Flow limitations and side/back sleep position impacts...

[Ron10]

1. First a question for the experts on this forum: What are some of the more common causes of increased 'flow limitation'?
2. A comment: After about 2 months of daily monitoring and searching for patterns, I now have a better understanding of what (for me) is a significant factor in explaining the sometimes extreme daily variance in my AHI. The answer initially appears to be sleeping position (back vs side).
The totals from the most recent 3 days on my back and then 3 on my side:
Mostly back sleeping Mostly side sleeping
Dec 6 AHI: 11.86 Dec 9 AHI: 2.51
Dec 7 AHI: 10.65 Dec 10 AHI: 3.51
Dec 8 AHI: 8.93 Dec 11 AHI: 1.62
3 day total hours: 7: 20+ 8:27+ 9:11 = 24 :58 24.97 5:35+ 5:42+ 8:40 = 19:57 19.95
3 day total Obstructive: 4+ 3+ 21 = 28 1.12 0+ 0 = 1 0.05
3 day total Clear Airway: 40+ 38+ 49 = 127 5.08 5+ 3+ 7 = 15 .75
3 day total Hypopnea: 43+ 49+12 = 104 4.16 8+ 17+ 7 = 32 1.60

Obviously as most of us know there are many other interlocking factors (ie leaks) at play which can skew these metrics. But for me, it has provided a window into my OSCAR data and future potential changes in therapy. As an example, if my maximum pressure were raised in hopes to reduce my diagnosed issue with obstructive apneas, the results would certainly need to account for an understanding of my sleeping positions during the evaluation period as noted above.
I am a total novice in the world of CPAP treatment of sleep disorders. But I would only suggest, if you haven’t evaluated your sleep positions as they relate to your understanding of your day-to-day OSCAR reported therapy results, you might consider the possibilities……

Ron Mason

[Ron10]

Sorry my columnar format between back sleeping and side sleeping was compressed and lost when posted.

Ron Mason

[Pugsy]

It is well known that sleeping positions affect OSA.
Supine sleeping is known to worsen OSA in a lot of people (not all but a considerable number) and cause the need for more pressure than side sleeping.
REM stage sleep is also known to worsen OSA in a lot of people (not all) and cause the need for more pressure than the other sleep stages.

Flow limitations are just the early warning signs that the airway is trying to collapse and will of course worsen if the OSA worsens because of supine sleeping or REM stage sleep.

The only monkey wrench in the flow limitation reporting is sometimes nasal congestion will confuse the machine and it thinks the airway is collapsing but instead it's swollen nasal membranes causing the reduction in air flow. The machine when in auto mode might try to fix flow limitations with more pressure that are caused my nasal membranes being swollen and more pressure won't help much with that.

[Ron10]

Pugsy,

Thanks for your input.
Is there any way to associate what stage of sleep (ie Rem) within the OSCAR timeline. I have seen hints that some CPCP hardware can somehow supply that information.

Thanks,
Ron

[Pugsy]

Since OSCAR can only report what the machine reports and the machine doesn't know if you are asleep or not much less sleep stages...no real reliable way to document sleep stages using OSCAR.

Now some people are able to spot probable REM by looking at the flow rate pattern when it is more active and for some it works but I have never been able to spot enough difference to really tell much.