Riddles in the dark

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Rise
Posts: 34
Joined: Thu Sep 13, 2012 9:12 am

Re: Riddles in the dark

Post by Rise » Mon Oct 15, 2012 2:26 pm

The problem is that that is high blood pressure. [...]
You are absolutely correct. I don't intend to ignore it and I didn't mean to dismiss it in my above comment, just noting that it was the same today as it was yesterday and the day before, so probably not the rock to look under for explanations (i.e. another effect rather than causal).

I could not get my doctors to pay attention to my central apneas. [...]
I'm hoping to have a better experience but have a small collection of previously submitted incorrectly managed issues on the other side of the scale fueling my cynical tendancies. I have an appointment - we'll see.

[...] damaged my kidneys [...]
Thank you for the warning. I will lean toward the 'longer living through less chemistry' side.

Where and how are you measuring pressure? It might be the location of your pressure sensor is responsible for that particular pressure waveform. CPAP machines measure pressure/flow at the machine, so there's plenty of elasticity between there and the old shnoz. Therefore my waveform and yours might both be OK.
Braebon Ultima sensor (sleep-lab kit) with nasal cannula fitted as indicated in the documentation.

How long have you been having non-restorative sleep? Do you wake up a lot at night?
I've always hated naps and have been known as a cranky so-and-so for a long time. I've had trouble with "excessive daytime sleepiness" to varying degrees for the last few years. I usually only wake once or twice, though I'm a 'tosser and turner' in addition to the waking.

Don't know if sleep/breathing is significantly disordered, though it's starting to seem so, and if so whether it is primary or secondary, but at least it can be backed into the corner and quantified. Seems the appropriate place to start.

1041
Posts: 121
Joined: Sat Aug 18, 2012 1:34 pm

Re: Riddles in the dark

Post by 1041 » Tue Oct 16, 2012 10:15 am

Do you have restless legs? Even if not, videotaping yourself might give ideas.

I'm very interested to see what your EEG reveals.

Rise
Posts: 34
Joined: Thu Sep 13, 2012 9:12 am

Re: Riddles in the dark

Post by Rise » Tue Oct 16, 2012 11:26 am

I have run a bit of video. I can only run a few hours at a time (old tape-based camcorder) but I see no indication of RLS/PLM in the periods I have recorded. I've looked at setting up a webcam with IR but haven't made the effort yet.

I switched the respiration monitor from 'flow' to 'flow + snore' and while I don't typically 'snore' per se there seems to be some indication of sound overlaid on inspiration in addition to the flattening demonstrated above even for the unstable/periodic pattern -
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I've been told some of my hyperventilation cycles can be quite dramatic. I was dreaming when I was awakened by one this morning so I don't know that it is in any way diagnostic, but it was apparently a quite significant (first image above overlaid at same scale for comparison)

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There are 4 or 5 more of comparable or near-comparable magnitude that I apparently slept through just fine. The pulse ox graph shows a minor increase in heart rate but from the imperfectly synchronized timestamps it's impossible to tell whether heart rate leads or follows. I assume at least for many it's the latter as there is effort associated with deeper respiration even if it isn't restricted in any way. With the first two graphs above there may be some evidence of leading, though I may just be seeing what I expect to see.

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I threw some wire and an amplifer chip at a breadboard last night but only netted a hot chip - had the pinout reversed. Not sure if I cooked it or not but I have a few more so I'll be back at it, a little more methodically this time.

Thanks for reading / chiming in.

1041
Posts: 121
Joined: Sat Aug 18, 2012 1:34 pm

Re: Riddles in the dark

Post by 1041 » Tue Oct 16, 2012 12:10 pm

There must be something triggering such dramatic breathing episodes. Could it be suppressed rage (during the day) that bursts forth at night? I'm half-joking, but have there been any recent traumatic events in your life?

Rise
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Re: Riddles in the dark

Post by Rise » Tue Oct 16, 2012 12:52 pm

I'm not without my history but it's not that traumatic. Yesterday was quite uneventful really. Quiet day, watched and enjoyed "The Voice" after dinner. Went to bed happy. Even used to the nasal cannula now...

Maybe the corner of my brain that's supposed to keep watch over things like breathing has gotten a bit self conscious about forgetting to mind the fort and likes to put on a show now and then for effect (shrug).

I printed the graphs for the consult with the sleep doc.

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Slartybartfast
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Re: Riddles in the dark

Post by Slartybartfast » Tue Oct 16, 2012 1:03 pm

1041 wrote:There must be something triggering such dramatic breathing episodes. Could it be suppressed rage (during the day) that bursts forth at night? I'm half-joking, but have there been any recent traumatic events in your life?
There's a name for that response above. Wish I could recall the $0.25 word for the apnea followed by a series of gasps. . . sleep doc mentioned it once as we were talking about data.
If you had EEG data, I bet that would correlate with an arousal.

