BiPAP numbers interpretation please.

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BiPAP numbers interpretation please.

Postby xm41907 » Sun Feb 05, 2012 8:51 am

I was recently moved to a BiPAP due to high clear airways. Here is my last nights Sleepyhead report. Even though I have a high AHI, it is really due to 2 periods of time that equates to a little over an hour, out of a nearly9 hour night. Would you consider this a major problem, or should I ask to be tested for an ASV. This data was similar to what I was getting on the CPAP with a similarly low pressure. If I increase it (CPAP or BiPAP), the clear airways increase.

As for the fairly high leaks, I'm using a nasal pillow and sometimes my moth opens during the night. I've been looking to get a chin strap.

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xm41907
 
Posts: 33
Joined: Thu Dec 08, 2011 6:46 pm
Machine: PR System One REMstar BiPAP Auto
Mask: Swift™ FX Nasal Pillow CPAP Mask wi
Humidifier: PR System One Heated Humi
Year Diagnosed: 2011

Re: BiPAP numbers interpretation please.

Postby Todzo » Mon Feb 06, 2012 1:53 pm

Answer below:

xm41907 wrote:I was recently moved to a BiPAP due to high clear airways. Here is my last nights Sleepyhead report. Even though I have a high AHI, it is really due to 2 periods of time that equates to a little over an hour, out of a nearly9 hour night. Would you consider this a major problem, or should I ask to be tested for an ASV. This data was similar to what I was getting on the CPAP with a similarly low pressure. If I increase it (CPAP or BiPAP), the clear airways increase.

As for the fairly high leaks, I'm using a nasal pillow and sometimes my moth opens during the night. I've been looking to get a chin strap.

Image

Image


Hi xm!

You do show a lot of ventilatory instability. Your Tidal Volume seems to want to hover around 500mL (about a pint per breath) but occasionally spikes to near half a gallon per breath! Your minute volume seems to want to be around 7 liters per minute which is average for a person at rest but sometimes spikes to nearly 7 times that. If you think about how hard you must be breathing to do that I think you can also see that the respiratory effort causes an arousal which helps the respiratory system to re-set (you stop breathing for a time - minute volumes near zero - so the blood can recover the heavy breathing washed out CO2 so circulation and oxygenation can resume) and during that non-breathing time your system senses a clear airway apnea. Yes, that many arousals along with the times when circulation and oxygenation are suppressed by having washed out too much CO2 are not healthy. You should be watching that, and talking with your doctor about that if it does not improve.

If you do go to your doctor, take this article: http://www.ncbi.nlm.nih.gov/pubmed/21206741

I deal with similar issues. I have found that it helps to wear a black beanie covering eyes and forehead during sleep (limits effects of light and especially changes in light level), noise isolating ear buds (when the neighbors are loud - have not solved the listening to the wake up alarm issue yet), limiting violent blue screen time (violent video games or TV), and breathing efficiency training during the day and with my CPAP (I use a pulse oximeter at rest or with constant exercise (treadmill) to adjust my breathing for minimum heart rate while keeping an eye on SpO2 to keep it above 94% - I think you could do this with a heart rate monitor alone being careful and patient). I think that exercise, eating anti-inflammatory foods while staying away from too much sugar, and a good social life would also help. Anything to reduce stress. Anything to help with circulation.

May we find more restful sleep!

Todzo
AHI=52 SpO2 Nadir=55% (!!!) Focus & Vigilance problems w/PTSD from Trauma
CPAP since 2003 Respironics REMstar Auto A-flex with EncoreViewer and SleepyHead SW
Pulse oximeter CMS-50-F, night audio recorded via Audacity or Linux “sox”. Zeo.
Todzo
 
Posts: 685
Joined: Tue Jul 15, 2008 6:41 am
Location: Seattle, WA

Re: BiPAP numbers interpretation please.

Postby xm41907 » Mon Feb 06, 2012 5:01 pm

Thanks Todzo, that's a completely different view of what is going on than others have mentioned. Most are only looking at the number of events and not how the combination of events is affecting my system. I'll definitely be looking into that article.
xm41907
 
Posts: 33
Joined: Thu Dec 08, 2011 6:46 pm
Machine: PR System One REMstar BiPAP Auto
Mask: Swift™ FX Nasal Pillow CPAP Mask wi
Humidifier: PR System One Heated Humi
Year Diagnosed: 2011

Re: BiPAP numbers interpretation please.

Postby xm41907 » Mon Feb 13, 2012 9:17 am

I think I may have found the answer to my centrals. I can't be for certain as it's only one night, but last night marked the first time since going on a xPAP that my AHI was actually "controlled". What is this mysterious thing that worked some sort of voodoo magic to keep the centrals away?? [Moderated. Please refer to posting guidelines regarding self treatment]....

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"How do you like them apples?"

[Moderated. Please refer to posting guidelines regarding self treatment]
xm41907
 
Posts: 33
Joined: Thu Dec 08, 2011 6:46 pm
Machine: PR System One REMstar BiPAP Auto
Mask: Swift™ FX Nasal Pillow CPAP Mask wi
Humidifier: PR System One Heated Humi
Year Diagnosed: 2011

Re: BiPAP numbers interpretation please.

Postby Todzo » Mon Feb 13, 2012 8:43 pm

xm41907 wrote:I think I may have found the answer to my centrals. I can't be for certain as it's only one night, but last night marked the first time since going on a xPAP that my AHI was actually "controlled". What is this mysterious thing that worked some sort of voodoo magic to keep the centrals away?? It's melatonin, 9mg to be exact. Now I'm not one to be convinced after one night of success (especially considering I took 6mg the night before and it didn't change anything), so I'll hold of on making that decision. Irregardless, something was different last night. Just take a look at my event log....

Image

"How do you like them apples?"

I sure am hoping this trend continues. If I can get "controlled" numbers for the next 4-5 days, then my plan is to stop the melatonin for a few days and see if the centrals return. I want to use myself as a controlled experiment to see if the melatonin is the true reason, or if there is something else that just so happened to fall on the same day.


Hi xm!

This was Sunday?

I am reminded of when I cooked for our local Mariners. It was only home games of course so we might be a few days on and a week off or two weeks on straight. From my symptoms (no data monitoring back then) I would guess that the longer I worked in a row the worse the machine worked for me. Stress means inflammation (so a tendency for more apnea) and frayed nerves (perhaps a tendency towards the ventilatory instability that results in centrals). I wish I had the data support. I would probably have been talking with my doctors and had an easier time at work and more success there as well.

That is a lot of melatonin!

Take care!

Todzo
AHI=52 SpO2 Nadir=55% (!!!) Focus & Vigilance problems w/PTSD from Trauma
CPAP since 2003 Respironics REMstar Auto A-flex with EncoreViewer and SleepyHead SW
Pulse oximeter CMS-50-F, night audio recorded via Audacity or Linux “sox”. Zeo.
Todzo
 
Posts: 685
Joined: Tue Jul 15, 2008 6:41 am
Location: Seattle, WA

PostThis post was deleted by Daniel on Tue Feb 14, 2012 4:06 pm.
Reason: Posting guidelines



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