Is it possible I was misdiagnosed and CPAP is just not for me?

Yeah, those were my thoughts too when looking at the chart! Actually I did zoom a lot more but I tried to include more in less pictures so I wouldn't upload like 15 images But yeah, I noticed very few of the OA events seem 'real'.

So, for now you suggest we keep the same settings?

Also, how zoomed in would you like the snippets to be?

The goal for now is sleep and not allow real asleep OAs or hyponeas in too many numbers with the lower and fixed pressures in an effort to get that sleep.

Here's the deal with awake/arousal breathing and the machine's response....it doesn't know if you are asleep or not as it just measures air flow. It will flag AND respond to awake breathing irregularities just like if you are asleep since it is responding to air flow irregularities. This makes it extremely difficult to figure out your pressure needs.
If going by how the machine responds ...on paper you "need" a lot more pressure so in auto mode the machine will try to fix the air flow irregularities but the arousal/awake flow irregularities can't be fixed with more pressure.
Instead we have to try to fix or reduce the times awake....or simply not use a big auto mode range.
The machine though (in auto mode) will try to fix those awake/arousal related breathing irregularities with more pressure BUT in your situation more pressure sure won't fix them AND while it is doing that it is creating more problems that is messing with your already fragile sleep. More pressure can cause more leak challenges which then can cause you to wake up more.
More pressure pressure just sometimes causes more problems than it fixes. Higher pressures can cause comfort issues which in turn can create staying asleep problems.

In your situation with your already fragile sleep (from whatever) maybe letting the machine go on a hunting and killing expedition isn't the optimal way of addressing air flow issues. It's maybe contributing to already just bad sleep from most likely a lot of spontaneous arousals. Bad sleep can come from any number of reasons and sleep apnea or airway issues is just one of a very long list of potential culprits.
Right now I just want to try to improve overall sleep quality as best we can given what we know or don't know right now.
We don't know how accurate the home study results were because actual sleep itself wasn't ever measured. You are at some point in the future going to have a real in lab sleep study which will answer a lot of questions. In the meantime we try to do what we can to optimize the cpap treatment in an effort to deal with real asleep OSA events just in case you for sure do have OSA because we want to err on the side of caution and not allow untreated sleep apnea to happen if we can prevent it. It wouldn't be impossible for you to have 2 problems....OSA and a truckload of spontaneous arousals messing with your sleep quality. We can't do much about the spontaneous arousals (and I have no doubt that you are having a lot of them) with cpap pressure but we can deal with any OSA related arousals with cpap.

My thoughts are fix what we can fix with cpap and then see what is left that is maybe a problem.

For some people the machine going on a hunting expedition in auto mode chasing awake/arousal false positives doesn't really create any problems. I am one of those people which is why I just let the machine do its thing but some people with already fragile sleep those false positives does create a problem so we rein it in a bit. There are several ways to rein it in....just go to fixed pressures or maybe use a tight auto range.

As far as optimal zooming in....it depends on what we are looking at and how "iffy" the flow rate is for figuring out awake vs asleep. Sometimes it's easy to spot and sometimes not so easy to spot and the iffier it is the more we have to zoom in.
Since I couldn't see times on your screen shots I can't give you a time frame example but usually 3 to 6 minute segments will do it. When you crowd too much time in a screen shot we can't tell much.
The one you did above where there were 2 very obvious false positive OAs flagged...super easy to spot level of zooming in and scale.

I don't need to see all of them. I just wanted you to get an idea about the overall arousal index that points to awake times that you might or might not remember and any events flagged during obvious arousal breathing aren't real and they don't count and we can manually remove them from in AHI evaluation.

A while back I had an AHI of 9.4 night...whoa....pretty impressive on the face of it but once I looked at each flagged event I could easily see I was awake when they were flagged. Just had a really, really bad night from back pain because this old woman over did her gardening and paid for it later. Fully 95% of all my flagged events were awake false positives.
I already knew I had a crappy night's sleep anyway because I hurt like hell all night. The machine increased the pressure like crazy too....but it didn't help. It didn't help reduce any events because I wasn't really asleep.

So I don't really need to see all your "arousal" episodes unless you are unsure of them...and if you are unsure I probably need a 3 to 5 minute segment. It won't take you long to get a good handle on what you are seeing.
Asleep breathing is very boring and rhythmic...anything else is arousal/awake breathing.
Sometimes it isn't always so easy to tell for even if zoomed in but most of the time you will know fairly easily.

A real asleep flagged event...not a cause for alarm as long as random and rare. I don't expect zero real asleep events in the results.
As long as we keep the overall average of real asleep flagged events to less than 2 per hour...it's acceptable.

For now I want you to just continue doing what you are doing.
Do try to avoid napping during the day if at all possible because that will also mess with your sleep quality at night and tend you make you wake up more often or too early.

Getting the sleep itself is first and foremost on your to do list. Lets see if fixed at 7 cm continues to do a good job preventing real asleep events and lets see if we can get the number of arousals in general down.

