Any problems with this ahi result?

https://sleephq.com/public/534361cf-04a ... 0af18130e8

Hi Apnea community,
Just wondering if someone could check my sleep data and tell me if they see any cause for concern?
thank you

How are you sleeping and how are you feeling?

I took a quick look through your flow rate/breaths and the bulk of the flagged events that compose your AHI are related to arousal/awake breathing irregularities and not airway issues.
You are doing a great job with the apnea event prevention department.

Now there is quite a bit of irregular breathing which points to being awake or semi awake and that just means not sound asleep.
If feeling good and sleeping good....I wouldn't worry about anything.

Pugsy wrote: ↑

Wed Feb 01, 2023 5:48 pm

How are you sleeping and how are you feeling?

I took a quick look through your flow rate/breaths and the bulk of the flagged events that compose your AHI are related to arousal/awake breathing irregularities and not airway issues.
You are doing a great job with the apnea event prevention department.

Now there is quite a bit of irregular breathing which points to being awake or semi awake and that just means not sound asleep.
If feeling good and sleeping good....I wouldn't worry about anything.

Hi Pugsy
Thank you for your advice. Yes I have hip and back problems that interrupt my sleep so I wake a lot and toss and turn.
But its very reassuring to receive your confirmation that the apnea issues are being taken care of.

thanks again Pugsy

Ahhh....back/hip and pelvic (along with shoulder) pain I understand all too well.
I got that tossing and turning problem myself and probably 75% of any flagged events I see are related to awake/arousal breathing. I suspect yours are the same but even if every single flagged event was the real deal and you were sound asleep then the AHI isn't all that bad...and when we can discount the awake breathing stuff...your asleep AHI is actually very, very low.

I don't even bother looking up close at my events until I see an AHI in the 5 ish range since I already know that most of any flagged events I might have are awake related irregular breathing events. The machine only measure air flow/breathing and it doesn't have any way to know that the irregularities it might be sensing are related to awake/arousal breathing.
It is what it is.

I see no reason to change any of your settings....they are doing a good job.

Pugsy wrote: ↑

Wed Feb 01, 2023 6:47 pm

Ahhh....back/hip and pelvic (along with shoulder) pain I understand all too well.
I got that tossing and turning problem myself and probably 75% of any flagged events I see are related to awake/arousal breathing. I suspect yours are the same but even if every single flagged event was the real deal and you were sound asleep then the AHI isn't all that bad...and when we can discount the awake breathing stuff...your asleep AHI is actually very, very low.

I don't even bother looking up close at my events until I see an AHI in the 5 ish range since I already know that most of any flagged events I might have are awake related irregular breathing events. The machine only measure air flow/breathing and it doesn't have any way to know that the irregularities it might be sensing are related to awake/arousal breathing.
It is what it is.

I see no reason to change any of your settings....they are doing a good job.

Very reassuring Pugsy, thank you. Yes the ol back / hip and yes shoulder pain. A consequence of having had the good fortune to get old

Pugsy, Is it correct to say that if an AHI's occur, when FL's are very low or zero, these AHI's are not related to the airway limitation/CPAP therapy, but have another cause: movement in the bed or other?

thank you

Albatros wrote: ↑

Thu Feb 02, 2023 6:13 am

Pugsy, Is it correct to say that if an AHI's occur, when FL's are very low or zero, these AHI's are not related to the airway limitation/CPAP therapy, but have another cause: movement in the bed or other?

thank you

Not to my understanding. You don't have to be having FLs to have some sort of apnea event.
I rarely have any FLs to speak of yet I have seen real asleep events flagged.
Now a person can have arousal/awake breathing flagged events which aren't real asleep events for any number of reasons but the absence of FLs when flagged doesn't mean much at all.

I don't use the presence or absence of FLs as a marker for whether the flagged events are asleep or awake events.

Thank you Pugsy.
If I may, i would have another question :how did you detect in Marcusstephen's graphs that the AHI were arousal/awake irregularities and not airway related events ?

