Flow Rate Disturbances But No Events?

Hey all,

I drilled through last night's OSCAR data, and I'm seeing a bunch of disturbances from the "expected" flow rate, but they are not being marked as events. Are any of these problematic? If so, any idea what kind of events they are?

Expected flow rate:

https://imgur.com/a/80ojpgN

Flow rate disturbances:

https://imgur.com/a/PFaYcss

No flagging because the criteria to earn a flag isn't met.

That little irregularity at is just a very short lived arousal episode. It isn't a big deal and you probably don't even remember that arousal. If you see LOTS of these sort of arousal segments then it might point to poor sleep quality for some reason or other. Evidence of fragmented sleep.
When I say LOTS....I mean 30 to 50 of those segments.

You don't have to have an apnea event flagged to have an arousal/awakening.

That one you zoomed in on looks like a very brief spontaneous arousal.

Pugsy wrote: ↑

Mon Apr 04, 2022 10:07 pm

No flagging because the criteria to earn a flag isn't met.

That little irregularity at is just a very short lived arousal episode. It isn't a big deal and you probably don't even remember that arousal. If you see LOTS of these sort of arousal segments then it might point to poor sleep quality for some reason or other. Evidence of fragmented sleep.
When I say LOTS....I mean 30 to 50 of those segments.

You don't have to have an apnea event flagged to have an arousal/awakening.

That one you zoomed in on looks like a very brief spontaneous arousal.

In the second link there should be 12 attached screenshots from one night.
Do all of those look like the arousal episodes you're talking about?
If so, are you implying these are not breathing / apnea / RERA / UARS related arousals and something else?
What could it be?

They are ALL examples of irregular breathing while awake or half awake.
Now what caused the arousals...million dollar question but I am betting on some sort of spontaneous arousal.

2 types of arousals....respiratory or airway related and spontaneous which means no known cause.

If you are seeing a lot of those types of irregular breathing segments then you need to be looking at something outside the airway as to being the cause IMHO.

CPAP can only fix arousals that are airway related and I just don't see it on the examples you shared.
The list of potential culprits for spontaneous arousals is miles long.

Pugsy wrote: ↑

Tue Apr 05, 2022 8:09 am

They are ALL examples of irregular breathing while awake or half awake.
Now what caused the arousals...million dollar question but I am betting on some sort of spontaneous arousal.

2 types of arousals....respiratory or airway related and spontaneous which means no known cause.

If you are seeing a lot of those types of irregular breathing segments then you need to be looking at something outside the airway as to being the cause IMHO.

CPAP can only fix arousals that are airway related and I just don't see it on the examples you shared.
The list of potential culprits for spontaneous arousals is miles long.

So my at-home sleep test (WatchPAT) measured a pretty low ~2 AHI and ~11 RDI. If these flow rate disturbances are just arousal breathing, is it possible my at home test "RDI" was measuring these arousals as events, and these arousals are the real reason for my consistently poor sleep quality as opposed to airway obstruction issues? I have not felt much benefit from the CPAP therapy so far in the first week of usage... but I guess adherence has only been 3-5 hours out of the 9 hours of sleep a night.

cpapuser55 wrote: ↑

Tue Apr 05, 2022 9:41 am

, is it possible my at home test "RDI" was measuring these arousals as events, and these arousals are the real reason for my consistently poor sleep quality as opposed to airway obstruction issues?

It's possible. I have no idea what the home sleep study measured. Does it happen to give you a sleep stage breakdown in the report??? If it didn't measure sleep status we have zero way to know if what it flagged happened in sleep or not.
Meaning were the arousals causing the poor sleep or a symptom of the poor sleep.

cpapuser55 wrote: ↑

Tue Apr 05, 2022 9:41 am

I have not felt much benefit from the CPAP therapy so far in the first week of usage... but I guess adherence has only been 3-5 hours out of the 9 hours of sleep a night.

So only on cpap for a week and even only using it 3 to 5 hours a night and sleeping the rest of the night without it???

Your were expecting the overnight miracle??? And then further expecting to get the miracle with limited hours of sleep using the mask and machine?

Give yourself 3 months and don't ever sleep without the mask and machine on ....then see what is going on.
While giving it time you can look for other potential causes of unwanted arousals.
First suspect would be medication side effects.
Second suspect would be any other physical or mental health issues.
and there are lots more.

Now I don't know why you are having those arousals and obviously can't how much might be spontaneous vs airway related but
1.....it's much too soon to expect much of anything
2.....not enough hours of sleep using mask and machine.

It wouldn't be impossible for the arousals to just be your brain alerting you to the new thing on your face blowing air up your nose and once the brain comes to realize that the mask is its new best friend those arousals caused by the brain should decrease with time. I know it took my brain about 3 months to stop poking me just to tell me I had an alien on my face blowing air up my nose.

It took me about the same length of time to welcome the friendly alien.
Its "good night kiss" makes my breathing so much easier.
After around 3 months, I was surprised to discover that I could keep up with the dog
while walking him--and was able to catch him when I fumbled the leash.
The only change that happened right away was no morning headache.
Even after the titration sleep study!
Everything else was gradual--my disposition, concentration, and memory improved.

Pugsy wrote: ↑

Tue Apr 05, 2022 9:55 am

So only on cpap for a week and even only using it 3 to 5 hours a night and sleeping the rest of the night without it???

Your were expecting the overnight miracle??? And then further expecting to get the miracle with limited hours of sleep using the mask and machine?

Give yourself 3 months and don't ever sleep without the mask and machine on ....then see what is going on.
While giving it time you can look for other potential causes of unwanted arousals.
First suspect would be medication side effects.
Second suspect would be any other physical or mental health issues.
and there are lots more.

No medications, no physical or mental health issues.

I was having issues falling _back_ asleep once consciously aroused with the mask on. My sleep doctor told me it's better to take the mask off in that case, and try again next night, rather than struggle with trying to fall back asleep with the mask on. Before trying CPAP I wouldn't have many issues falling back asleep if I was consciously aroused in order to pee, or from some noise in the night or what have you. So when I do get consciously aroused with the mask on, it appears to be brain/body rejection as I have no other indication of what could've caused the arousal (such as mask leak, noise, etc) or why I can't fall back asleep.

Pugsy wrote: ↑

Tue Apr 05, 2022 9:55 am

Now I don't know why you are having those arousals and obviously can't how much might be spontaneous vs airway related but
1.....it's much too soon to expect much of anything
2.....not enough hours of sleep using mask and machine.

It wouldn't be impossible for the arousals to just be your brain alerting you to the new thing on your face blowing air up your nose and once the brain comes to realize that the mask is its new best friend those arousals caused by the brain should decrease with time. I know it took my brain about 3 months to stop poking me just to tell me I had an alien on my face blowing air up my nose.

So you are suggesting there's basically just no good indications of what those arousals could be at the moment? The flow rate disturbances that you believe to be arousals are NOT the arousals I spoke about above ^ (when I would wake up and not be able to fall back asleep). These flow rate disturbances are not associated with any conscious arousal on my part.

cpapuser55 wrote: ↑

Tue Apr 05, 2022 12:46 pm

So you are suggesting there's basically just no good indications of what those arousals could be at the moment? The flow rate disturbances that you believe to be arousals are NOT the arousals I spoke about above ^ (when I would wake up and not be able to fall back asleep). These flow rate disturbances are not associated with any conscious arousal on my part.

try this. when you wake up from those arousals, turn your machine off then back on. this will show as a break in the oscar graph. then you can see what event, if any, is related to the arousal.

good luck.