What happened here?

[m421]

A few days ago I woke up gasping for breath, feeling like I was trying to breath through a drink stirring straw or something. It took a while (no idea really how long, tens of seconds? A couple minutes?) for my airway to slowly open so I could breath normally. It's the sort of thing that used to happen when I got a bad cold or hay fever and got me diagnosed with sleep apnea and sleeping with a CPAP. And that pretty much stopped this happening, the only time it's happened in the four years since I stated using a CPAP was when I came down with pneumonia (and ended up in the ER and hospital) a few years back. So it was pretty surprising when it happened last week -- I'm feeling pretty much fine, and haven't come down with anything in the several days since. (And tested negative for COVID.)

Looking at the data in OSCAR, it's like the CPAP machine didn't even notice anything was happening? It's the first big gap in the night, the "large leak" (when I took off the mask). Later in the night I can see the CPAP machine doing its normal thing, ramping up pressure to solve problems. In this case, nothing. I wondered if my mouth fell open, which typically isn't a problem for me, but it barely registers any kind of leak in advance. (When I was coming down with pneumonia I also wondered if that was the problem, and switched to a full face mask, but it made no difference.)

Full night (link to full res: https://live.staticflickr.com/65535/519 ... 2bd3_o.jpg):


Zoomed in on the event (link to full res: https://live.staticflickr.com/65535/519 ... 2d6a_o.jpg):

[chunkyfrog]

If it were me, I would have gone to the ER.
Why didn't YOU?

[m421]

Mostly because, as I say, it's happened before? And it's why I have a CPAP. The last time this happened, when it eventually turned out I had pneumonia, the doctors initially just said "your CPAP machine must not be working right." I did talk to both my PCP who referred me to an RCP this time, but the RCP said from the data they give him, he couldn't tell. And to let my PCP know if it happened again. He was concerned, but in general I just don't find doctors take this stuff very seriously. I also got the impression that the RCP didn't get nearly as much data off my machine as I do off the card, which is why I'm asking here.

[jimbud]

Looks like your mouth opened, somewhat, and you woke up.

I get Flow Rates like that pretty often. Multiple times a night, some nights. I quit worrying about them.

If I am/should someone will Post. I have been wrong a few times.

JPB

[Miss Emerita]

I’m curious what was going on before the mad scramble. You don’t have a normal trace for your exhalations. Possibly you were exhaling through your mouth while inhaling through your nose. Does the rest of the night look like that?

[m421]

I’m curious what was going on before the mad scramble. You don’t have a normal trace for your exhalations. Possibly you were exhaling through your mouth while inhaling through your nose. Does the rest of the night look like that?

Me too -- I'm wondering if that 20 seconds happened before or after I woke up. I do recall gasping for a bit before taking off my mask, but it doesn't seem like that was 20 seconds. I haven't looked at every minute of the night, but in what I have looked at, only that 20 seconds has that noisy pattern.

[Miss Emerita]

I was so unclear! I was wondering about the period from the far left of the graph up to the beginning of the very irregular breathing. The trace shows you exhaling just a tiny bit, breath after breath. The air you inhaled has to be going somewhere, so I’m figuring you’re exhaling through your mouth while inhaling through your nose.

Do you see that same pattern during other parts of the graph?

[m421]

I was so unclear! I was wondering about the period from the far left of the graph up to the beginning of the very irregular breathing. The trace shows you exhaling just a tiny bit, breath after breath. The air you inhaled has to be going somewhere, so I’m figuring you’re exhaling through your mouth while inhaling through your nose.

Do you see that same pattern during other parts of the graph?

Good point, and looking at last night for example, most of the time there's a similar dip down in the curve, although there are a few periods like this when it never goes negative. On the night this happened, that no negative flow pattern started about 3 min before. Maybe my mouth is open more than I think it is.

[Miss Emerita]

So I’m wondering whether this nose-in, mouth-out breathing is what set off the incident. Could be.

[m421]

Looking over last night, I do see this same pattern before a couple of the apneas OSCAR flagged.

[m421]

I've tried a couple things since this, first a chin strap, then full face mask (one night each so far) to see if I could stop this by stopping any chance of air getting out through my mouth. Interestingly, this pattern of little or no exhale pressure still happens with each. So where is that air going? Am I slowly inflating? One difference is that in these last two nights the pattern hasn't ever been right before a flagged apnea, it's just random short periods through the night. One (with the full face mask) was right after an apnea.