Weird Flow Rate HELP

[bjbeck04]

Having trouble figuring out what I have such odd flow rate throughout the night, when there are no flow limits or apnea events. These often wake me up and just trying to see if anyone else has had this issue or seen this issue. Like, what caused it and how did you fix it? I posted a snip of Oscar data at time.

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[zonker]

bump

[Miss Emerita]

Looks like you had an arousal. Exhaled, paused, inhaled, held your breath, then exhaled. But I’m actually a bit skeptical whether you were asleep during any of the snippet. That’s because asleep breathing usually looks something like the flow rate in the Oscar logo. Take a look at your breathing when you are pretty sure you were asleep and see what it looks like.

[bjbeck04]

You were right, that was one I was awake. Here are three more snippets from times I am defintley asleep(I have a sleep tracker) with no mask leak(except last one appears to have a tiny little leak) or flow limitation. It’s from my SleepHQ, don’t have access to my Oscar right now. Let me know your thoughts. Thanks for the help!

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[ozij]

Please create a link - in SleepHQ - to the whole night.
Snippets taken out of the full night are not enough.


https://www.edu.gov.mb.ca/k12/cur/socst ... 8-1-1a.pdf

[bjbeck04]

Sorry, here is sleepHQ links with the various irregular breathing patterns. Let me know your thoughts on to why I don’t seem to have regular pattern throughout nights. Thanks.

https://sleephq.com/public/e76f137b-d42 ... 396e6dbae6

https://sleephq.com/public/c52821cf-03d ... 5343d9e055

[Pugsy]

The irregularities seem to point to arousal/awake breathing. When you are asleep your flow rate looks quite normal.

Now why you have so much awake/arousal breathing....million dollar question but it's not related to sleep apnea stuff that would show up on the reports.

Meds?
Spontaneous arousals?

[ozij]

Nobody has regular breathing pattern throughout the night. We have short arousals when we transition from one sleep stage to the next - and may take a deep breath, same when we turn over.

How are you sleeping, subjectively, and how are you feeling?

Some of those breathing irregularities are related to leaks - any chance your mouth is dropping open, causing a leak that disturbs you?

Look at 11:16:30: it starts with a flow limitation that makes the pressure go up, the your breathing is messed up, and there's a small leak - but it may be small enough disrupt your sleep.
See the way the flow diminishes at 12:20? The machine is not responding, but you are:


There are other places like that.

If your only concern is the way it looks, I wouldn't make any changes based on this chart. If you feel you could sleep better, I'd try raising the mimimum pressure a tiny bit - 0.2 or 0.4 more, it may just keep those pesky flow limitations away.

[bjbeck04]

How are you sleeping, subjectively, and how are you feeling?

I always wake up feeling horrible, like I didn’t get good sleep at all. I will try bumping up 0.2 and see if that helps. It seems that when I keep it on APAP mode the change is airflow wakes me up more so recently moved to standard CPAP mode. I will make your adjustment recommendation and see if that helps. Thanks so much for the suggestion!

[Pugsy]

It seems that when I keep it on APAP mode the change is airflow wakes me up more so recently moved to standard CPAP mode.

You aren't alone. Lots of people out there that feel they sleep better and feel better when in fixed cpap mode or an extremely tight auto adjusting range. Nothing wrong with that whatsoever.
Sleep is kinda important you know. We grab whatever little bits and pieces of anything that helps us sleep better.

Now fixed mode might require some compromises but they can be dealt with either with minor changes in something or just acceptance in the mind.

[bjbeck04]

Now why you have so much awake/arousal breathing....million dollar question but it's not related to sleep apnea stuff that would show up on the reports.

Meds?
Spontaneous arousals?

I currently take 1mg Clonazepam, 50mg seroquel, and 15mg of Buspar at night for sleep. Also take 5mg amlodipine for blood pressure and 5mg of solifenacin for overactive bladder. I rarely feel like I have to pee at night but did show 15.2 spontaneous arousals on sleep test. Trying to figure out if meds are causing these arousals or insomnia I may have developed from having these major hypopneas that used to wake me up gasping about every hour or two before I got on CPAP. My PSG did not show a high AHI but an at home sleep test showed I had about a 7 RDI. Which makes me think I might have UARS and going untreated for so long caused my body to go into flight or fight mode causing frequent arousals as soon as my airway tightens. I’m honestly not sure, just desperately trying to find a way to sleep through the night and stay in my sleep stages longer. What do you think it might be?

[Pugsy]

What do you think it might be?

Doesn't matter what I think. I doubt it is UARS though. We would expect to see quite a few RERAs (maybe) if there was UARS present and we don't see it in your reports. I do think that your arousals are likely spontaneous though but we simply don't have any way to know what the trigger is.

You might want to read up on Buspar though. Of the meds you mentioned this one stood out to me because it is well known to cause sleeping problems.
Plus there is a big long list of "if you are taking this then your doc may want to adjust dosages of all meds"....

https://www.mayoclinic.org/drugs-supple ... 062457?p=1

[bjbeck04]

What do you think it might be?

You might want to read up on Buspar though. Of the meds you mentioned this one stood out to me because it is well known to cause sleeping problems.
Plus there is a big long list of "if you are taking this then your doc may want to adjust dosages of all meds"....

https://www.mayoclinic.org/drugs-supple ... 062457?p=1

Oh wow, I had no clue. I’ve been taking it for so long and all the sleep issues started like 4 months ago. Wonder if the long term use has altered my sleep architecture. I will look into getting off and/or lower my medications that I am currently on. Thanks for the info!!

[bjbeck04]

So I tried adjusting CPAP to 9.2 to see if that would help at all. By end of night just tried 10 to see as well. But can anyone explain what could cause this erratic breathing between 11:59pm to 12:01am, it is during deep sleep stage. I included small snippet of what I am concerned about along with full night data link below.

https://sleephq.com/public/2d2b6f2f-f87 ... e57a493f22

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[Pugsy]

can anyone explain what could cause this erratic breathing between 11:59pm to 12:01am, it is during deep sleep stage. I included small snippet of what I am concerned about

You weren't in deep sound sleep. That's arousal breathing...you may or may not remember the arousal but you weren't asleep or at least in deep sleep.

What are you using to measure sleep status?