how serious is periodic breathing and clear airway

I am using bipap auto system one. My last night report gave the following results:

Periodic breathing 0.5% of Night.
Clear Airway Apeans = 0.1
Obstructie apneas =1.1
Hypopneas = 0.6
Flow Limitation = 0.3
Vibratory Snore = 0.3
RE =0.6
AHI =1.8
90% IPAP Pressure =11.1
90% EPAP Pressure = 8.2.

I would request the worthy Members of this forum to enlighten me, as to how serious is the periodic breathing of 0.5% of the night and clear airway apnea of 0.1. and RE of 0.6.

Does periodic breathing represent some wrong with my heart or lungs. Will appreciate your guidance. Thank you very much.

Your data looks very good - couldn't be much better!

I don't worry about that little periodic breathing that occurs once in a while. It is usually when I am getting to sleep or have gotten back in bed after a bathroom break. I think I hold my breath as I get settled or move a bit during the night. A clear airway of 0.1 is almost 0 centrals. No worries. You do have sleep apnea so 0 across the board is rare. The medical community sees an AHI of below 5 to be good therapy. Most of us do better with a lower AHI.; An AHI of 1.8 is very good.

I have the auto and not the bipap of the System One but as far as I can see your data is great.

I am not a medical person but your data does not indicate any problems at all with your heart of lungs.

Your data can't get much better. The question is - how are you feeling? Are you feeling rested after a night's sleep? Are the pre cpap conditons gone or going?

Just WHAT is periodic breathing? What are its implications?

Slinky wrote:Just WHAT is periodic breathing? What are its implications?

Periodic breathing is a regular breathing pattern briefly interupted by a pause between breaths (seen by your machine as not breathing). It can be due to something as simple as holding your breath when rolling over in bed - you might even notice it when awake when you hold your breath while picking up a heavy object or stretching to do something. It can indicate a heart problem, but that's when it occurs a heck of a lot more often than your data indicates.

I'd give away my firstborn child to have your data -it looks great.

Thank you, Bons. I had a lot more PB than that when first starting on the PR S1 BPAP Auto I had the privilege of using for several months but it declined to "good" levels as the S1 and I got familiar w/each other. I remember 11.7% PB and quite a few 10% range.

As I understand it, the clear airway apneas and the periodic breathing can both occur during the transtion to and from sleep. Essentially, our bodies use one method to regulate breathing while awake and another while asleep. When we transition to or from sleep, the methods must overlap. Sometimes that leads to an occassional central apnea. And until things settle down, you might have some persiodic breathing.

Of course, both can occur during the evening. An occassional episode of either is perfectly normal. In fact, as Bons notes, these numbers appear to be outstanding. You do not need to worry about either the CA events or the periodic breathing.

But most important, I hope this also indicates you are sleeping much better with your unit and getting good restful sleep. That's the most important thing.

Is this new? It looks like a pacemaker for the diaphragm for PB and CA?
http://clinicaltrials.gov/ct2/show/NCT0 ... 370&rank=1

This is the company doing the trial
http://www.cardiacconcepts.com/heart-failure

What is the difference between periodic breathing and a central apnea event?

Gadget_OSA wrote:What is the difference between periodic breathing and a central apnea event?

Periodic Breathing is characterized by a waxing and waning of the respiration. That is you slowly breathe deeper and more. There can be a tendency to hyperventilate (breathe faster than normal) during the waxing stage. Then the respiration tapers off and starts to wane. The breathes become shallower and shallower. Often there is a tendency to hypoventilate (breathe slower than normal) during the waning stage. Sometimes the waning can reach a point that NO effort is made to breathe. Then the periodic breathing also includes central apnea. After which the breathing resumes and slowly waxes strong again. This repeated cycle is known as Periodic Breathing. Most of the time it is due to cardiac issues. The most common type of periodic breathing is known as Cheyne-Stokes Respiration (CSR).

However, a central apnea can occur at any time. This is when the nervous system fails to trigger any breathing effort. As an example, I have problems with my brain stem. As a result, autonomic nervous system response are not always consistent. One of those is the effort to breathe. During NREM (non-REM) sleep and especially during the transition to or from sleep, my body often fails to trigger a breath. There is no effort at all to breathe. So, the cessation of breathing without any effort is known as a central sleep apnea because the root cause is within the central nervous system.

An obstructive apnea is when the body tries to breathe, but the airway is obstructed (by the tongue and/or soft palette). Then the diagraphram continues to make the effort to breathe. Just no air enters the lungs. This effort to breathe is completely missing during a central apnea.

Hope that explains it well enough.

JohnBFisher wrote:

Gadget_OSA wrote:What is the difference between periodic breathing and a central apnea event?

Periodic Breathing is characterized by a waxing and waning of the respiration. That is you slowly breathe deeper and more. There can be a tendency to hyperventilate (breathe faster than normal) during the waxing stage. Then the respiration tapers off and starts to wane. The breathes become shallower and shallower. Often there is a tendency to hypoventilate (breathe slower than normal) during the waning stage. Sometimes the waning can reach a point that NO effort is made to breathe. Then the periodic breathing also includes central apnea. After which the breathing resumes and slowly waxes strong again. This repeated cycle is known as Periodic Breathing. Most of the time it is due to cardiac issues. The most common type of periodic breathing is known as Cheyne-Stokes Respiration (CSR).

However, a central apnea can occur at any time. This is when the nervous system fails to trigger any breathing effort. As an example, I have problems with my brain stem. As a result, autonomic nervous system response are not always consistent. One of those is the effort to breathe. During NREM (non-REM) sleep and especially during the transition to or from sleep, my body often fails to trigger a breath. There is no effort at all to breathe. So, the cessation of breathing without any effort is known as a central sleep apnea because the root cause is within the central nervous system.

An obstructive apnea is when the body tries to breathe, but the airway is obstructed (by the tongue and/or soft palette). Then the diagraphram continues to make the effort to breathe. Just no air enters the lungs. This effort to breathe is completely missing during a central apnea.

Hope that explains it well enough.

Wow! Thanks for that. I always wanted an explanation of that stuff in layman's terms. That was it if I ever saw it. Been wondering about that stuff for a while.

Good Stuff!!!

Thank you all for very illuminating discussion on periodic breathing and central apneas. As an incidental point, is it advisable to buy Respironics Bipap Auto ASV to take care for central apneas and periodic breathing instead of using Biapap Auto with Biflex which I am presently using. Thank you all for time to educate the less educated in this forum, for which the rewards in the Heavens.

JohnBFisher wrote:
Hope that explains it well enough.

Exceptionally well. Thankyou John.

endurance wrote:... is it advisable to buy Respironics Bipap Auto ASV to take care for central apneas and periodic breathing ...

Nope. You are well within normal range. Your numbers for both are so low that they are almost zilch. As I noted, it's likely the periodic breathing and/or central apnea occurred during the transition to or from sleep. The ASV type machine costs a LOT of money compared to the current machine. And that extra cost would only kick in perhaps once per evening. And the increased pressure awakens most folks - unless it occurs so frequently that the body can adjust. So, not only is it not needed, but it would actually disturb your sleep more than your current setup.

Hope that helps.

snnnark wrote:Is this new? It looks like a pacemaker for the diaphragm for PB and CA?
http://clinicaltrials.gov/ct2/show/NCT0 ... 370&rank=1

This is the company doing the trial
http://www.cardiacconcepts.com/heart-failure

Snnnark, you should post this as a separate post. This one got lost in the shuffle. It looks new to me, but I don't follow the clinical trials.