Examples...mouth breathing leak, dry mouth, false positive flagging

So yesterday I woke up with massive dry mouth and I was mouth breathing big time.
Mouth was so dry it felt like someone had poured cement in my mouth and it had set up.
Figured I would download the data and see just how "bad" things were.

Remember that we tell people that it doesn't take a lot of mouth breathing to dry out the mouth nor does it automatically mean that the mouth breathing is causing a massive horrible large leak for the machine to try to deal with that is totally trashing the entire night's therapy.

See this example... I barely crossed the 24 L/min line and when I did...very brief. Yet my mouth was glued shut...or sure felt like it. It's very obvious when I was mouth breathing....and I have been using the Eclipse and it didn't come loose at all.



Also happened to have a good example of when the machine thinks the airway is obstructed and responds as such but I wasn't asleep when the false positive OA flagging occurred. I wasn't sound asleep when these OA flags happened. The flow rate breaths clearly point to irregular and not asleep breathing prior to and during all those flags.

So I just now took the time to review all the flagged events from Thursday night.
Only one flagged event was flagged when I was asleep.
This one below....looks like I was asleep before and after the flagged solo event. All the rest of the flagged events I wasn't sound asleep.

So out of 20 events flagged that night...only 1 appears to be a real asleep event flagging. The others flagged weren't even "iffy"...they were blatant arousal/awake related flags.

Approx 8 hours of use and 1 real event....
That makes my adjusted AHI for that night 0.125. Certainly a far cry from the reported 2.44.

See why numbers all by themselves don't mean much? Even rather numerous OA flags doesn't necessarily mean that more pressure is needed.

Remember false positive flagging isn't limited to just centrals.....we can have false positive OAs and hyponeas as well and the machine can/will respond to the obstructive flagged stuff even if they aren't real asleep event flags.

Remember the machine only measures air flow. It cannot and will not measure sleep status at all.

this may want to be a stickie?

in any event, thanks for sharing!

zonker wrote: ↑

Sat Feb 25, 2023 12:15 pm

this may want to be a stickie?

Maybe....depends on where it goes and how much activity it gets and what people want or need.

I have been thinking about a topic/thread used just for people posting zoomed in pictures of flagged events so they can figure out if arousal related or asleep related flagging is going on. You know a place where someone posts an image to ask if we think arousal related or a real asleep flagged event.

Not sure this topic is what I want to get derailed though....I can't decide yet what I want to do with it.
It's supposed to be educational though and I think the examples I shared are fairly easy to understand.
I have more examples of asleep vs arousal/awake flagged events handy if people want to see them and compare.

I prefer maybe only a half a dozen stickies....I think when we have too many stickies people just blow them off especially if they get large numbers of posts.

The beauty of it....I can decide sooner or later or never.

I'm actually really upset about a trend in my sleep therapy, that started last October.

I always thought myself very fortunate since starting therapy about 5 years ago, that I have been able to use nasal masks without concern for mouth breathing. Historically, my leak line was been relatively flat and well below the ResMed 24L/M threshold. Maybe the occasional mouth-leak blowout, but never enough to interfere with my sleep or therapy.

That is until last October. All of a sudden, my mouth-leaks started going through the roof, they were waking me, excessive dry mouth. I've got graphs demonstrating hours upon hours, well above 24L/M.

I've tried a few nights with a FF mask, and not loving it. And starting to have better success mouth taping.

With regard to false positives. During this ordeal, I been woken up to the point where I can't get back to sleep. And while lying there awake, flagged a ton of false positives. Both OSA and CA. I get more "events" awake, then asleep.

Didn't want to post graphs, but can. I don't want to hijack this topic and turn it into a personal therapy topic.

But do want to add, that even if one has had years of success, solely with a nasal mask, something can change causing mouth breathing or leaks.

Pugsy wrote: ↑

Sat Feb 25, 2023 9:08 am

Also happened to have a good example of when the machine thinks the airway is obstructed and responds as such but I wasn't asleep when the false positive OA flagging occurred. I wasn't sound asleep when these OA flags happened. The flow rate breaths clearly point to irregular and not asleep breathing prior to and during all those flags.

