Fewer arousals without CPAP

[blades]

Couple questions.

I recently noticed that my Fitbit records way fewer arousals on the random odd nights that I sleep without my CPAP than nights when I do. Like, half as many. Is this "normal?" It seems like the CPAP must be causing arousals, but what should I be looking at to find a cause?

Also, how many arousals are "normal" per night? My Fitbit records usually 30-50, which seems high to me.

What does Fitbit use to categorize an arousal (i.e. is Fitbit even reliable for this?)?

Interested to hear some thoughts on this.

[kteague]

Do you have any limb movement issues, jumpy legs when you sleep?

[HollyL]

My Fitbit records usually 30-50, which seems high to me.

Does this match what you see from your CPAP data? As in, are you getting AHI scores of between 30-50? You might want to post some charts for the experienced members to pop in and take a look.
I haven't used my Fitbit since being on CPAP (since 23rd Jan) so I'm curious to follow this post.

[Pugsy]

What does Fitbit use to categorize an arousal (i.e. is Fitbit even reliable for this?)?

I think movement and pulse rate to denote sleep stages or awake status is what it uses.

Accuracy......I used to have one that did the sleep stages....it once told me I was in deep sleep when I was up letting the dog out to go pee. So definitely not 100% accurate.

Do you move around a lot in sleep....lots of tossing or turning perhaps? More with the mask on maybe? That might account for some of the difference since movement is a factor in what it reports.

You would do better to take the time to learn how to spot arousal breathing vs asleep breathing.
Watch the videos here. Do you have OSCAR or SleepyHead software? The S9 AutoSet shows flow rate which is what you have to zoom in on to see if you were asleep or not. Won't tell stages since the machine doesn't know if you are asleep or not but asleep breathing is fairly easy to spot and so is arousal/awake irregular breathing.

http://freecpapadvice.com/sleepyhead-free-software

[blades]

What does Fitbit use to categorize an arousal (i.e. is Fitbit even reliable for this?)?

I think movement and pulse rate to denote sleep stages or awake status is what it uses.

Accuracy......I used to have one that did the sleep stages....it once told me I was in deep sleep when I was up letting the dog out to go pee. So definitely not 100% accurate.

Do you move around a lot in sleep....lots of tossing or turning perhaps? More with the mask on maybe? That might account for some of the difference since movement is a factor in what it reports.

I’m not aware of excessive movement. Many mornings I wake up in the exact same position in which I fell asleep! But I sleep alone, so have no way of confirming this, aside from filming myself overnight...

You would do better to take the time to learn how to spot arousal breathing vs asleep breathing.
Watch the videos here. Do you have OSCAR or SleepyHead software? The S9 AutoSet shows flow rate which is what you have to zoom in on to see if you were asleep or not. Won't tell stages since the machine doesn't know if you are asleep or not but asleep breathing is fairly easy to spot and so is arousal/awake irregular breathing.

http://freecpapadvice.com/sleepyhead-free-software

I do have OSCAR, and I’m pretty sure that it is picking up the same arousals that my Fitbit is. I’ll take some screen grabs when I get home later and post them. I appreciate the help!

[Pugsy]

There's a thing called spontaneous arousals. No known cause. Quite common and can be related to meds, environment, comfort, pain, etc. They can destroy our sleep quality by causing us to not get the needed progression into each sleep stage and the needed amount in in each sleep stage.
And then there are breathing related arousals.
We can fix the breathing related arousals with cpap but spontaneous arousals we have to try to figure out what is causing them.

As to your original question (assuming the fitbit is fairly accurate which it probably is with a few exceptions) I have no idea why more arousals when on cpap than not unless related to the use of cpap or the mask causing some sleep disruptions that would fall into the spontaneous category. Maybe the brain is just not quite accepting of the mask and machine yet and wants to let you know the alien is stuck on your face again.

[chunkyfrog]

Throw away the fitbit.
They are NOT medical devices--some even state, "For entertainment only".
They are also a fad, intended to encourage daytime activity.
The sleep monitor feature is notoriously inaccurate,
especially compared to tech commonly used in sleep labs.

[blades]

Okay, here are some screen shots of the other night. The full night, then zoomed in view of some of the flags. These look like they are post-arousal, yes? I'll post some other arousals in another post in just a second.

[blades]

I have quite a few of these types of arousals throughout the night. They show up as often as every 5-10 minutes, and are rarely spaced further than 20-30 minutes.

[Pugsy]

Yes, post arousal flagged events and pretty blatant. We don't normally take big gulps of air while asleep.
Now what caused the arousal...I don't see anything immediately prior to the arousal that might point to the airway being compromised.
So maybe a spontaneous arousal from some unknown cause???? Unless you know of a possible cause?

I see arousal breathing sections like that with no flags at least 25 times during a night. I don't remember all of them but I remember some of them. About 80% of my AHI is made up of flagged events that are post arousal.
In my case I have a pretty good clue as to the cause. Usually it's discomfort/pain and I have to change position because I hurt so bad.
Sometimes it's the cat deciding I make a good pillow and I swear that darn cat weighs 30 pounds. Sometimes a hot flash....sometimes I just don't know why I woke up.

[blades]

Ugh, okay. That's what I was afraid of. I wish I knew a way to figure out what is causing all these arousals. I am exhausted all day, even with 8-9 hours of sleep and an AHI < 1.

As far as arousals go, the red circle is an obvious one, but what about the red arrow? Is that (and the other blips around it) an arousal? How much of a change from the regular flow rate shape would indicate an arousal?

[Pugsy]

My thought is that the entire segment before and after the red arrow looks like arousal breathing.
It's all irregular.

[blades]

My thought is that the entire segment before and after the red arrow looks like arousal breathing.
It's all irregular.

Well that's concerning, seeing as the majority of most nights look just like that. I rarely have a stretch longer than 10 minutes without one of those blips the arrow is pointing to, or worse.

[Pugsy]

Well I could be wrong. I am not perfect by any means but it doesn't look like normal sleep breathing to me. It's almost but not quite rhythmic and even keel ...at least to my eye.

Have you ever set up your software to check for flow reductions that the machine won't flag because it doesn't meet criteria?
Custom User event flagging ...you can set up the criteria....Preferences/CPAP tab lower left corner. See if you have many flow reductions that don't really show up.

You want to see some really crappy sleep. This person doesn't have OSA. Confirmed with an in lab sleep study and AHI of less than 1.0 for the diagnostic study. When you see asleep breathing (which this guy didn't have very much of) in this format it makes it a little easier to compare and see. He tried cpap to see if it would help...it didn't fix his sleep problems because OSA wasn't the cause.

[blades]

Well I could be wrong. I am not perfect by any means but it doesn't look like normal sleep breathing to me. It's almost but not quite rhythmic and even keel ...at least to my eye.

Have you ever set up your software to check for flow reductions that the machine won't flag because it doesn't meet criteria?
Custom User event flagging ...you can set up the criteria....Preferences/CPAP tab lower left corner. See if you have many flow reductions that don't really show up.

You want to see some really crappy sleep. This person doesn't have OSA. Confirmed with an in lab sleep study and AHI of less than 1.0 for the diagnostic study. When you see asleep breathing (which this guy didn't have very much of) in this format it makes it a little easier to compare and see. He tried cpap to see if it would help...it didn't fix his sleep problems because OSA wasn't the cause.

Hey, where'd you get my charts!? I'm actually not entirely kidding when I say that my charts do not look dissimilar to this. I'm going to try to paste together a few hours worth into a couple photos to show you what I mean...