New user trying to understand why apnea events are not <5

[Pugsy]

We got off on the wrong foot, you and I. Since you're the boss of this place I probably should just give up and leave. But I'm not going to, you're going to have to be the SuperSleeper of CpapTalk and kick me out. Is this a discussion forum or Pugsy's Place? You decide.

No.....not yet on the banning of you. You will just come back under another alias (I suspect you already have other accounts here under different names and using a different email account to register. I would just have to go ferret you out again. What I could do about your posts is simply declare a warning that you are an asshole troublemaker every time you post your bullshit. And I am bitch enough to do it and not bat an eyelash.

Please no more bullshit posts like this in this thread....you ever heard of the term "hijacking a thread"??? That's what you have done here (and yes I have contributed but won't do it any longer here). Take your bullshit posts over to your own thread if you wish to make this about me and you.
It has no place in a helping thread.

Further bullshit off topic posts attacking me in this thread coming from you will be promptly deleted.
One warning...that's it.
So I suggest that you STFU.

[Gagne]

Pugsy: You spoke about learning to spot an arousal in the flow limitation chart. I do not I know how to see those spots on the chart. Can you help me to understand what that looks like?

This is last night’s data:

https://sleephq.com/public/25e0b5de-8a8 ... 489997585c

Subjective report: I remember waking a time or two maybe about 3am? I didn’t need to get up to use the bathroom. I woke about 5am and went to the bathroom but I put the mask back on. I had trouble going back to sleep and think I was in and out for two hours. I did not have the ear pressure or pain like the previous night. I felt a bit tired once up but no headache like yesterday.

Thanks for your help.

[Pugsy]

You spoke about learning to spot an arousal in the flow limitation chart.

Did I say flow limitations or did I say flow rate/breaths? It's NOT the flow limitation graph.

Please see this thread for examples.
viewtopic.php?f=1&t=187767&p=1451526#p1451526

[Pugsy]

These are NOT from your report. They are from someone else. I don't have the time to take screen shots of your reports right now and get them uploaded and all that.

Asleep breathing is very boring and very predictable.
I circled the asleep breathing here in red. All that mess after the red circle....I wasn't asleep.

same time frame but zoomed out a bit so you can get a better overall picture. I had more awake/arousal breathing than I did asleep breathing.


Here below are some examples of arousal/awake breathing. Now these I circled the breath that tells us the person wasn't asleep. Again...not from your reports but you had the same sort of irregularity on your report.







And here's a good one....it shows definite asleep breathing and then the arousal breaths. I even wrote "Asleep" on it so it is easily seen. All that breathing to the right of the red vertical line....this person wasn't asleep.

[Gagne]

Thank you for that clarification and the examples. I was confused and now I see what you are talking about with the actually asleep versus not fully awake/awake.

[Pugsy]

Don't fret if you can't tell for sure about a breath. Sometimes there are VERY subtle changes that make it an arousal breath and not an asleep breath and sometimes it's just hard to spot.
A few months back I posted what I thought was an "iffy" breath meaning I wasn't quite sure but I was leaning towards an asleep breath and a sleep tech pointed out to me a teeny tiny irregularity that made it an awake/arousal breath and not an asleep flagged event. We are talking teeny tiny subtle changes here and even myself, and my years of experience looking at this stuff, sometimes have a problem knowing for sure.

So if your eyes cross looking at all this stuff don't beat yourself up over it.

For the most part the majority of your flagged events are most definitely arousal related. Might have been a handful of real asleep events flagged or even maybe one that was "iffy" but for the most part....the bulk of your flagged events are arousal/awake related.

[Gagne]

Excuse my ignorance with the next question. Is it better or worse to have most of your events be arousal events? If you are actually awake how am I still not breathing? If they are arousal events do I even need the APAP machine? I feel like I am in school again. So much to learn!

I have had poor sleep for probably 5-6 years. Everyone was blaming it on the leukemia medicine but the sleep study said otherwise.
I have chronic myeloid leukemia and take 50mg of Sprycel daily for it. I also have borderline high blood pressure and take 25mg of metoprolol. The cardiologist thinks the high blood pressure may be from the severe OSA so maybe I can come off that at some point.

[Pugsy]

Is it better or worse to have most of your events be arousal events?

From a cpap therapy and OSA therapy standpoint it is better for the flagged events to be arousal related. A low number of real asleep flagged events means that the therapy is doing what it is supposed to do.

From a sleep quality standpoint very many arousals mean not so great of sleep quality or lots of awakenings.
If I come over to your house tonight and stick a pin in you to cause you to wake up....just how good do you think you will feel the next day if I stick that pin in you every 30 minutes? Bet you feel like total crap.

If you are actually awake how am I still not breathing?

Hold your breath for 15 seconds...no air moving and the machine might think that is a central apnea because there is no effort to breath. The machine only measures air flow or breathing. I can't tell if we are asleep or not.
Our awake breathing is very irregular....it can "confuse" the machine.

If they are arousal events do I even need the APAP machine?

Maybe you need the machine because without it you would have even more arousals from real asleep apnea events that cause even more arousals.

There's a big difference between a no cpap use AHI and a treated by cpap use AHI.
Just because a treated cpap use AHI is low doesn't mean you don't have OSA.

[Gagne]

I appreciate you taking to the time to reply to all my questions. This thread has been very helpful for me to have a better understanding what is happening and why.