Rubicon wrote: ↑Tue Oct 18, 2022 3:31 pm
robysue1 wrote: ↑Sat Oct 15, 2022 3:26 pm
Yes, there is one cluster of events that starts around 2:50 AM (EDT since I'm in Buffalo, NY) that has 6 OAs scored in a 6-7 minute period. It would be really useful if someone like Rubicon or Pugsy looked at those OAs. To my eyes, it's not clear whether there was an arousal before the cluster started. It is clear that just before the cluster starts, your pressure was at 8.3cm. And it's clear that the machine increases the pressure from 8.3 to 11cm in a 1-minute long period between 2:50 and 2:51 EDT. The pressure increase is in response to the first two apneas being scored along with a flow limitation being scored. But the machine can't go any higher in response to the 3rd, 4th, 5th, and 6th OAs nor the continuing flow limitations that occur between 2:51 and 2:57 EDT.
Regular sleep breathing is established by around 2:57 EDT and continues 3:22:30 EDT. During this time the machine goes through a long pressure decrease specifically because there is nothing to "respond" to and your minimum pressure setting of 7.6 is not reached.
IMO at least 2 of those events are unambiguous respiratory events. Given the time of night, duration of disturbed breathing, machine response and sudden appearance and disappearance, that could very have been a REM period. The thing to remember about REM periods, they don't like being jostled. Poke 'em a couple times and the body will simply stop trying to REM and that period will be lost. Indeed, in severe severe OSA there may be no REM whatsoever. Put on them on xPAP and they REM till the cows. Massive REM rebound.
Thanks for looking at this Rubicon. As I said, this was not at all clear to me.
Which of the events are most unambiguously respiratory events? I want to learn from your expertise.
I would like to know what you are looking at when you say, "Given the time of night, duration of disturbed breathing, machine response and sudden appearance and disappearance, that could very have been a REM period."
Time of night I understand. I even understand that this cluster and the associated disturbed breathing lasts about 7 or 8 minutes and that some REM cycles are about that long and if a person's OSA is worse in REM that would explain the sudden start at the beginning of the REM cycle and end at the end of the REM cycle. But what do you mean by "machine response"?
The thing to remember about REM periods, they don't like being jostled.
Other than obstructive events, what else can jostle a REM period?
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