Great AHI etc. but also fragmented sleep?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
DayDreamBeliever
Posts: 28
Joined: Fri Sep 02, 2022 1:05 am

Re: Great AHI etc. but also fragmented sleep?

Post by DayDreamBeliever » Thu Dec 08, 2022 2:59 pm

Well LankyLefty has a lot of videos about scoring, I just went through the ones suggested before as well as
Sleep Respiratory Scoring and OSCAR TIPS
Exciting Respiratory Video: Hints and Tips on CPAP Breathing Patterns
Central Sleep Apneas, REM Sleep Breathing and SleepyHead OSCAR Tutorial
Not sure if any of these these are one Miss Emerita was thinking of.

Since he uses PSG data he can tell whether a flow pattern is actually an arousal or not by what happens to the EEG at the same point. With just flow data to go on it's much harder to tell.

Anyway, following Miss Emerita's suggestion I'm trying standard response for a few days.

User avatar
ozij
Posts: 10120
Joined: Fri Mar 18, 2005 11:52 pm

Re: Great AHI etc. but also fragmented sleep?

Post by ozij » Thu Dec 08, 2022 10:10 pm

DayDreamBeliever wrote:
Thu Dec 08, 2022 2:59 pm
Well LankyLefty has a lot of videos about scoring, I just went through the ones suggested before as well as
Sleep Respiratory Scoring and OSCAR TIPS
Exciting Respiratory Video: Hints and Tips on CPAP Breathing Patterns
Central Sleep Apneas, REM Sleep Breathing and SleepyHead OSCAR Tutorial
Not sure if any of these these are one Miss Emerita was thinking of.

Since he uses PSG data he can tell whether a flow pattern is actually an arousal or not by what happens to the EEG at the same point. With just flow data to go on it's much harder to tell.

[...]
He's not using / doing a PSG when he's analyzing OSCAR data.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine: Resmed AirSense10 for Her with Climateline heated hose ; alternating masks.
And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
Antoine de Saint-Exupery

Good advice is compromised by missing data
Forum member Dog Slobber Nov. 2023

DayDreamBeliever
Posts: 28
Joined: Fri Sep 02, 2022 1:05 am

Re: Great AHI etc. but also fragmented sleep?

Post by DayDreamBeliever » Fri Dec 09, 2022 2:52 am

Yes, his titles are a little misleading...

User avatar
zonker
Posts: 11012
Joined: Fri Jun 19, 2015 4:36 pm

Re: Great AHI etc. but also fragmented sleep?

Post by zonker » Fri Dec 09, 2022 4:36 pm

ozij wrote:
Thu Dec 08, 2022 10:10 pm


He's not using / doing a PSG when he's analyzing OSCAR data.
in this instance, what does PSG stand for?

google has let me down.
:(
people say i'm self absorbed.
but that's enough about them.
Oscar-Win
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1-Win64.exe
Oscar-Mac
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1.dmg

User avatar
ChicagoGranny
Posts: 14409
Joined: Sun Jan 29, 2012 1:43 pm
Location: USA

Re: Great AHI etc. but also fragmented sleep?

Post by ChicagoGranny » Fri Dec 09, 2022 6:39 pm

zonker wrote:
Fri Dec 09, 2022 4:36 pm
ozij wrote:
Thu Dec 08, 2022 10:10 pm


He's not using / doing a PSG when he's analyzing OSCAR data.
in this instance, what does PSG stand for?

google has let me down.
:(
https://www.google.com/search?client=av ... 1&ie=UTF-8

User avatar
Jlfinkels
Posts: 468
Joined: Sun Jun 20, 2021 3:51 pm

Re: Great AHI etc. but also fragmented sleep?

Post by Jlfinkels » Fri Dec 09, 2022 6:41 pm

zonker wrote:
Fri Dec 09, 2022 4:36 pm
in this instance, what does PSG stand for?

google has let me down.
:(
Polysomnogram
Sometimes it is the very people who no one imagines anything of who do the things that no one imagines

User avatar
zonker
Posts: 11012
Joined: Fri Jun 19, 2015 4:36 pm

Re: Great AHI etc. but also fragmented sleep?

