Do these look like OAs?

[clenchingtobreathe]

After watching all the videos on how to interpret my charts, I have a question for those of you who are trained in this. In the video where Jason reviews a SH report, nearly all the OAs he points out begin with normal breathing, then flat lines and then ends with arousal breaths. Mine seem to be opposite of that, so I'm confused....
Your opinions, please! I'm trying not to obsess about it...but I'd like to know what the machine is sensing. Here's a sampling of what nearly all my recorded OAs look like.

[Pugsy]

The first one looks like probably more of a post arousal flagged event...SWJ and not real.
The second one looks more like you were asleep than post arousal but that weird little big breath right before the flat line makes me wonder if that was an arousal.

We have arousals in the night that we may or may not remember and the machine can and will flag irregular breathing after the arousal as some sort of apnea event but they aren't real.

The other night I had an AHI of 1.68 I think it was...short number of hours of sleep at around 4 so not a lot of events but every single one of them was SWJ post arousal flagged events. Not one was real.

[clenchingtobreathe]

that weird little big breath right before the flat line makes me wonder if that was an arousal.

Every one of the OA's reported by the machine last night had that weird little breath at the beginning...7 of them. All the CAs reported are clearly arousal related....but I don't know how to decipher these OA's....especially if they are recorded at 20 or more seconds and there is no big breath following it!

[palerider]

It's entirely possible to both hold ones breath, and block ones airway. If there's weird breathing before, then it's likely post arousal,then you shift position or something, holding your breath while doing so.

[clenchingtobreathe]

It's entirely possible to both hold ones breath, and block ones airway. If there's weird breathing before, then it's likely post arousal,then you shift position or something, holding your breath while doing so.

Many of the events flagged as OA are 20-30 seconds long. It surprises me...whether awake or not that I don't see a big breath following that length of non-breathing.

[Pugsy]

Maybe it is a low level arousal and you just fell back asleep without a big breath after the flag. Sort of maybe half awake kind of thing.
These things aren't always clear cut and easy to know for sure. I have a lot of them that I sit here scratching my head because they are a bit iffy. We are trying to do stuff with the data that it was never really designed to do with this level of under the microscope scrutiny.

[palerider]

It's entirely possible to both hold ones breath, and block ones airway. If there's weird breathing before, then it's likely post arousal,then you shift position or something, holding your breath while doing so.

Many of the events flagged as OA are 20-30 seconds long. It surprises me...whether awake or not that I don't see a big breath following that length of non-breathing.

Recovery breaths happen after you're fighting for breath. If you're not fighting for breath, then recovery breaths are less likely.

[clenchingtobreathe]

THANKS, you guys! I appreciate your knowledge so much!

[clenchingtobreathe]

Show and tell! Last night it felt like I slept better than usual and THIS happened. I have always had a hard time telling if SH recorded events are actual or not, but this cluster of events looks like a REAL OA event to me. Never had an extended event that looked like this, so it's a new little surprise.
I have a much harder time with the 2nd series of events telling fact from fiction.
Any thoughts from you guys who see this stuff all the time?

screenshot-20181103-090304.png (62.01 KiB) Viewed 1167 times

screenshot-20181103-090705.png (56.74 KiB) Viewed 1167 times

[palerider]

Here's a little tip on how to make the charts more readable... though it may not make much difference in the interpretation.

SH charts .... try... to auto scale, and sometimes that gets thrown off by a single cough... so while you're having small breaths, mostly around 20, the chart's going from -110 to 110.

right click in 'flow rate', Y-axis, then pick 'override' and put in some numbers that are more reasonable for the scaling, like around 66 for yours.

Also go into 'dotted lines' and turn on the zero line. It'll make things easier to see when you're poking around in the breath shapes and such.

Yes, they look like your throat was closed, you can see there's little FOT response (the blurryness that precedes the CA markers), However, they all look like they *may* be related to sleep disturbed by something besides breathing.

[clenchingtobreathe]

Yes, they look like your throat was closed, you can see there's little FOT response (the blurryness that precedes the CA markers), However, they all look like they *may* be related to sleep disturbed by something besides breathing.

Thanks for the directions for SH. I copied them to my desktop so I can have them at hand when I open SH.

99% of everything that's flagged in SH has the same appearance as the 2nd chart. It's nearly impossible for me to tell any difference between what's flagged as CA or OA unless it is absolutely associated with an arousal...then I know it's not real. But, perhaps, I am a victim of a LITTLE knowledge being a dangerous thing! I appreciate your expertise!

[palerider]

99% of everything that's flagged in SH has the same appearance as the 2nd chart. It's nearly impossible for me to tell any difference between what's flagged as CA or OA unless it is absolutely associated with an arousal...then I know it's not real. But, perhaps, I am a victim of a LITTLE knowledge being a dangerous thing! I appreciate your expertise!

The machine is quite good about differentiating between central and obstructive.

https://www.youtube.com/watch?v=4GW97Xk06N8

If your leaks are excessive, then the machine won't be able to tell and it'll report an Unknown Apnea.

Now, sometimes I have seen centrals reported as obstructives, which can happen when you have a central, but your throat closes up at the same time. I've got a chart showing classic Cheyne Stokes Respiration from someone that turned out to have severe heart failure, but because the pressure was also to low for him, a lot of the centrals got shown as obstructives.. (come to think of it, that was on a Respironics machine, and maybe it wasn't as good as differentiating... I'm not sure.)

[Pugsy]

The bottom image...
To me looks like a combination of a bit of SWJ (that first flagged OA) maybe because of the gulp of air prior to the flat line. Not clear cut ...a bit iffy.
We don't always get clear cut ones to look at.
The second event...the CA...again not clear cut but I am leaning towards post arousal...maybe from the preceding OA if it was real.

The last 2 OAs...I am leaning towards real and asleep on those.

It's nice when they are clear cut and easy to evaluate like these 2. 99.99 % sure I was asleep.


Or this one which is SWJ breathing near the flagged hyponea and the red circled area is asleep breathing.


Unfortunately we don't always get nice clear cut easy to spot to evaluate.

[clenchingtobreathe]

Unfortunately we don't always get nice clear cut easy to spot to evaluate.
[/quote]

I RARELY see anything clear cut except obvious wakefulness. 99% my CAs and OA's are preceded by that odd little breath. That's why the top chart seemed SO clear to me....
Of course I have no idea what the odd breath is and have wondered if most of my events are somehow related to the clenching. I have read lots of articles about apnea & clenching but most of them lean towards clenching as a result of apnea. I've not read any theories about clenching causing apnea but I have sure wondered about it......
At least I slept more soundly last night. I'll take whatever I can get!!

[clenchingtobreathe]

Here's a little tip on how to make the charts more readable... though it may not make much difference in the interpretation.

SH charts .... try... to auto scale, and sometimes that gets thrown off by a single cough... so while you're having small breaths, mostly around 20, the chart's going from -110 to 110.

right click in 'flow rate', Y-axis, then pick 'override' and put in some numbers that are more reasonable for the scaling, like around 66 for yours.

Also go into 'dotted lines' and turn on the zero line. It'll make things easier to see when you're poking around in the breath shapes and such.

Wow! What a difference changing those settings made! I've been a little nervous about fooling around with SH settings since I'm not knowledgeable enough about it, but your info was REALLY helpful! Thank you! Not that it helps me understand what all those breaths are before every event.....