is this PP? plz help interpret flow graph

sleepyzzzz · Post by **sleepyzzzz** » Wed Oct 16, 2019 12:33 pm

After a year and usage of CPAP/BiLevel, MAD device, a UPPP(removed uvula, epiglottis, upper palate shaving) and a parial base of tongue shaving(15mm), i am still having arousals in sleep causing a defragmented sleep and drowsiness through the day..

I have recorded last night sleeping with the minimum pressure to check the flow rate graph and see if i can catch what is happening, i am using EPAP 4/PS 0/max IPAP 4 and nasal mask.

the screenshots are for flow graph right before i get an arousal where i turn off then on the machine to mark it.

Do you see Palatal Prolapse in these graphs? is the little flat line in expiratory curve a PP or is that normal ? the reason i am suspecting it is because my audio recordings(smaple below) show a clicking noise or groaning noise only in expiratory breath before i wake up with a RERA.

before a RERA

3 Audio recordings:
-----------------------
clicking noise before a rera:
https://drive.google.com/file/d/1Kfzywo ... sp=sharing

groaning noise before rera:
https://drive.google.com/file/d/1jz66Og ... sp=sharing

just rera on exhale breath:
https://drive.google.com/file/d/1skMUFK ... sp=sharing

zonker · Post by **zonker** » Thu Oct 17, 2019 11:23 am

jnk... · Post by **jnk...** » Thu Oct 17, 2019 11:48 am

If it were me, I might simplify my approach to sleep-breathing treatment by simply keeping my airway as reasonably stable as possible as I continued my search for other possible causes for my sleep issues beyond just the stability of my airway.

The primary purpose of properly optimized PAP is to stabilize the airway so that good sleep is POSSIBLE. That in and of itself, however, does not make good sleep probable, likely, or definite whenever there are other things are that affecting someone's sleep. When other things affect sleep, those things can still show up in home-treatment-machine reports as if they were breathing events, even though, at their root, they are not. That is because those other primary things that affect sleep can also secondarily affect the breathing, even when it is not the breathing that is at the root of the sleep/tiredness issue or at the root of the event that shows up as a change in breathing in a specific instance in a chart.

PAP is a great cure for a specific set of issues, but it is in no way a cure-all.

And, btw, I admire the panache of your willingness to use both "PP" and "flow" together in the same subject line.

sleepyzzzz · Post by **sleepyzzzz** » Thu Oct 17, 2019 1:22 pm

@jnk hahaha, i did not notice

i wish i could just not worry about all that and just use the cpap to sleep normal, problem is i am not able to sleep with cpap even i went to pressure 10 (i can't tolerate more than that ) but using CPAP is same for me as not using it. i'm still having the arousals all the same.
So i don't really know what to do to fix this

ChicagoGranny · Post by **ChicagoGranny** » Thu Oct 17, 2019 3:35 pm

sleepyzzzz wrote: ↑
Thu Oct 17, 2019 1:22 pm
i'm still having the arousals all the same.

Have you made a close examination of your sleep hygiene habits? Poor habits are endemic to our society.

Good Sleep for CPAPers

- Practice good sleep hygiene (Google it and read several sources; ignore extreme advice.)
- Eat a good diet
- Have a regular, moderate exercise program
- Try to avoid daytime naps
- Practice total abstinence of caffeine including sources like chocolate (sigh)
- Review all medicines, vitamins and supplements you are taking to make sure none are interfering with sleep
- Use the bedroom for sleeping (and sex) only, and make sure the bedroom and bed are comfortable.
- Learn to appropriately handle emotional stress in your life
- Do not listen to your breathing or the sound of the machine as you are falling asleep. (Some people, including me, actually find listening to their breathing and the sound of the machine to be relaxing.)
- Distract your mind by thinking of a pleasant, relaxing activity that you enjoy.
- If you are awakening at night, do not be too concerned. It is actually a normal part of sleep. (It does become a problem though for people who, when they awaken, become frustrated and have difficulty returning to sleep.)
- Use CPAP software, such as the free OSCAR (or the free SleepyHead), to make sure your therapy is optimized
- If you still don't feel or sleep well, make sure you have regular medical checkups to confirm there are no other medical problems

This is a checklist. Some of the things you already do. Some are easy and can be done right away. Others you can work at over time.

CG

sleepyzzzz · Post by **sleepyzzzz** » Thu Oct 17, 2019 6:00 pm

my charts ALWAYS looked great, but something is "closing" my airway and waking me up. it's just the machine is not registering it. the reason i am closing the machine is to MARK each time i have an awakening. so i can check the graph later. so you can see i woke up around 7-8 times "consciously"

my initial sleep study before all the surgeries showed 23 arousals / hour NO OSA, 16.6 Hypopnea / hr and 6.5 RERA/hr, so something is narrwoing my airway causing my brain to wake me up thinking i will suffocate. problem is the machine does not show the hypopneas now because i wake up as soo n as it happens.
i'm trying to understand the graphs and the audio recordings and all i could think of is it's something to do with expiration maybe my throat closes? and when expiring, air flow is narrow it makes a noise as a side effect, and my brain due of the closing wakes me up to open the throat muscles again ?

yrnkrn · Post by **yrnkrn** » Mon Dec 30, 2019 3:46 pm

From "Palatal prolapse as a signature of expiratory flow limitation and inspiratory palatal collapse in patients with obstructive sleep apnea",
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5915321/, palatal prolapse flow graph looks like:

I don't see this pattern in the graphs you posted.

chris_lucy@live.com · Post by **chris_lucy@live.com** » Mon Apr 20, 2020 12:04 am

Are you still selling Alaxo?

is this PP? plz help interpret flow graph

is this PP? plz help interpret flow graph

Re: is this PP? plz help interpret flow graph

Re: is this PP? plz help interpret flow graph

Re: is this PP? plz help interpret flow graph

Re: is this PP? plz help interpret flow graph

Re: is this PP? plz help interpret flow graph

Re: is this PP? plz help interpret flow graph

Re: is this PP? plz help interpret flow graph