Inhale, Exhale, Pause - Wave Flow & Sleep Breathing Cycle

[wut]

Sometimes I wonder if I obsess about having too much data from my machine... and absolutely no training on how to to read the wave flow data or its significance in improving my sleep.

The normal sleep breathing cycle has an inhale, exhale, & pause. What's considered a "normal" pause? (anything less than 10 seconds, no EEG arousal, flow rate not reduced by 50% or more ??????) In looking at each wave flow sleepyhead breath, my pauses are irregular. The pauses may be insignificant, but since I never wake up rested, I'm hoping there are some clues in the data.

I've used a couple of arrows to show 3 different pauses - "extra long", "short", and "not as long". There are likely many more things going on with the data sample as well. It looks like the breath before the "extra long" pause is not rounded, but not reduced flow either.

[Julie]

I wonder if you've considered that you might be losing therapy air through your mouth if it opens once you're asleep? Have you ever tried a FF mask, chinstrap or tape?

[wut]

For the past few nights, my mouth has been taped shut. Prior to taping, I've been using a chin strap.

[Pugsy]

If the May 11 report is with the mouth taped and the tape was still secure when you woke up...the leaks are still a bit ugly and while they technically don't go into large leak territory...they are big enough and frequent enough that they could potentially be a disrupting factor to sleep quality and if mouth is taped shut...those leaks are coming from the mask somewhere.
How is your sleep quality? Wake up often for any reason?

Regarding the "pauses" question. The "pause" on the far left looks like a reduction in air flow that didn't last 10 seconds or maybe didn't meet the % of reduction criteria to earn a flag. It hard to measure the exact number of seconds that these non flagged reductions in air flow last. Did you actually "pause" your breathing to cause the reduction in flow...beats me...we have no way to know if you held your breath briefly or the airway tissues sagged a bit.

The 2 on the right..minimal flow reduction whether it be a pause in breathing that was very brief or actual reduction in flow from very minor airway collapse.
I don't have an answer for you except what we are told for the criteria that is needed to earn some sort of apnea event flag.

Do you see a lot of "pauses" like the one on the far left of the graph you posted that go unflagged?
I doubt random "pauses" like it are the cause of your not feeling so great. Now a truck load of them associated with a lot of arousals...yeah maybe but even then we don't know if they are a cause or effect from whatever caused the arousal in the first place.

Trying to micro analyze your reports at this level under the microscope is not what these machines are really meant to do.
I understand the frustration of not feeling the good numbers that people tend to expect and they want to put everything under the microscope in an effort to spot a culprit.

IMHO..the first thing that stands out to me on your report is the leak line...while you aren't technically in large leak so that therapy is probably not compromised...it is ugly enough that sleep quality itself could be compromised. That would be something I looked at first instead of zooming in on tiny flow reductions.

I would do the usual....look at sleep quality...wake ups...meds...and try to improve on the leak line just in case it is impacting sleep quality.

[DavidT1954]

I found that my attempted analysis of data was worthless until I finally got my leak situation under control. Simply going from the full face to the nose has corrected my leaks to where now my data can make some sort of sense... or at least be relevant to my sleep. I am trying to keep leaks under 10% spikes, and zero to a couple of percent for the lion's share of the sleep period. Still learning....

[wut]

The leak problem was caused by poor mouth taping technique and I believe is now solved. So according to the machine, my OSA is being treated.

Getting to the source of why I wake up tired, am a light sleeper and don't feel rested is next challenge. It's also possible that the machine is not properly treating the UARS and flow limitations. (ambien CR 12.5 may be a factor, but not likely). My sleep hygiene is very well managed. I'm hoping increasing the IPAP will drive out micro-arousals. I'm also going to try fixing the pressures at 16 / 9.5 to see if the machine saw tooth pressure probing disrupts my sleep.

All other suggestions are welcome too!