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Posted: **Wed Dec 14, 2022 10:57 am**

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Okay gals, hope the "hijacking message" got back to Papnapper . . . BACK TO MY THREAD NOW

I'm posting last night's OSCAR report https://imgur.com/zBgij5L for two reasons:

1. Last night I was Supine MOST OF THE NIGHT . . . yet my Pressure never surged past 14 (when MAX P was set at 18.6) unlike previous supine nights when pressure surges "maxed out" at the MAX P setting of 16. Wonder why? I'm hoping it's because my new, very comfortable velvety "Eliminator Sleep Cushion" worked to prevent "chin tucking". First night I used it, so we'll see. https://www.amazon.com/Eliminator-Washa ... ljaz10cnVl

2. When I zoomed slightly on the Flow Rate graph between 5:48am-6:57am . . . I see a lot of "waxing & waning". I would like to know if this is what is called PERIODIC BREATHING (similar to CSR) and what, if any, significance it has.

I also zoomed in more closely on the "reported" CA Clusters w/ an occasional OA at the same time period. Most, if not all, of these reported events appeared clearly "False" to me because of all the SWJ just before & after. Would appreciated it if one of the experts would check this out for me to confirm that I am right (or wrong).

Here is the SleepHQ link for last night which allows you to Zoom in & out: https://sleephq.com/public/671d9a80-056 ... 55b0d4d689
Press "Z" to Zoom-in, "X" to Zoom-out, or "R" to Return to original Flow Rate graph. (As with OSCAR, use the "arrows" to move Left & Right.)

Thanks, in advance, for your input and insight!

Joy

Posted: **Wed Dec 14, 2022 11:15 am**

Some of that Periodic Breathing looking waveform is awake/arousal breathing...some may be PB and for some reason the machine didn't flag it as CSR. Maybe it didn't quite make the criteria for some reason.
Anyway it's not indicative of anything that you need to worry about even if it is real. PB is just a waxing and waning of the air flow and unless someone is seeing truck loads of Centrals with it....doesn't mean much.

JoyD. wrote: ↑
Wed Dec 14, 2022 10:57 am
1. Last night I was Supine MOST OF THE NIGHT . . . yet my Pressure never surged past 14 (when MAX P was set at 18.6) unlike previous supine nights when pressure surges "maxed out" at the MAX P setting of 16. Wonder why? I'm hoping it's because my new, very comfortable velvety "Eliminator Sleep Cushion" worked to prevent "chin tucking". First night I used it, so we'll see.

That is very possible. Need more nights of data to know for sure or not.

Posted: **Thu Dec 15, 2022 6:51 pm**

Sorry people for not following protocol. I did not find any posts with my concern so I replied to the thread as it seemed to be recent about the O2ring.
I will post as a new topic.

Posted: **Thu Dec 15, 2022 6:56 pm**

JoyD. wrote: ↑
Wed Dec 14, 2022 7:29 am

papnapper wrote: ↑
Wed Dec 14, 2022 3:18 am
On the day I received my Wellvue O2-ring, 3 months ago, I was concerned about the possibility of personal identification data being sent via the internet when plugged into my PC to ?????
I sent 3 emails to the makers, the support and the software people asking what was in the unusually large connector of the supplied USB cable. I have never received a reply.
I decided never to plug into my PC but I have been using the app on my Android phone. The only permission I had to allow the app was Bluetooth UNTIL YESTERDAY. It suddenly asked for permission to know my location! Then today, it also wanted permission to access " Photos / Multimedia / Files storage ... in the cache".

I am not being paranoid with my concern as I am simply following the common advice to avoid having personal information published, in order to avoid spam, fraud, hacks etc.

I would not be posting the above if I had received a reply to the emails I sent either.
Papnapper,
I am puzzled as to what your post above has to do with the subject of my thread ???

JoyD.

Sorry JoyD. I am bowing humbly from the ankles. Please see my other apology. I'll sheck your thread when I get time and if I can help, be assured I shall.

