Oscar chart

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: Oscar chart

Post by Pugsy » Mon Jun 20, 2022 3:32 pm

jumblegirl wrote:
Mon Jun 20, 2022 3:18 pm
so I just posted 3 close ups with more time breathing before and I don't know where they went here is the last one

https://imgur.com/a/Xw3xjvp
I get nothing to see except a button that says "next".
If I click on it...looks like I get spam from imgur. :lol:

Here's a few flow rate charts I like to share with people so they can look at bigger chunks of flow rate.
This person does NOT have OSA and in fact his AHI during an in lab sleep study was only 1.8.
He DOES have really crappy sleep quality from something but it isn't related to his airway.

I think you can easily spot what little asleep breathing he has along with the alot of arousal breathing he has and every single one of his flagged events, no matter what they are called, are arousal/awake related.

Image

Image

Image
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Re: Oscar chart

Post by jumblegirl » Mon Jun 20, 2022 4:02 pm

how do you get those charts to appear like that?

does this link work? sigh, I did test it

https://imgur.com/a/Xw3xjvp

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Re: Oscar chart

Post by jumblegirl » Mon Jun 20, 2022 4:03 pm

So what did he have that was affecting his breathing/sleep that was not OSA?

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zonker
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Re: Oscar chart

Post by zonker » Mon Jun 20, 2022 4:12 pm

jumblegirl wrote:
Mon Jun 20, 2022 4:02 pm
how do you get those charts to appear like that?

does this link work? sigh, I did test it

https://imgur.com/a/Xw3xjvp
both links worked for me. maybe pugsy is being visited by aliens again. :lol:

just in case, here is what you posted-

Image
why folks don't like it when asked to clarify their statements?
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Pugsy
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Re: Oscar chart

Post by Pugsy » Mon Jun 20, 2022 4:33 pm

jumblegirl wrote:
Mon Jun 20, 2022 4:02 pm
how do you get those charts to appear like that?

does this link work? sigh, I did test it

https://imgur.com/a/Xw3xjvp
Yes, the link works for me now but didn't before. There's a big gulp of air right before the flagged event.....arousal related. Now what caused the arousal....unknown.

Those reports/charts were from a different machine using different software. That particular report is really the only thing that Encore and Respironics ever did that I really liked that ResMed can't do.
jumblegirl wrote:
Mon Jun 20, 2022 4:03 pm
So what did he have that was affecting his breathing/sleep that was not OSA?
His problem wasn't with his breathing. It was with his sleep quality but he sure wanted cpap/apap to fix things.
It goes back to the old saying .....cpap can't fix bad sleep when the bad sleep isn't caused by airway issues.
We never could figure out exactly what was going on with this guy because he didn't really want to explore anything other than fixing with cpap/apap/even asv. He was taking some medication that was well known to mess with sleep quality and cause arousals and mess with sleep stages but was unwilling to consider that aspect.

I shared those flow rate charts with a couple of sleep techs just to see if they agreed with my thoughts.
they both said "ewwwww....crappy sleep"
The problem with crappy sleep is we don't always know what is causing it and it's really hard to fix a problem when we don't know the cause of the problem.
It wasn't OSA though...and he had an in lab sleep study done to prove it. He bailed before it was ever really resolved because he wasn't getting the results he wanted or expected.
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Re: Oscar chart

Post by jumblegirl » Mon Jun 20, 2022 4:42 pm

So did the big gulp of air cause the central apnea? Mask leak or fell off even?

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Re: Oscar chart

Post by Pugsy » Mon Jun 20, 2022 4:57 pm

jumblegirl wrote:
Mon Jun 20, 2022 4:42 pm
So did the big gulp of air cause the central apnea? Mask leak or fell off even?
No. The big gulp of air was just arousal breathing...very brief.
The gulp of air doesn't cause the central per se.
If I was laying bets....that looks like a turn over in bed hold your breath central. We often will take a bigger breath and not realize it while half awake and turning over in bed which often we hold our breath at the same time.

Hold your breath for 10 seconds...that's essentially a 10 second central apnea. No big deal...no distress...not nearly long enough to cause a problem with desats. That's most likely what happened here. You woke up briefly, decided to turn over in bed/change position and while turning you held your breath. You most likely have no memory of it at all.
No big deal.
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Re: Oscar chart

Post by ChicagoGranny » Tue Jun 21, 2022 11:09 am

jumblegirl wrote:
Mon Jun 20, 2022 4:42 pm
So did the big gulp of air cause the central apnea?
I think you are beyond this, but just for good order's sake and good terminology, it's not an apnea if the subject is awake - not a central apnea and not an apnea of any kind. The machine will flag it as an apnea because the machine's assumption is that you are sleeping when using the machine.

