Need help with interpreting OSCAR data

Hi everyone, I just joined here to get help related to UARS diagnosis/treatment. I would be grateful if anyone can help me by sharing their knowledge and experience on the issue. To keep the post short, I will quickly summarize my history, but please let me know if you need any more info.
• I am currently suspecting upper airways resistance syndrome.
• I had polysomnography (PSG) done three years ago, but it came back negative
• In the meantime, I bought a CPAP machine myself and I have been using it despite the negative polysomnography results, since using CPAP greatly helped my daytime fatigue and quality of sleep which were the issues that prompted me to get the PSG.
• From time to time my fatigue and quality of sleep would get worse and I would need to increase my CPAP pressure to resolve the symptoms for another few months. Now I am on 10.4 cmH20 and beyond this, I start getting aerophagia
• For ~1.5 years my fatigue has been getting progressively worse.
• I am currently suspecting upper airways resistance syndrome UARS and I had a WatchPat One test done and the results point in the direction of UARS but also the recording stopped when my sleep and breathing were getting worse during the test, so I suspect that the values are much worse. I am planning to do the test again.
• In the meantime, I bought a second-hand BiPAP (Aircurve 10 VAUTO) to see if that helps but so far, I haven’t had much luck.
• I would be grateful if looking at the OCSAR data anyone can share what sort of disordered breathing can be seen and what settings to change to hopefully improve. Also, I often see such a breathing pattern in my data, which I am guessing is irregular. It seems like my expirations are long and with some weird fluctuations Similarly, another weird breathing pattern I often notice looks like follows: This sort of breathing pattern also coincides with the time in my sleep when I am having the most trouble with breathing and arousals.

Your flow rate/breathing just screams poor sleep quality but I am not so sure it is all airway related.

Do you take any medications of any kind? If so, what?

Do you have any other physical or mental health issues that might impact sleep quality?
Example...pain, arthritis, depression.... etc.

Hi Pugsy,

Thanks for your reply. Good to know that it is not just in my head

Generally, I am in good physical condition. I am 33 years old and slighly underweight so that's why I started looking into UARS.

I have been on Effexor and low-dose Seroquel for anxiety/depression for almost 8 years. I hope it is not related to the long-term use of these medications.

Another direction my GP is currently looking into is lung-related issues. He did a lung functioning test, which according to him showed minor abnormalities so he has referred me to a pulmonologist but he didn't share any information with me as to what he suspects

Also, I suspect that my issues are REM-related. I did a WatchPat One study and it showed respiratory events were mainly in the REM cycles. Unfortunately, the device stopped recording automatically (falsely detected that I was awake), right when my sleep and breathing were getting more disturbed though I was still asleep.

Zombied wrote: ↑

Mon Jul 05, 2021 3:02 pm

I have been on Effexor and low-dose Seroquel for anxiety/depression for almost 8 years. I hope it is not related to the long-term use of these medications.

OUCH....there is a reason I ask the meds and general health questions first thing.
It's because often crappy sleep quality is tied to medication side effects. Mood altering meds....number one prime culprit for what they are know to do with sleep in general.

Google SNRIs and SSRIs and sleep...and start reading. They are well known to mess with sleep stages as well as cause a lot of arousals and poor sleep quality...what I would call "light sleeping" in layman's terms. Wake often for the least little thing and we don't always remember the arousal/awakening. Often they can cause insomnia as well.

Your first zoomed in graph that you post at around 6:45...all that flow rate looks like arousal/awake breathing to me....you weren't ever sound asleep.
Asleep breathing is extremely regular and smooth...not erratic and all over the place.
Same thing with the 06:00 zoomed in image but even more irregular than the 6:45...you weren't asleep.

Let me get some examples to show you but my computer is screwed up right now and I can't access any of my bookmarks.
Looks like I need a reboot...or throw the damn thing out the window. It must know I have been shopping new laptops.

Okay....asleep breathing/flow rate is circled in red. Note the smooth regular breaths.



and a not so zoomed in image of the same flow rate time frame....everything you see after the red circle I wasn't asleep.

If we aren't asleep then other than make us wonder why we weren't asleep they don't count.



So when you spot arousal breathing you need to examine the flow rate just prior to the change and look for evidence of airway issues while actually asleep just to see if possibly the air flow reduction when for sure asleep might have been the cause of the arousal.
On your images here...can't see the asleep for sure flow rate that preceded the arousal breathing.

Now as for medication side effects....might not be your entire problem but I am betting they are a factor.
I realize that the problem you take them for can also mess with sleep though so this is one of those damned if you do and damned if you don't situations.
Also...it is entirely possible that people have more than one thing messing with sleep...you might have some UARS stuff going on and also have medication side effects going on as well.

It's really hard to spot UARS stuff on these reports because these machines weren't really ever designed to fight UARS.
To spot flow limitations you have to examine each breath up close and personal.