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A Propensity to Hold my Breath!
This probably sounds a bit odd, but I don't think I'm breathing regularly. It's not just an issue of breathing during sleep, but I've noticed this during daytime as well. During the day, I often notice that I've - in effect - been holding my breath, and then seek a large breath to fill my lungs and make up for the irregular rhythm.
I've come to find myself doing the same thing during the night. So, in the morning, I'll wake up and realize that my CPAP has been pushing air into me for some time - even as I resist it.
During my second titration at the clinic, the therapist determined that I'd do better on a BiPAP. For whatever reason, they started me on a CPAP and that's what I've had for the past four months. My sense is that a BiPAP might have helped me to model a breathing rhythm that's otherwise absent (well, it's my working theory!) The particular Respironics CPAP I was given had some technology called C-Flex that sort of exhibited this back and forth behavior (I guess it's actually high and low continuous pressure); however, the machine was making an annoying noise when in C-Flex mode, so my therapist turned C-Flex off.
I don't feel as if I'm getting anywhere near the benefit I felt during the first week or usage: perhaps that's normal? I've been bouncing around settings from the CPAP tech: from a pressure of 9 up to 13, and now back to 11. (At 9, she thought I wasn't getting sufficient benefit - and had too many events. At 13, my AHI went up to 10.8; now it's back down to 7.0. Leakage, by the way is at ~40)
But, I'm also believing that this propensity I have for holding my breath might be a problem. Any suggestions from others, either with regard to unconsciously holding one's breath or the value of BiPAP vs CPAP vs C-Flex?
Thanks very much!
I've come to find myself doing the same thing during the night. So, in the morning, I'll wake up and realize that my CPAP has been pushing air into me for some time - even as I resist it.
During my second titration at the clinic, the therapist determined that I'd do better on a BiPAP. For whatever reason, they started me on a CPAP and that's what I've had for the past four months. My sense is that a BiPAP might have helped me to model a breathing rhythm that's otherwise absent (well, it's my working theory!) The particular Respironics CPAP I was given had some technology called C-Flex that sort of exhibited this back and forth behavior (I guess it's actually high and low continuous pressure); however, the machine was making an annoying noise when in C-Flex mode, so my therapist turned C-Flex off.
I don't feel as if I'm getting anywhere near the benefit I felt during the first week or usage: perhaps that's normal? I've been bouncing around settings from the CPAP tech: from a pressure of 9 up to 13, and now back to 11. (At 9, she thought I wasn't getting sufficient benefit - and had too many events. At 13, my AHI went up to 10.8; now it's back down to 7.0. Leakage, by the way is at ~40)
But, I'm also believing that this propensity I have for holding my breath might be a problem. Any suggestions from others, either with regard to unconsciously holding one's breath or the value of BiPAP vs CPAP vs C-Flex?
Thanks very much!
Views: 1052
Replies to This Discussion
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Permalink Reply by RockRpsgt on
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I could help you better if you could answer a few questions for us. How long have you been on PAP therapy? What mask are you using? Is your machine fully data capabilities. Can you post copies of your studies? Did they monitor your co2 levels during the study? What kind of events did you have at 13? If you can answer any of these questions, or post anymore info we might be able to help you better.
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Permalink Reply by FHB on
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thanks Rock. I'll get a copy of the study, and respond here in a couple of days.
Rock Hinkle said:I could help you better if you could answer a few questions for us. How long have you been on PAP therapy? What mask are you using? Is your machine fully data capabilities. Can you post copies of your studies? Did they monitor your co2 levels during the study? What kind of events did you have at 13? If you can answer any of these questions, or post anymore info we might be able to help you better.
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Permalink Reply by amott1973 on
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Interesting. I don't know if this is the same thing I do or not. I tend to breathe very shallowly all the time. Related to my asthma that went untreated as a kid and my fear that breathing deeply would start The Cough. But I've also noticed that if I'm really still and relaxed, like reading on my computer at work or something else, kind of zoning out a bit, I'll breathe more and more shallow till I'm really not breathing, almost like I'm having apnea in the daytime! If I'm actively engaged I don't seem to do it though. Maybe this is more of hypopnea? Here's a link about it: http://en.wikipedia.org/wiki/Hypopnea
I hope they can figure it out and get your machine set up right for you!
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So, I'm sorry for the delay! I did, however, get my records so that I can post some of the data you were asking about.
In the original study, the conclusion was: "delayed sleep onset, no REM onset, and no REM sleep. Moderate to severe sleep fragmentation was present." In this study, the respiratory disturbance index was recorded as 26.3 episodes per hour, and AHI was 16.6. A month later, in a follow-on study, CPAP/BiPAP titration was used. This time, the clinician concluded, "delayed sleep onset, delayed REM onset, and a normal percentage of REM sleep."