The question about "do you really have OSA at all given the questionable home study".....that remains to be answered.

Do you know what the oxygen level data showed on that home study? Did it drop much? Ever get below 88 % for any length of time? That in itself is a huge red flag if it did.

Thanks again Pugsy!! I tried the same setup a second night and I feel like I slept pretty crappy.. no idea why though! I made a huge image with many many screenshots all in one image so you can really see what's going on. At least with these settings (and still using tape, no clue if I need it or now) we took care of the leaks... the average here is almost 0!

I just checked my test results and it says the lower I got was 90% saturation. Also, there's an index for how many times I desaturated and it was 5.1/hour. Unfortunately I can't really upload the test results here since they're all in French... but if you need any info I can get from it, I can try to figure out the terms.

So yeah, after having checked my whole night in OSCAR, I can see that I had lots of arousals and very few events seem to be real, but maybe you'll have a different opinion when looking... I'm pretty good at spotting the ones that are obviously not real asleep events, but there are some that are maybe a bit less obvious.

Anyway, I hope these screenshots work better and thanks again for helping!!!

EDIT : Ooops.. just noticed the same snippet is there twice in the 'big' image, and two of them are inverted (I tried to make them chronological)

EDIT 2 : I just rechecked my test results and noticed there are lots of screenshots from my test results at the bottom of the PDF pointing to 'obstructive abnormalities' and the software they use is in English. Of course I don't understand ANYTHING about it, but if you want, I could post these screenshots here!

Screw that! I couldn't put all the screenshots in one file, so I uploaded it all to Google Drive, here's the link : https://drive.google.com/drive/folders/ ... sp=sharing


There's one where it pointed ''important obstruction with snore'' and the ''HRVAS'' one or something, I'm pretty sure that's the French term for UARS.

One night really good or really bad doesn't make a trend. That's why I don't get all upset or worried or dance a jig after one night.

Lots of arousals.

Most of the flagged events are arousal related but I spotted one that I think for sure is a real asleep flagged OA...10:12:40ish.
And I suspect that the irregularity after that flagged event is arousal related because the OA likely caused an arousal.

When you see a big gulp of air just prior to a bit of a flat line and a flag...most likely arousal related. Maybe a hold your breath and turn over in bed flagged event.
We don't take big gulps of air when we are asleep unless we might do it AFTER the flagged event and then we do a recovery breath or big gulp. Not before event flags though.

Djonne wrote: ↑

Tue Aug 10, 2021 6:22 pm

I tried the same setup a second night and I feel like I slept pretty crappy.. no idea why though!

Why do you think it was a crappy night? Remember a lot of wake up or tossing or turning or what?????

The sleep test images don't help me much because I don't have a baseline or reference point for any of those images because I have no idea how they were obtained. Sorry...above my pay grade. Not familiar with the product or software at all.
They do appear to confirm a lot of arousal breathing though...which we already kinda knew.

Pugsy wrote: ↑

Tue Aug 10, 2021 6:39 pm

Why do you think it was a crappy night? Remember a lot of wake up or tossing or turning or what?????

Yeah, I remember being awake almost all night long and I feel like crap today!

Djonne wrote: ↑

Tue Aug 10, 2021 7:28 pm

Pugsy wrote: ↑

Tue Aug 10, 2021 6:39 pm

Why do you think it was a crappy night? Remember a lot of wake up or tossing or turning or what?????

Yeah, I remember being awake almost all night long and I feel like crap today!

Well...I totally understand. Been there and done that.
It's really hard to fix bad sleep like that even if we knew why...and in your situation we don't know why.
Bad sleep is a bitch. I wish it were easy to fix with cpap and sleep apnea was the only ever cause of bad sleep but it just isn't always easy. We can't fix bad sleep with cpap if the bad sleep isn't from the airway issues.

If the Benadryl doesn't seem to hold well enough...try that RX sleep aid you have available. Maybe with the fixed pressures and leaks not being a factor it will stand a better chance of helping.

Sleep onset insomnia....trouble falling asleep.
Sleep maintenance insomnia...trouble staying asleep (waking often during the night or maybe earlier than we want).

We just keep trying stuff to see if we can find something that helps. Like what are the options??? Give up??? Not try???
Not in my dictionary.

Not in mine either!

I think you should get some confirmation of sleep apnea before continuing with CPAP.

Some things you could try (simplest first):
1) audio recording with an app like SnoreLab . Check for loud snoring and sudden stops/choking/gasping.
2) pulse oximeter . See how far your oxygen levels drop.
3) At home sleep test. Get one that you can have for more than one night, so that you can start recording(s) when you are so tired that you will be sure to sleep while it is one. Easiest to just pay out of pocket and get it quickly. Something like https://www.1800cpap.com/home-sleep-apn ... device-kit

fstrife wrote: ↑

Tue Aug 10, 2021 10:34 pm

I think you should get some confirmation of sleep apnea before continuing with CPAP.