Posted: **Mon Jan 09, 2023 2:55 pm**

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Found an excellent recent publication from Circulation, July 20, 2021 issue called "Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement from the American Heart Association. One of the contributors is Virend K. Somers, MD, PhD, a recognized expert on the topic from Mayo Clinic College of Medicine.

https://www.ahajournals.org/doi/epub/10 ... 0000000988

The article mentions one ongoing clinical trial, the ADVENT - HF [Effect of Adaptive Servo Ventilation on Survival and Hospital Admissions in Heart Failure] which I am most interest in seeing the outcome.

Posted: **Thu Feb 02, 2023 9:24 am**

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This morning I just want to say THANKS to Pugsy, Ozij, RobySue1, and others for your help in getting me in a better place with my CPAP therapy. I am posting my last nights OSCAR report showing what I have been seeing for the past two weeks:

* A smoother Flow Rate graph (fewer arousals)
* Flow Limits now down to -- 0.3-0.4 -- 95% of the night (I keep my EPR at 3 now)
* An AHI of under 2.0 (and probably much lower because of False reports).
* Fewer times up to pee

The main thing, I believe, that has made such a difference is that my MINIMUM PRESSURE is now at 13.0 (10.0 EPAP with an EPR of 3). I have been using this minimum pressure & EPR since Jan 13th. ALSO, I go to bed when I'm tired (11:00 to midnight) and do not fret anymore. And I feel refreshed when I wake up. So . . . thanks for your help achieving this!

Here is last night's report: PLEASE NOTE that the "cluster of CAs" at the very end after I woke up are FALSE - I was awake, and struggling over my pillows to reach over to turn off my machine, no doubt holding my breath in the process . . .
https://imgur.com/a/PK4h9Ro

I still don't like to see more CAs than OAs & Hs every night, even with low AHIs. But I figure with the above results I'm getting, it's not anything to worry about. (And I've rarely been seeing CSRs reported so I ignore them now.) Would you agree?

I HAVE THREE QUESTIONS pertaining to "reading & interpreting" OSCAR graphs:

1. With REAL CAs, do you have "recovery breaths" after the reported event (as with OAs) ?
2. If there is SWJ-looking breaths JUST PRIOR to a reported CA does that indicate that it is FALSE ?
3. Does the Respiratory Rate graph help to identify TRUE from FALSE CAs & OAs with a drop in RR? Must this drop reach zero to be considered a REAL event?

Joy
PS - Waiting patiently for the arrival of my Bleep Eclipse . . . the bags under my eyes have been terrible!

Posted: **Thu Feb 02, 2023 9:38 am**

JoyD. wrote: ↑
Thu Feb 02, 2023 9:24 am
If there is SWJ-looking breaths JUST PRIOR to a reported CA does that indicate that it is FALSE ?

You can think of them as false positives in terms of the flagging being related to the airway but they happened. They just aren't anything bad except it points to not being sound asleep.
We don't breath irregularly like that if we are asleep so we must be awake/semi awake when the flagging happened.

Just saw a good example in someone else's report. The asleep breathing is obvious and the arousal/awake breathing is just as obvious.

JoyD. wrote: ↑
Thu Feb 02, 2023 9:24 am
Does the Respiratory Rate graph help to identify TRUE from FALSE CAs & OAs with a drop in RR? Must this drop reach zero to be considered a REAL event?

I have never been able to spot a correlation when evaluating RR. My RR is always all over the place so it's not a reliable baseline. Other people might be able to spot something but I don't even try. The breath itself is self explanatory and I don't need anything else to verify.

Posted: **Thu Feb 02, 2023 12:22 pm**

JoyD. wrote: ↑
Thu Feb 02, 2023 9:24 am
I still don't like to see more CAs than OAs & Hs every night, even with low AHIs. But I figure with the above results I'm getting, it's not anything to worry about. (And I've rarely been seeing CSRs reported so I ignore them now.) Would you agree?

Absolutely. No need for concern.
And it sounds great.

When the machine reports a "clear airway apnea" it's simply saying: "You're not breathing, and I don't see indications of obstruction". If your breathing cessation don't appear out of nowhere within your regular sleep breathing, you can ignore them.