Rise
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Joined: Thu Sep 13, 2012 9:12 am

Re: Riddles in the dark

Post by Rise » Sun Oct 21, 2012 3:37 pm

Well, I went to the consult. Very helpful. She wants to do a lab study. Going to have to pay for it out of pocket so one last go around before pulling the rip cord (study is scheduled for Friday night)...

Got into this whole thing because my wife said I "breathe funny" when I'm sleeping. Bought the oximeter and thought "that's interesting" -

(these are from last wed night where I woke up quite tired, but not 'feeling aweful')

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After several nights of that I added the pressure sensor to get some insight into actual flow.

I understand a level of instability is expected but this seems excessive. Can anyone point me to online examples of similar flow that has been blessed as 'normal'?

A little over 2 1/2 hour window.
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First 40 minutes of above
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4
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I don't have effort belts and I don't really know if these are problematic or not but they look restricted from what I've read.

I appreciate all the feedback from everyone that has replied so far. If anyone has knowledge of how to interpret these or perhaps knows a friendly sleep tech that could take a look and comment (I would be glad to compensate them for their time - contact me via pm if you can help or know someone).
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These would seem to be a combination of the two patterns, but then again I don't really know.

Again, thanks to all for reading and any help interpreting is much appreciated.


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1041
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Re: Riddles in the dark

Post by 1041 » Tue Oct 23, 2012 11:43 am

How about recording your breathing while awake to establish what a nice unobstructed waveform, for you, looks like.

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Slartybartfast
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Re: Riddles in the dark

Post by Slartybartfast » Tue Oct 23, 2012 12:45 pm

The dearth of comments is probably because the waveforms you're posting don't correspond very well to anything most of us have seen in our data. Your SPO2 doesn't drop below 90%, but it does vary and seems to be in synch with changes in your pulse rate. And the pattern of no breathing followed by small, then larger, than large, then smaller, then small breaths looks like periodic breathing which can accompany congestive heart failure, or it can be innocuous. Only a sleep study with full orchestration of sensors will tell for sure. Think of it as an investment in your health. You can wonder and ponder, or you can get an expert to tell you what is going on. If it heads off a coronary or a stroke, you're way ahead healthwise and financially to spend the money on the study.

If your wife says you breathe funny, that's probably the best indication that this needs to be looked into. Wonder what the sleep study showed.

Rise
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Re: Riddles in the dark

Post by Rise » Tue Oct 23, 2012 1:52 pm

The lab study is this Friday. Posting the above I was hoping to find someone familiar with that angle of view to confirm or correct my interpretation. I'll be having the study, just wanted something more concrete to hang the anticipation of the expenditure on.

I'll be surprised if there's anything cardiac related. I haven't been ecg'd, but I've been given a good listening to a couple times and pretty much come and go and do as I please when I'm awake. Tired yes, but I can rake, mow, or workout just fine. It's the waking up, staying awake throughout the day, and concentrating that's eluding me.

Of course, I could be wrong...

One tech did comment though that they suspected the apparent nulls were actually hypos rather than CSR/apneas (did't say why)

Thanks for reading. No problem on the 'dearth of comments', I know it's primarily a user's forum. I'll post what they find when they wire me up.

1041
Posts: 121
Joined: Sat Aug 18, 2012 1:34 pm

Re: Riddles in the dark

Post by 1041 » Tue Oct 23, 2012 2:27 pm

Don't be discouraged if the sleep technician refuses to share any information with you. But if they do, ask them if they thought anything was interesting about your eeg readings.

Rise
Posts: 34
Joined: Thu Sep 13, 2012 9:12 am

Re: Riddles in the dark

Post by Rise » Tue Oct 23, 2012 2:50 pm

Will do.

So far the best I have is one night of raw data from a Zeo headband. There's some high frequency content I don't expect to see in places (as I understand it there should be a ac line noise filter already, but perhaps not) but small amplitude overlayed on lower frequency content, not seizure spikes. There's some high frequency very high amplitude content coincident with the largest hyperventilations, but I can reproduce it reliably in a waking state by twitching brow muscles, so they would seem to be movement artifacts (albeit indicative of a corresponding state of arousal).

But again, I will ask, and definitely on my interest list as well.

1041
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Re: Riddles in the dark

Post by 1041 » Tue Oct 23, 2012 3:08 pm

Rise wrote:small amplitude overlayed on lower frequency content, not seizure spikes.
Wonder if that's alpha intrusion.

Rise
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Joined: Thu Sep 13, 2012 9:12 am

Re: Riddles in the dark

Post by Rise » Tue Oct 23, 2012 3:13 pm

Wondered that as well. Need to run it through an fft and get the frequency [range]. For the moment Occam says line noise, and I'm not aware of any reason why I should have it, but I'm not dismissing it just yet either.

1041
Posts: 121
Joined: Sat Aug 18, 2012 1:34 pm

Re: Riddles in the dark

Post by 1041 » Thu Nov 15, 2012 4:50 pm

How are you doing, Rise?