Albatros wrote: ↑

Thu Feb 02, 2023 6:58 am

Thank you Pugsy.
If I may, i would have another question :how did you detect in Marcusstephen's graphs that the AHI were arousal/awake irregularities and not airway related events ?

I zoomed in on the breaths and looked for asleep breathing vs arousal/awake breathing and anytime there is evidence of arousal/awake breathing right before a flagged event then I know that the flagged event wasn't an asleep event.

Asleep breathing is very regular and rhythmic. Awake/arousal breathing is very irregular when compared to asleep breathing.

Some examples below.

Here are 2 flagged events right in the middle of asleep breathing. Note how rhythmic the breaths are.



And here I have circled the asleep breathing in red and what follows the red circle is all arousal/awake breathing including the flagged events.



and a more zoomed out image that shows a lot more irregular breathing.



And finally here's a snapshot of one of the OP's flagged events that is arousal related and not airway related.
Note how right before the flagged event the breaths are irregular and all over the place.
He wasn't sound asleep when this got flagged. Now he may or may not remember that arousal but it happened.
The breaths don't lie.
In this one I circled in red the AROUSAL/AWAKE breathing since it is a shorter time frame.
The flow rate/breaths right before and after the red circled area all point to being asleep since it is so rhythmic.
But right before the flag....big gulps of air and irregular breathing and we don't breathe like that when we are asleep....so that means must be awake or semi awake.
Scrolling through all the flow rate I saw lots of examples of that arousal breathing like I circled here. Some with flagged events and some without.

Excellent. And very useful. Thank you, Pugsy.
Why not a Sticky for the Forum on this subject ?

Albatros wrote: ↑

Thu Feb 02, 2023 7:50 am

Excellent. And very useful. Thank you, Pugsy.
Why not a Sticky for the Forum on this subject ?

Several reasons I guess....main one is I already have some stickies that no one bothers to read anyway.
Another is I don't have the time or energy to devout to making stickies right now that no one will read.
How do I know people don't read them???? Because I continually see questions that were either answered in a sticky or they post images of reports that are NOT in the format that we normally like to see. If they had bothered to read the sticky(s) they wouldn't be posting stuff that we don't normally want or need to see.

There used to be a video over on Jason's (now not working) forum that did a nice job of explaining it all so I would just tell people to watch that video.

When I see evidence that people actually take the time to read my current stickies and someone actually wants some sort of educational sticky.....then I might take the time to create another sticky.

I have been thinking about it lately though....making a new sticky about interpreting the flow rate zoomed in ....just haven't had the time or energy to get it done or motivated to do it.
It took me probably 2 years of daily looking at my flow rate to get sort of comfortable with this sort of evaluation. Hundreds/thousands of hours devoted to looking at those breaths.
It's not a quick easy lesson to try to teach.

I have a full plate outside this forum as well. I have a 90 year old mother who is failing and her mind is the first thing out the door. I have been ill since first of October with something very difficult to resolve and my life is both physically and mentally exhausting. I can't sleep well because of pain issues and when I don't sleep so great I feel like crap.
I got 5 hours and 15 minutes on the machine last night....not nearly enough sleep and there was some of that time I wasn't asleep. Today I have a lot of stuff to do and I feel like crap already......it's not going to be a good day.
The last thing I want to do today is create another educational sticky that no one will bother to read.

Besides....I am not the only person here who could make that sticky. I am not the only person who can interpret the flow rate. We have several other forum members with the education and skill levels to get it done.

I am now 4.5 months into Cpap therapy.
And it has, from day 1, become a significant part of my life. Because, I have the feeling that by working seriously and thanks to the experience of some, I will be able to influence the result. I know that it will take time to adjust. It is intellectually challenging which I like.
To get back to the stickys. I read them, but too early in the game, without really assimilating them. That's why I read them a second time.
So, they are read and useful !

Anyway, thank you again for what you and some others bring to the Forum.