The Respiratory Analysis stated: "CPAP was initially applied at 4cm H2o and incrementally increased to a maximal level of 9cmH2O as noted above. The technologist then initiated BiPAP since he felt that there were significant numbers of central apreas. BiPAP was started at IPAP/EPAP 8/4 and reached maximal pressures of 11/7. Apneas and oxyhemoglobin desaturations were optimally abolished at BiPAP 10/6cm H2O.
The clinician's recommendation was: "Trial of home CPAP therapy wiht 11cm H2O, with a small nasal mask, heated humidifier, and a device to monitor compliance. If the patient does not tolerate this pressure, consider changing to BiPAP with IPAP/EPAP of 10.0/6.0 cm H2O.
CURRENT SITUATION: I'm typically getting just under 5 hours of CPAP per night (according to the machine). System leak registers around 43.5L/min, and the AHI index is 6.9. I also have the compliance details, printed out from the machine if there's any value to providing that info.
The key questions for me are: a) am I using the right machine (I'm into treatment now for 6 months), and 2) are the settings optimal? As I said, I felt a good deal more relief when I first started using the machine than I now do. I've been told that I should shoot for 6 hours of treatment per night, but for some reason I'm unconsciously disconnnecting myself during the night.
Thanks for any advice you might be able to offer!
Rock Hinkle said:I could help you better if you could answer a few questions for us. How long have you been on PAP therapy? What mask are you using? Is your machine fully data capabilities. Can you post copies of your studies? Did they monitor your co2 levels during the study? What kind of events did you have at 13? If you can answer any of these questions, or post anymore info we might be able to help you better.
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Welcome back FHB. Well you have knocked 10 points off of your AHI so far. I notice in your report the leak is at 43.5l/min. With a nasal mask that is a little high. It might help to get that between 35 and 40L/min. What type of mask are you using? The important thing is to not give up. try wearing your mask during the day while your awake to get adjusted to having it on. 6 hours is good, but we need to try and keep the mask on the entire time you are asleep. When it is on your AHI is as low as 6. When you take it off it will shoot back up to 16.
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I also tend to hold my breath when conscious, and have been diagnosed with central/complex sleep apneas. I have read that these are caused by underlying conditions, such as neurological irregularities, congestive heart failure, and other bad things..
I kinda hoped that the apneas were due to my holding my breath, and not the bad things, but is it really the other way around: I hold my breath while conscious, for the same reasons I don't breathe while asleep?
I have a Respironics Bipap Auto SV, which works very well. The adjusting pressure is great and very intuitive, my AHI is now at .7
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Thanks for the support!
To address your question,
- the mask I'm currently using is ResMed Ultra Mirage II. I apparently have a small space between my upper lip and nose, so they had a bit of a challenge finding a mask that worked
I was wondering about the CPAP machine, and whether it's the 'right' one for me. Are there any insights from what I've posted as to whether I'd fare better with a BiPAP or C-Flex? I find it interesting that I seem to have felt greater progress in the weeks after I started, and that's now faded. (I also had no problem getting 6-7 hours of usage then, whereas I'm at about 5 now!)
Thanks again for your tips!
- FHB
Rock Hinkle said:Welcome back FHB. Well you have knocked 10 points off of your AHI so far. I notice in your report the leak is at 43.5l/min. With a nasal mask that is a little high. It might help to get that between 35 and 40L/min. What type of mask are you using? The important thing is to not give up. try wearing your mask during the day while your awake to get adjusted to having it on. 6 hours is good, but we need to try and keep the mask on the entire time you are asleep. When it is on your AHI is as low as 6. When you take it off it will shoot back up to 16.
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With the information you have given it is hard to tell which is going to be right for you. that is more of a decision between you and your doc. Do you have copies of the reports from the studies? It would help if you could post them. The full titration report would be alot of help.
FHB said:Thanks for the support!
To address your question,
- the mask I'm currently using is ResMed Ultra Mirage II. I apparently have a small space between my upper lip and nose, so they had a bit of a challenge finding a mask that worked
I was wondering about the CPAP machine, and whether it's the 'right' one for me. Are there any insights from what I've posted as to whether I'd fare better with a BiPAP or C-Flex? I find it interesting that I seem to have felt greater progress in the weeks after I started, and that's now faded. (I also had no problem getting 6-7 hours of usage then, whereas I'm at about 5 now!)
Thanks again for your tips!
- FHB
Rock Hinkle said:Welcome back FHB. Well you have knocked 10 points off of your AHI so far. I notice in your report the leak is at 43.5l/min. With a nasal mask that is a little high. It might help to get that between 35 and 40L/min. What type of mask are you using? The important thing is to not give up. try wearing your mask during the day while your awake to get adjusted to having it on. 6 hours is good, but we need to try and keep the mask on the entire time you are asleep. When it is on your AHI is as low as 6. When you take it off it will shoot back up to 16.
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