Post by zonker » Fri Dec 09, 2022 8:03 pm

Jlfinkels wrote:
Fri Dec 09, 2022 6:41 pm
zonker wrote:
Fri Dec 09, 2022 4:36 pm
in this instance, what does PSG stand for?

google has let me down.
:(
Polysomnogram
gesundheit!

thanks, i seem to remember, now that you've reminded me, that from other posts on the forum.
people say i'm self absorbed.
but that's enough about them.
Oscar-Win
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1-Win64.exe
Oscar-Mac
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1.dmg

User avatar
ozij
Posts: 10120
Joined: Fri Mar 18, 2005 11:52 pm

Re: Great AHI etc. but also fragmented sleep?

Post by ozij » Fri Dec 09, 2022 11:02 pm

zonker wrote:
Fri Dec 09, 2022 8:03 pm
gesundheit!
And the "poly" is there to remind us that during that somno (sleep) study many sensors channels are recorded at the same time.

So let's translate PSG to "Plenty Sleep Graphs" (an approximation)
and remember that xPAP machines don't have that plenty:
They don't have EEG
They don't have effort belts on chest and stomach
The don't have sensors for eye movement
The they don't have sensors for leg movements
They don't have sensors for oxygenation.

The only thing PSG's and xPAPs have in common is a flow sensor.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine: Resmed AirSense10 for Her with Climateline heated hose ; alternating masks.
And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
Antoine de Saint-Exupery

Good advice is compromised by missing data
Forum member Dog Slobber Nov. 2023

User avatar
zonker
Posts: 11012
Joined: Fri Jun 19, 2015 4:36 pm

Re: Great AHI etc. but also fragmented sleep?

Post by zonker » Sat Dec 10, 2022 12:13 pm

ozij wrote:
Fri Dec 09, 2022 11:02 pm
zonker wrote:
Fri Dec 09, 2022 8:03 pm
gesundheit!


So let's translate PSG to "Plenty Sleep Graphs" (an approximation)
i like that!
people say i'm self absorbed.
but that's enough about them.
Oscar-Win
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1-Win64.exe
Oscar-Mac
https://www.apneaboard.com/OSCAR/OSCAR-1.5.1.dmg

DayDreamBeliever
Posts: 28
Joined: Fri Sep 02, 2022 1:05 am

Re: Great AHI etc. but also fragmented sleep?

Post by DayDreamBeliever » Fri Dec 23, 2022 5:32 am

DayDreamBeliever wrote:
Thu Dec 08, 2022 2:59 pm
Anyway, following Miss Emerita's suggestion I'm trying standard response for a few days.
So after a couple of weeks with Response on Standard instead of Soft, I have a subjective feeling that I'm sleeping a bit more soundly, but my daytime sleepiness is still mostly the same, i.e. quite significant.

I don't see much difference in my charts. Everything seems basically fine, and the small number of CAs seem to follow arousals.

There still seems like a lot more variablity in the flow chart than most other people's I've seen on this forum. I don't know if this indicates objectively that my sleep is still disturbed?

User avatar
Miss Emerita
Posts: 3416
Joined: Sun Nov 04, 2018 8:07 pm

Re: Great AHI etc. but also fragmented sleep?

Post by Miss Emerita » Fri Dec 23, 2022 12:43 pm

Your flow chart doesn't look that unusual to me. I think you're right that the CAs generally follow arousal breathing; it's the arousals, not the CAs that are a potential culprit.

It's normal to wake up off and on during the night, and I think brief arousals are also fairly normal. But something is interfering with your ability to feel rested during the day. Here are three ideas for you to try. Ideally, you'll try them one at a time, giving each around a week, so you can gauge what's helping and what isn't.

First, do try allowing yourself more time to sleep. You may well be one of those people who needs a longer time in bed so as to have 8 hours of actually sleeping. It can be hard to change your habits, especially if that will change things for other people in your household. But give it a try. Just keep in mind how wonderful it would be to feel rested.

Second, try increasing your EPR to 3 and increasing your minimum to 7. You have significant flow limitations. These may or may not be interfering with restful sleep. Going up to EPR of 3 may reduce the FLs. (They may also cause some increase in CAs, but unless there are a crazy number of them, that might not be something to worry about.) You'd need the minimum of 7 to get the full benefit of EPR throughout the night, since the machine can't go lower than 4.

Third, try setting min = max = 7. This will eliminate pressure changes as a possible cause of unrestful sleep. You may see an uptick in OAs or Hs. If you see that for a few nights, try min = max = 7.6 or so. You'd be looking for the lowest pressure that will deal with your OAs and Hs.
Oscar software is available at https://www.sleepfiles.com/OSCAR/