Pugsy gave some examples a few hours ago:
viewtopic.php?f=1&t=186067&p=1433576&hi ... s#p1433570

Posted: **Thu Feb 02, 2023 10:13 pm**

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Thanks Pugsy and Ozij. Your feedback is always appreciated!

Joy

Posted: **Mon Feb 13, 2023 10:37 am**

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I'm still trying to get better interpreting my Flow Rate breaths.

Below are two zoomed-in shots of breaths that I'd like feedback on please . . .

1. The first are "smaller breaths with tails at the exhale" (first half of my zoomed shot). I OFTEN see these "sleep breaths", even for an extended period of time like up to 15 minutes. -- Contrast them with what I would call "NORMAL sleep breaths" seen at the very end of the shot (7:35am).
-- Do you see these in your Flow Rate? What do you think they are??
https://imgur.com/a/x63tzhA

2. The second zoomed in shot is of a CLUSTER OF 6 CA's that appear to be REAL CAs to me (since they don't have SWJ or arousals prior). In the shot below you see only four of the six, but all look the same.
-- I rarely see "REAL" CA's in my Flow Rate since most of the time they have SWJs just prior. Here is what I would call a GOOD NIGHT (feel rested & low AHI) . . . so what's going on?? I wonder what would cause a CLUSTER of SIX that appear to be "real"?? Any ideas about this?
https://imgur.com/a/l9TvFiG

Thanks,
Joy

Posted: **Mon Feb 13, 2023 7:20 pm**

JoyD. wrote: ↑
Mon Feb 13, 2023 10:37 am
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I'm still trying to get better interpreting my Flow Rate breaths.

Below are two zoomed-in shots of breaths that I'd like feedback on please . . .

It would help us tremendously if you included the flow limitation graph as well as the flow rate graph.

1. The first are "smaller breaths with tails at the exhale" (first half of my zoomed shot). I OFTEN see these "sleep breaths", even for an extended period of time like up to 15 minutes. -- Contrast them with what I would call "NORMAL sleep breaths" seen at the very end of the shot (7:35am).
-- Do you see these in your Flow Rate? What do you think they are??

Here is your image:

The usual suspect for this kind of flow rate data is "expiratory mouth breathing"---meaning opening your mouth on exhalation, but closing it on inhalation. The reason this is the usual suspect is a figure showing several different kinds of typical flow rate patterns that may (or may not) indicate flow limitation problems. The original figure was drawn from source that I don't remember and this image has been posted both here at cpaptalk and over at apneaboard.com a number of times. That figure, which is posted on apneaboard's wiki pages looks like this:

Yes, I regularly see this kind of thing in my own flow data. Here's a typical stretch of this kind of stuff from my own data:

You should notice that my AirCurve 10 is not increasing the pressure the way it would if the machine thought my airway was beginning to be compromised--there are no flow limitations being flagged and no snoring detected. And in spite of the possibility that I am opening my mouth on exhalation, there are no leaks. And that's actually pretty typical of these kinds of areas in my flow rate data.

When I see this kind of stuff and the machine is happy enough with my breathing to not increase the pressure and there are no leaks and I don't remember any restlessness and I wake up feeling pretty decent, I just ignore this stuff and write it off as a variation of my normal sleep breathing, most likely caused by my mouth opening on exhalations and closing on inhalations.

2. The second zoomed in shot is of a CLUSTER OF 6 CA's that appear to be REAL CAs to me (since they don't have SWJ or arousals prior). In the shot below you see only four of the six, but all look the same.
-- I rarely see "REAL" CA's in my Flow Rate since most of the time they have SWJs just prior. Here is what I would call a GOOD NIGHT (feel rested & low AHI) . . . so what's going on?? I wonder what would cause a CLUSTER of SIX that appear to be "real"?? Any ideas about this?

Here is your image:

What we can't see is what was going on just before the first of these CAs was scored. You say that when you usually see CAs, you don't think they're real because they've got some SWJ and/or arousal breathing before the (first) CA is scored. But in the snippet you have shown us, you didn't show us what the breathing looked like before the first CA.

Since you self describe this as a GOOD NIGHT (feel rested & low AHI), I'd be inclined to not overthink or worry about this. Write it off as a visit from Pugsy's aliens.

