Low AHI, but is my breathing normal?

mike2020 · Post by **mike2020** » Wed Aug 25, 2021 9:22 am

After using a cervical collar in combination with bleep mask, I have consistently low AHI (never above 1.0) but looking at the OSCAR flow rate graph, there are so many "spikes" in the breathing pattern? I see this spikes pattern every night and the attached screenshot is one example. Does anyone know if there is something wrong or nothing to worry about?

Julie · Post by **Julie** » Wed Aug 25, 2021 9:29 am

LOOKS terrific (by AHI), but if you get 0 every night, even without an apnea diagnosis, it would be unrealistic... the occasional 0 is great, but in real life you're likely to have small changes, so something may not be as it should with the machine - experts should be by soon to comment.

Miss Emerita · Post by **Miss Emerita** » Wed Aug 25, 2021 11:37 am

Hello, Mike. Could you zoom in to about a 5-minute interval where we can see a spike or two? You may just be sighing in your sleep, or your may be experiencing arousals. I'm not sure we'll be able to tell the difference, but let's try.

I looked at an older thread of yours, back when you were using the Airsense 10 Autoset. You had your EPR set at 3 then, and I see your pressure support on the VAuto is just 1. Any particular reason for the change?

palerider · Post by **palerider** » Wed Aug 25, 2021 12:41 pm

Yeah, we need to see a little more detail.

Your breathing could be better, there's more to sleep disturbed breathing than just apneas and hypopneas (which are what's counted in the AHI), your flow limitations are pretty rough, and that's at least part of what's driving your pressure increases.

If you're comfortable with it, try bumping your PS to 2, and see if that helps any, it's a minor change.

I second what Miss Em says about needing to see some detail around the spikes, zoom in and let's see what's happening.

mike2020 · Post by **mike2020** » Thu Aug 26, 2021 6:26 am

Thanks for all your reply. Here's some zoom-ins.
For the PS level, I have tried all from 5, 4, 3, 2 and 1. I thought I remember watching Jason's youtube video about making the PS level small but I don't remember the reason. I don't feel any difference in comfort for different PS levels and they didn't seem to affect my AHI number so I think I must have forgotten about it and left it at level 1. I will change the PS level back to 2 and then 3 again to see if it lessen the spikes.

Miss Emerita · Post by **Miss Emerita** » Thu Aug 26, 2021 9:43 am

Palerider has the expertise, but to my eye this is arousal breathing. A brief arousal may or may not wake you all the way up, and even it if does, you may not remember the awakening.

Arousals can interfere with the normal progression of sleep stages -- or not. So a big question is how you feel during the day. If you feel fine and seem to be functioning normally, then I wouldn't give this too much thought.

Still, I do encourage you to try Palerider's suggestion of increasing your EPR, which might reduce flow limitations and smooth things out for you.

Pugsy · Post by **Pugsy** » Thu Aug 26, 2021 10:05 am

Miss Emerita wrote: ↑
Thu Aug 26, 2021 9:43 am
to my eye this is arousal breathing.

Mine too.

Now what might have caused the arousal.....million dollar question.

palerider · Post by **palerider** » Thu Aug 26, 2021 1:17 pm

mike2020 wrote: ↑
Thu Aug 26, 2021 6:26 am
Thanks for all your reply. Here's some zoom-ins.
For the PS level, I have tried all from 5, 4, 3, 2 and 1. I thought I remember watching Jason's youtube video about making the PS level small but I don't remember the reason. I don't feel any difference in comfort for different PS levels and they didn't seem to affect my AHI number so I think I must have forgotten about it and left it at level 1. I will change the PS level back to 2 and then 3 again to see if it lessen the spikes.

The first pic looks like you're awake at the time that happened, awake breathing and asleep breathing traces *usually* look different.

The second one seems like it too, though it's a little too scrunched up to tell for sure.

musculus · Post by **musculus** » Sat Aug 28, 2021 1:03 pm

Miss Emerita wrote: ↑
Wed Aug 25, 2021 11:37 am
Hello, Mike. Could you zoom in to about a 5-minute interval where we can see a spike or two? You may just be sighing in your sleep, or your may be experiencing arousals. I'm not sure we'll be able to tell the difference, but let's try.

I looked at an older thread of yours, back when you were using the Airsense 10 Autoset. You had your EPR set at 3 then, and I see your pressure support on the VAuto is just 1. Any particular reason for the change?

and zoom in at those clusters of flow limitations would be very helpful

Low AHI, but is my breathing normal?

Low AHI, but is my breathing normal?

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Re: Low AHI, but is my breathing normal?

Re: Low AHI, but is my breathing normal?

Re: Low AHI, but is my breathing normal?

Re: Low AHI, but is my breathing normal?

Re: Low AHI, but is my breathing normal?

Re: Low AHI, but is my breathing normal?

Re: Low AHI, but is my breathing normal?