wouldn't panic too much in the meantime, but make sure your machine isn't leaking anywhere, and possibly unplug and replug, just in case it's some kind of glitch in the system. Good luck and do let us know how it turns out.

I don't understand how an internist can diagnose diverticulitis which is in the gastrointestinal tract? Usually, a GI doctor diagnose it by endoscopy or X ray.
I have some of it and IMO it has nothing to do with respiration.

I use straight CPAP and I sometimes see 1 to 3 PB flags a night. It is usually clear from the waveforms why the machine is issuing the flags. If you zoom in to the flow rate / breathing waveform you should see an undulating wax and waning pattern. In my case it is almost always during REM sleep.

I have to agree w/Avi, how does an internist manage to Dx diverticulitis??? That Dx requires a "visual" exam or at the very least a previously CONFIRMED Dx of diverticulosis, via an imaging procedure, a sigmoidosocopy, or colonoscopy. Diverticulosis is just the confirmed presence of one or more diverticulum. It/they can be present for years w/o causing ANY symptoms. It takes irritation and/or inflammation of these diverticulum to cause symptoms. Now - there ARE internists who are trained and certified to do sigmoidoscopies and colonoscopies and, of course, most any doctor can Rx an imaging procedure. IF one of these is the method of Dx for the "diverticulitis" I CAN understand your internist's Dx.

Aerophagia (air swallowing) CAN cause abdominal pain AND accompany, or be the result of, CPAP therapy.

My internist "suspects" (not confirmed) diverticulitis based on the location of the pain, my having a fever, and other symptoms. If we all had x-rays every time we have a pain we'd probably be suffering from some cancer as a result as well as adding to the enormous cost of health care. The doctor prescribed Cipro as a drug I can tolerate and which treats diverticulitis. He said I should feel much better in 2 days- and I am about 75% better. I have a history of diverticulosis seen in colonoscopies so this isn't unexpected.

My PB reading went back down to zero last night and my AHI went back to 2. I just don't understand how I could have a PB of 100% with a low AHI and why my having "suspect" diverticulitis has anything to do with it.

BasementDwellingGeek wrote:I use straight CPAP and I sometimes see 1 to 3 PB flags a night. It is usually clear from the waveforms why the machine is issuing the flags. If you zoom in to the flow rate / breathing waveform you should see an undulating wax and waning pattern. In my case it is almost always during REM sleep.

I have noticed recently that unmistakable PB occurs, among other times during the night, just before I am aroused/awakened, after only 3 hours sleep or so. I think the PB is the cause of the arousal. Not sure yet how often this occurs. I need to research this in my earlier graphs, but believe I can only go back to see one week's worth of detailed graphs.

I have noticed recently that unmistakable periodic breathing occurs, among other times during the night, just before I am aroused/awakened, after only 3 hours sleep or so. I think the PB is the cause of the arousal. Not sure yet how often this occurs. I need to research this in my earlier graphs, but believe I can only go back to see one week's worth of detailed graphs.

Went to my pulmonary guy yesterday and showed him my printouts. He said they were just aberrations and not to worry about them. He said no doctors pay much attention to those numbers other than the AHI. My AHI's were fine, so he's happy.

I had the same thing happen to me about 2 months ago. Never had any PB show up before, had one night with 50%, next night 100%. Haven't showed up again since.
No explanation. Asked my pulmonologist about it, he asked me what PB meant? haha.
Do other machines not record PB?

Went to the Pulmonary Dr. Tues and he also is only interested in my AHI. He didn't know what pb stood for. I told him I would send him the meanings and he said he is too busy to read them.