False CA Events?

[Recoil]

I'm still trying to learn how to interpret the graphs in Oscar/SleepHQ. Given last night's data here: https://sleephq.com/public/bec5c27e-4aa ... e5f2728c2f
Would the CA events earlier in the night be false flagged as it appears I wasn't truly asleep or possibly in the process of turning over in bed when they were flagged? I know the large leak early in the morning was mouth leak related because I remember waking up with dry mouth, even though my mouth was taped

[robysue1]

I'm still trying to learn how to interpret the graphs in Oscar/SleepHQ. Given last night's data here: https://sleephq.com/public/bec5c27e-4aa ... e5f2728c2f
Would the CA events earlier in the night be false flagged as it appears I wasn't truly asleep or possibly in the process of turning over in bed when they were flagged? I know the large leak early in the morning was mouth leak related because I remember waking up with dry mouth, even though my mouth was taped

First, You only had a grand total of four CAs all night long. So even if all your CAs were "real" there are not enough of them to worry about.

Second, if we zoom in on the events early in the night, this is what it looks like:


I believe that you had some kind of arousal or wake at roughly 11:20. And it looks to me like you never got fully back to sleep until after you turned the machine off around 11:52. All that breathing looks like wake breathing or perhaps "sleep-wake-junk" breathing where you are going between wake and very light sleep.

As a consequence, I'd say those first two CAs are definitely false---i.e. mis-scored "events".

The third CA occurs about 20 minutes after you turn the machine back on and there's a somewhat regular, but somewhat ragged breathing pattern throughout the time between when you turn the machine on and the CA is flagged. A zoomed in snippet looks like this:



My guess is that you may have been in a very light sleep or possibly bouncing between wake and sleep during the blue boxes that I've added to the image. The breathing in the red box is most likely an arousal. And so again, this CA is most likely a false event.

[Recoil]

Thank you @robysue1. Is SWJ breathing normal?

[robysue1]

Thank you @robysue1. Is SWJ breathing normal?

Sleep-Wake-Junk (SWJ) breathing is just a sign that you are not soundly asleep at that point in the night.

It takes most people between 10 and 20 minutes to get to a sound sleep at the beginning of the night. During that time, you're likely to see patterns that look like SWJ, and that would be considered normal.

If you wake up in the middle of the night for a few minutes, you are likely to see SWJ breathing. And it's worth remembering that a few short wakes during the night is pretty normal even for people with no sleep apnea problems. (We typically do not remember any wake that lasts less than 5 minutes.)

Obviously, if you spend time tossing and turning and not sleeping well, that's likely to show up as some extended periods of SWJ. But if that's not happening every single night? That could just indicate that on that particular night you had a really bad night's sleep. Even people with the best sleep sometimes have a bad night, particularly if there is some kind of stressful event in their life going on.

If you wake up and lie in bed for any length of time before turning the machine off and getting up in the morning, you're likely to see SWJ breathing during the time you were lying in bed. And since a lot of people do like to lie in bed for 15-30 minutes before getting up for the day, seeing SWJ breathing at the end of the night is quite normal.

Here's the thing: SWJ breathing is not a symptom that there is something wrong with the machine's therapeutic settings. Anybody with no sleep apnea problem, but who is lying in bed half-awake is likely to have a breathing pattern that is SWJ. And even people with totally normal sleep patterns have a few short wakes every night, and during those short wakes? You'll typically see some breathing patterns that are referred to as SWJ around there. It's just that folks without sleep apnea are unlikely to ever see a full night's trace of their breathing patterns all night long, and so they're never going to micro-analyze their breathing and see the periods of SWJ breathing during the night and wonder whether it indicates some kind of problem.

In other words, an excessive amount of SWJ is only a problem if you subjectively feel like you are not getting enough sleep night after night after night and you feel like you are spending a lot of time tossing and turning during most nights. And then what the presence of a lot of SWJ means is that you may be spending too much time not sleeping while in bed. And that leads to the question of why you aren't sleeping as soundly as you should be sleeping.

Now, for CPAP newbies, the answer may just be that you're still learning to sleep well with the machine. Sleeping with a six foot hose on your nose is not exactly natural, and some people have more trouble mastering that skill than others do. Also typical newbie CPAPer problems with mask leaks, mask comfort, hose management, and/or rainout can lead to a lot of SWJ as well. People who have a lot of chronic pain issues will often have a lot of spontaneous arousals that can lead to more SWJ than expected. And finally a lot of SWJ night after night may indicate that you have an insomnia problem that you have to work on rather than ineffective CPAP therapy.

[Recoil]

Thank you so much for the detailed explanation and the time to do so! I greatly appreciate your expertise!