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Re: Oscar chart

Post by jumblegirl » Tue Jun 21, 2022 11:32 am

Got it, so it just means I'm waking up a lot and then the machine is mislabeling as apnea.

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Re: Oscar chart

Post by jumblegirl » Tue Jun 21, 2022 11:38 am

Todays graph with big gap can't explain, mask problem I think

https://imgur.com/a/00UGQRg

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Re: Oscar chart

Post by ChicagoGranny » Tue Jun 21, 2022 11:46 am

jumblegirl wrote:
Tue Jun 21, 2022 11:38 am
Todays graph with big gap can't explain, mask problem I think

https://imgur.com/a/00UGQRg
There are things happening just before the gap - pressure increase, large leak. I would guess the mask comes off the face.

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Pugsy
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Re: Oscar chart

Post by Pugsy » Tue Jun 21, 2022 11:54 am

jumblegirl wrote:
Tue Jun 21, 2022 11:32 am
Got it, so it just means I'm waking up a lot and then the machine is mislabeling as apnea.
Exactly....the machine can't tell if you are awake or asleep. All it can do is measure air flow and when we are awake the air flow or our breathing is very irregular but the machine can only see the irregularities and so it flags them. It doesn't know if we are awake and those irregularities aren't real apneas.

Ultimately it's the awake breathing that is causing the false positive flagging...and the fix for that would be obviously reduce the time awake so that the chance for false positives is reduced. Easier said than done sometimes....well all the time if truth be known.

It's very common to wake up a lot when new to cpap therapy. If nothing else just from the newness of everything.
I think it took me at least 3 months before my brain quit waking me up just from the newness of it all and I didn't have problems with leaks or comfort or pressures or anything like that. My brain would just wake me up to point out the fact that I had an alien plastered on my face blowing air up my nose....and I didn't have a problem with that fact but my brain had a problem. Then we add in real problems that might cause us to wake up like comfort or leaks or whatever....
it makes for a period of time when we simply wake up often and sometimes we just don't know why.
This is why I always expect that some flagged events that newbies are going to see are very likely those false positive flags simply from awake/arousal irregular breathing.

Now I don't presume to blame all your flagged events on awake breathing irregularities but I do suspect a sizeable chunk are going to be explained away as false positives.
This is why most doctors adopt a wait and see approach before they will even consider doing anything about anything the reports might show when someone is brand new to therapy.....because sometimes it just takes time for the person to get adjusted to the new way of doing things and have the sleep quality settle down a bit and the chances of false positive flagging diminishes.

It's why I tell people who aren't sleeping so great to work on whatever it might be that is fixable so that chances of awake breathing isn't mucking up the data. We have to be asleep for anything flagged to really matter in terms sleep apnea therapy.

It is called sleep apnea for a reason....it isn't called awake apnea.
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Re: Oscar chart

Post by jumblegirl » Tue Jun 21, 2022 12:00 pm

so could the weird bouncing blue dots on the touch screen with the pressure # (in the middle of the night like 3am), mean the mask was off? it might have been on my face but not really hooked up. the blue dots were so strange but I do not think I was hallucinating.

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Re: Oscar chart

Post by Pugsy » Tue Jun 21, 2022 12:07 pm

ChicagoGranny wrote:
Tue Jun 21, 2022 11:46 am
jumblegirl wrote:
Tue Jun 21, 2022 11:38 am
Todays graph with big gap can't explain, mask problem I think

https://imgur.com/a/00UGQRg
There are things happening just before the gap - pressure increase, large leak. I would guess the mask comes off the face.
I agree.

Mask came off...and SmartStop was enabled and the machine quit recording anything.
Very possible that the mask was simply removed in the middle of the night and the person has no memory of that happening.
Possibly a good excuse to use the "tape the mask to the face trick"... and/or turn off the SmartStop feature and let the machine continue to blow which might wake the person up so they could put the mask back on again....or at least give us the flat line for BND (breathing not detected) reporting.

Also seen are some short breaks in therapy once the mask was put back on again and the blower restarted which means intermittent mask on/off was happening. Again potentially done while asleep ...sort of...and no memory of it occurring.
It's evidence of the mask coming off...unfortunately it can't tell us why it came off but I suspect our old friend the brain wanting to get rid of the alien on the face because he just hasn't come to grips with the fact that the alien is its new best friend.

I have no idea what you are seeing with the bouncing blue dots. Sorry.
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Re: Oscar chart

Post by jumblegirl » Tue Jun 21, 2022 12:15 pm

Yeah I turned off smartstop like you suggested so won't have it on for tonight.

At one point I noticed my mask was on but one of the magnets was completely detached so I'm sure the mask was dislodged. So I redid the magnet. That's all I remember besides the blue bouncing dots which I'm going to get a picture of next time :)

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