Strictly Rem related disordered breathing? Oscar data.

[Ynot]

Hi, I attached photos of my Oscar data as well as the closeups of the flow rate during rem and outside of rem.

After a couple years of very poor sleep and insomnia, I had a sleep study, and was diagnosed with mild sleep apnea and moderate to severe UARS: (Only 6.2 AHI but an RDI of 23.3/hr (44.5 in the supine position), AHI in rem of 21.8/hr (4.1 outside of rem) (No apneas, only hypopneas). (Only about 3h of sleep).

These results lead me to believe that my sleep apnea is unusually “rem specific” compared to other people with the condition. And this is consistent with my insomnia prior to treatment which consisted of waking up after only about 5h of sleep and not being able to go back to sleep (more arousals during rem which become more common during the morning.)

I know flow rate is usually more volatile during rem, but given what I know and suspect about my sleep, I worry that my flow is not normal and indicative of disordered breathing. And I do not think that the machine is great at identifying more mild forms of disordered breathing.

link to pics: https://imgur.com/a/e4cxcVE

The images I provided clearly consist of rem sleep indicated by the periodic flow limitation bundles spaced around 1.5 h apart, which correspond to the flow waves I attached.

As you can see, the flow is pretty flat and consistent outside of rem, and pretty erratic during rem.

As a side note, I am very tired and do not feel rested at all, and the flow wave pattern during rem does not seem to change with an increase of pressure. Also, I often have nasal congestion when I lie down which is associated with sleep apnea, not too sure how to prevent that (Face mask though).

What do you guys think?


Thanks!

[zonker]

a little background, if it's relevant to anyone answering the question-
viewtopic/t187467/Epr-and-flow-limitations.html

[Miss Emerita]

After consulting with one of the forum's experts, I'd venture a guess that you may sometimes be experiencing palatal prolapse. This occurs when your soft palate and uvula droop down into your pharynx.

For this reason, I'd recommend that you see an ENT doctor to see whether this is part or all of your sleep problem. Be sure to show the ENT doctor your flow-rate traces -- both the nice regular ones and the chaotic-looking ones. You might want to take your laptop in with you if that is an option.

[Ynot]

After consulting with one of the forum's experts, I'd venture a guess that you may sometimes be experiencing palatal prolapse. This occurs when your soft palate and uvula droop down into your pharynx.

For this reason, I'd recommend that you see an ENT doctor to see whether this is part or all of your sleep problem. Be sure to show the ENT doctor your flow-rate traces -- both the nice regular ones and the chaotic-looking ones. You might want to take your laptop in with you if that is an option.

I read a little bit about it.
On one hand, palatal prolapse is known to cause arousals which can lead to insomnia which I have. Also, palatal prolapse worsened drastically during rem sleep which fits my situation.

However, my flow rate graphs do not really look that similar (at least to me) to the ones posted on sites about palatal prolapse (I could be wrong), and I also read the following statement: ''Pressure reduction on exhalation: EPR, C-Flex or Bi-Level PAP reinforces the expiratory flow, pushing the palate like a sail in the wind and is likely to worsen the prolapse'' which does not fit my situation since, strangely, epr results in less flow limitation according to Oscar graphs.

Let me know what you think please, I appreciate the help.

Also, how are rem flow rates supposed to look like? Do people with properly treated sleep apnea have a rem flow chart that is nearly as flat as their NREM flow chart.

Thanks.

[Miss Emerita]

I think what's important is for you to find out what a doctor thinks. That's why I've recommended you see an ENT and show him or her your flow-rate traces.

I don't think there's any distinctive "look" to flow-rate traces during REM sleep. As it happens, I can often identify REM sleep because my respiration rate increases during part of it. My flow-rate traces during REM periods aren't distinctive. (How do I know the higher RR rates correlate with REM? I had a gizmo with EEG inputs that I would sometimes wear on my head. It isn't manufactured any more. Its identification of REM lined up with the periods of higher RRs.)

[Rubicon]

IMO getting a list of medications as requested in the other thread; complete sleep studies; and some SleepHQ would go a long way in getting some in-depth discussion/analysis going.