Some things you could try (simplest first):
1) audio recording with an app like SnoreLab . Check for loud snoring and sudden stops/choking/gasping.
2) pulse oximeter . See how far your oxygen levels drop.
3) At home sleep test. Get one that you can have for more than one night, so that you can start recording(s) when you are so tired that you will be sure to sleep while it is one. Easiest to just pay out of pocket and get it quickly. Something like https://www.1800cpap.com/home-sleep-apn ... device-kit

All that is well and good to offer but OP is in France.
His choices might be limited and not the same as we have here in the US.

AND he has already had a home sleep study done but it wasn't a Type 2 study....didn't record sleep or awake or have EEG leads. That home study did confirm OSA at least from the data it gathered but the data was limited.
I wouldn't even consider another home sleep study unless it was a type 2 study.
The device and home study offered by 1800cpap...is the ApneaLink home study....a type 3 sleep study probably very similar to what he had.

His oxygen levels dropped only to 90%....we don't know the baseline but that isn't going to be a red flag with any certainty.
Just because the O2 levels didn't drop much doesn't mean no OSA but if they had dropped significant it would have been a more positive confirmation. They didn't drop enough to be a definitive sign of OSA in the sleep study he had.

Pulse oximeters might confirm a diagnosis but the absence of any drops doesn't really mean much. People can have severe OSA and not see any drops in O2. I have a friend to had an in lab study and her O2 never dropped below 94% from a baseline of 96% while awake....and her in lab study gave her a diagnosis of AHI over 60 per hour.

At this point an in lab sleep study is on the books for sometime in the future...so it is being worked on.

I'm not in France, I'm in Quebec! We speak French

Djonne wrote: ↑

Tue Aug 10, 2021 11:27 pm

I'm not in France, I'm in Quebec! We speak French

Sorry about that.
Same explanation though....what is available in the US isn't necessarily available in Canada.
Both Canada and and France have a long wait time for a lot of medical services and same options we have here aren't available for you guys.

Though if you could find a way to get your hands on a Type 2 home study....it's extremely accurate and comprehensive compared to what you had done and would answer some questions anyway.

Have you considered asking for a repeat home study but this time make sure it is a Type 2???
Just a thought. Might be worth considering since it is unknown when you can get an in lab study.

Hey....I know this is your thread but since I did bear my soul a bit about my problems with sleep I thought I would share something with you.
I saw a doctor today about my pain issues (it's very relevant to my sleep issues since pain is what screws with my sleep) and there is a procedure that I can try that might help with the pain. I need some new x rays and a MRI first though.
More on that later in a separate thread maybe ...but I mention this because I told you that I don't quit.
I don't quit on myself and I won't quit on you as long as you want to try.

You do need a sleep study where they can tell if you are asleep though because we need to confirm if you really need cpap.
The reason I offer all these ideas right now is because I don't know that you don't have OSA...or really how bad it might be if you do....and I would rather at least try to help with the sleep and OSA than just not do anything because if you do have OSA...it needs to be treated and cpap won't hurt you to use it even if you don't have enough apneas to earn the diagnosis.
I would rather be safe than sorry.

Besides....you need help with your sleep quality problems no matter what.

I share my experiences so you know you aren't alone in this struggle.

Yeah, thanks for sharing!! I hope your pain improves... or should I say worsens haha!

Actually I can't ask for a study, it has to be requested by a doctor or else it costs A LOT, 1000$ and more... I'll have to wait for the sleep lab study. I don't think they do the type of home study you'd want, but I'm not sure.

One thing's for sure regarding my diagnosis is that I know that I used to snore a lot, but not every night though. If I fell asleep, especially when I laid on my back and fell asleep without necessarily wanting it, like laying down and accidentally fall asleep, I'd wake up from snoring super loudly! So let's say I don't have OSA, the ResMed that I already paid for can still help with that... I'm used to it anyway.

And yeah, the more I look at my OSCAR charts, the more I see that I have many, many arousal episodes whether linked with false events or not... and very few OSAs that happen to be real with the pressure at 7, so I doubt we need to increase it indeed! I need to figure out a way to sleep better that's for sure. I'll try the Zopiclone tonight and see how I sleep. I haven't tried the combo of the Zopiclone with these settings on the machine, maybe it'll be better.

Many people have suggested that I try CBD as well. Are you familiar with it?

Like I said, I've always had a lot of sleep troubles, but never as much as I have lately. I'm starting to think that one of the problems is the fact I sleep with my girlfriend and she often has to wake up earlier than me and I think that kind of configured my brain into even lighter sleep, knowing I'll be awoken at some point... ! She'll be away for two weeks starting Thursday so that's gonna be a great way to figure out whether I sleep better without her. If so, I'll set a bed up in my studio room and sleep there from now on. My sleep has been so problematic ever since I got the CPAP that it's starting to impair everything in my life, including work. I'm also a singer and I absolutely CAN'T train my voice properly when I'm so messed up from the lack of sleep... so I'm not gonna give up for sure.. I never give up! The same goes for my voice... been training for 7 years without results and I still don't give up