trying to figure out what is happening in prior to this arousal

hello,

It has been a long time since i have posted I am not sure if this screenshot method is possible. Let me know if i have to try to figure our the imgur site again to post a link. I am trying to figure out what is happening in this screen shot prior to an arousal. it seems to happen most nights twice a night to wake me up. I think if I can mitigate the wakeup using my settings that it would be beneficial. Thank you for any insight that you may be able to provide.

If you are talking about the arousal that happens after the funky part of the graph, that's easy: Super large leak caused the machine to not be able to track your breathing very well. So it looks like the machine just "gave up" trying to track your breathing.

Any chance you've got SmartStart turned "On"? If so, once the machine lost track of your breathing, it may very well have turned itself off. And when you took some big breaths (as part of your waking up), the machine turned itself back on (and at its minimum pressure settings.)

If most of your wakes look like this one, then you need to address the leak problem: What's causing them? I haven't the foggiest idea. Could be moving around in bed. Could be opening your mouth. Could be you unconsciously moving the mask a bit in your sleep to scratch your nose.

Now, it's also a bit interesting that there appears to be an arousal just before the large leak starts. My guess? You probably were doing nothing more than moving around in bed, possibly during a normal post-REM arousal, just to get a bit more comfortable. But when you moved around, somehow the mask got pushed around and it probably triggered the large leak.

As for what might be an arousal at 22:38? Again, my guess is it is just an ordinary old (normal) post REM wake, particularly since you turned the machine on about 80 minutes or so before this happened. That would be a bit short for the first REM cycle, but it's not so short that you can just eliminating the idea of a rather ordinary (normal) post-REM arousal.

In other words, I don't think there are any settings that can/should be tweaked to address those wakes. I think you just need to not worry about them---particularly in the middle of the night. If you wake up---just allow yourself to establish that there's nothing "wrong" in your sleep environment and then perhaps be a bit more careful in turning over so you don't trigger a large leak as you're going back to sleep.

Thank you so much for your thoughts on that and for taking the time to reply. I have been trying to evaluate that exactly from your point of view. My CPAP has the smart start enabled. I usually wake up an hour after I fall asleep and exactly around 4 am with the same scenario. I spent a lot of time money and effort titrating my machine. I have a vcom attachment for the degree of aerophagia that I was experiencing for my necessary pressure support settings. That vcom interferes with the smart stop and start features for some reason.
The large leak shows when I take my mask off for the two restroom breaks I take on average each night. The machine continues to run until I cycle it off and back on when I return to bed.
I am just attempting to find out what causes the breathing or physiological disturbance prior to the wake ups. I’m not even sure it is related to sleep breathing or something else. Thanks again for your assessment of the situation.


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fastandthecurious wrote: ↑

Sun Mar 16, 2025 12:22 pm

I am just attempting to find out what causes the breathing or physiological disturbance prior to the wake ups. I’m not even sure it is related to sleep breathing or something else. Thanks again for your assessment of the situation.

My guess is that if the timing of those wakes is roughly in intervals of 80-90 minutes from the time you fall asleep (or the last wake), then there's a high probability that the wake is really nothing more than a normal post-REM wake that is being extended to last long enough for you to remember and worry about specifically because you think there's "something wrong" when, in reality there's nothing wrong.

A few wakes now and then, particularly after a REM cycle is pretty common even in people with no sleep problems who report high quality sleep. The difference is that when they do wake up after a REM cycle, their brain quickly establishes there's nothing wrong and it snuggles back down and immediately goes back to sleep. If the wake lasts less than 5 minutes, the person more than likely doesn't even remember the post-REM wake.