Now if you were saying that you were seeing a lot of CA clusters that looked like this on a night where you woke up feeling like the night had been a bad night---i.e. you woke up feeling not particularly rested and the AHI, including the CAI, was higher than you typically see, then I would think there might be something to be gained by trying to figure out what was going on.

Posted: **Wed Feb 22, 2023 5:00 pm**

robysue1 wrote: ↑
Mon Feb 13, 2023 7:20 pm

The usual suspect for this kind of flow rate data is "expiratory mouth breathing"---meaning opening your mouth on exhalation, but closing it on inhalation. The reason this is the usual suspect is a figure showing several different kinds of typical flow rate patterns that may (or may not) indicate flow limitation problems. The original figure was drawn from source that I don't remember and this image has been posted both here at cpaptalk and over at apneaboard.com a number of times. That figure, which is posted on apneaboard's wiki pages looks like this:

Yes, Robysue, I have seen this figure before . . . the thing is that I tape my mouth every night and it stays well fixed, so I assume that means that I can't be having "expiratory mouth breathing", right? My posting sure looks like the pattern though.

Joy

PS - Is it okay to post graphs and figures now, rather than use links to Imgur?? If so, I'll start doing that.

Posted: **Fri Feb 24, 2023 9:57 am**

JoyD. wrote: ↑
Wed Feb 22, 2023 5:00 pm

robysue1 wrote: ↑
Mon Feb 13, 2023 7:20 pm

The usual suspect for this kind of flow rate data is "expiratory mouth breathing"---meaning opening your mouth on exhalation, but closing it on inhalation. The reason this is the usual suspect is a figure showing several different kinds of typical flow rate patterns that may (or may not) indicate flow limitation problems. The original figure was drawn from source that I don't remember and this image has been posted both here at cpaptalk and over at apneaboard.com a number of times. That figure, which is posted on apneaboard's wiki pages looks like this:

Yes, Robysue, I have seen this figure before . . . the thing is that I tape my mouth every night and it stays well fixed, so I assume that means that I can't be having "expiratory mouth breathing", right? My posting sure looks like the pattern though.

Joy

PS - Is it okay to post graphs and figures now, rather than use links to Imgur?? If so, I'll start doing that.
1) I'd strongly suggest that you continue using imgur: The storage for images at cpaptalk is very limited and pugsy can't clear them out. The image I posted is part of the wiki over at apneaboard, not here at cpaptalk.

2) Mouth taping prevents your mouth from dropping wide open. But for most people, it does not prevent the lips from opening slightly. If you can "buzz" you your lips when your mouth is taped, then my guess is that enough air can escape through those lips to trigger an "expiratory mouth breathing" wave form in the flow rate graph. But if your leak line is ok and you are feeling decent enough on waking, I would not worry about this particular thing popping up in the flow rate graph.

Posted: **Fri Feb 24, 2023 10:04 am**

You can still use imgur to host your screenshots either as a link like you have been doing or as an embedded image like the one below. I have instructions for how to embed images somewhere....can't lay my hands on it at the moment.

Here's an image from a recent report of mine that I saved so I could brag and pat myself on the back for the 0.0 leak line graph. I don't see those all that often so for me it's a red letter day. Usually I have a very short period of some sort of mouth opening leak messing up my leak line. I sleep through it....so other than being a bit annoyed because I missed 0.0 again..I don't really care.

Posted: **Fri Feb 24, 2023 10:56 am**

Pugsy wrote: ↑
Fri Feb 24, 2023 10:04 am
You can still use imgur to host your screenshots either as a link like you have been doing or as an embedded image like the one below. I have instructions for how to embed images somewhere....can't lay my hands on it at the moment.

Here's an image from a recent report of mine that I saved so I could brag and pat myself on the back for the 0.0 leak line graph. I don't see those all that often so for me it's a red letter day.

What I'M so impressed with is the "smoothness" of your Flow Rate graph . . . mine is always fuzzy with arousals &/or periodic breathing (at least part of the night)!! Was this "smoothness" also the case when you had a regular APAP with being limited to how much pressure support you could use?

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