Thank you for posting your charts and starting this topic, it's something I've been wondering about. One question: You thought you were awake with the 1:10am OA, how do you know you weren't in REM sleep? My breathing can get very erratic during REM and I'm not sure how to tell the difference between that and being awake.

Dog Slobber wrote: ↑

Sat Feb 25, 2023 3:36 pm

Didn't want to post graphs, but can. I don't want to hijack this topic and turn it into a personal therapy topic.

Go ahead if you want to. I think people can still learn stuff from reading our own stuff. After all....that's how I learned or even still learn.
And besides....this isn't me asking for help kind of therapy help thread.
This is just me sharing some of my own stuff that I find interesting and sort of proves my past points.
Like we don't have to mouth breath all night to get dry mouth and you don't always have these huge massive leaks when we mouth breath.

Dog Slobber wrote: ↑

Sat Feb 25, 2023 3:36 pm

I've tried a few nights with a FF mask, and not loving it.

There's a reason I don't even own a full face mask.

samican wrote: ↑

Sat Feb 25, 2023 4:09 pm

One question: You thought you were awake with the 1:10am OA, how do you know you weren't in REM sleep?

2 reasons why I don't think it was REM related.
1....a REM cycle doesn't normally last over an hour especially that early in the sleep session
2....if it was REM related I would expect to see more irregular breathing at the intervals where REM cycles normally occur.
Like first REM 90 minutes or so after sleep onset kind of thing and I just can't tell any difference in my flow rate anywhere near where I would expect REM. I don't see those.

I would have to wait and see what Rubicon might offer if he thinks we breathe that weird during REM or if maybe we have a tonic vs phasic REM thing going on. I don't know for sure....above my pay grade.

https://www.sciencedirect.com/science/a ... 9220300484

I made this topic a sticky because the forum search I made for it came up empty and it shouldn't have...so it's too difficult to find and link to it.

I am also going to make a post about false positive flagging of central apneas because people are worrying about just a handful of centrals (real or not) and I am tired of people going into a panic over 2 or 3 centrals over the entire night.
The same question gets asked over and over again...sort of like the distilled water questions.

I don't have the time right now to make that post though.

Give me a little bit of time to compose and get examples the share.

Place holder for upcoming post about false positive central flags.

Edit 4/13/23 .....It may be a few days....I have been under the weather. Some dumb ass decided to get 2 vaccinations the same day. Caused some sleep problems as well as some general feeling like crap stuff.

Another place holder in case it is needed.

Pugsy wrote: ↑

Sat Feb 25, 2023 1:19 pm

zonker wrote: ↑

Sat Feb 25, 2023 12:15 pm

this may want to be a stickie?

Maybe....depends on where it goes and how much activity it gets and what people want or need.

I have been thinking about a topic/thread used just for people posting zoomed in pictures of flagged events so they can figure out if arousal related or asleep related flagging is going on. You know a place where someone posts an image to ask if we think arousal related or a real asleep flagged event.

Not sure this topic is what I want to get derailed though....I can't decide yet what I want to do with it.
It's supposed to be educational though and I think the examples I shared are fairly easy to understand.
I have more examples of asleep vs arousal/awake flagged events handy if people want to see them and compare.

I prefer maybe only a half a dozen stickies....I think when we have too many stickies people just blow them off especially if they get large numbers of posts.

The beauty of it....I can decide sooner or later or never.

I would love the links again on how I can post data to be reviewed to see if this applies to me.

Pugsy wrote: ↑

Sat Feb 25, 2023 4:36 pm

Dog Slobber wrote: ↑Sat Feb 25, 2023 10:36 pm
Didn't want to post graphs, but can. I don't want to hijack this topic and turn it into a personal therapy topic.

Dog Slobber
Could you, for the benefit of education, attach an Oscar graph of your OA's occurring when you are awake?
The fact is that I may have a lot of these false OA's. But it is not easy to be sure.

Thank you

Here's a bunch of OAs being flagged and NONE of them are real asleep OAs....they are all related to arousal/awake breathing irregularities. The breathing prior to the flagging is really irregular for quite a bit of time before the flagging.



This one is a real asleep flagged OA and if you look carefully a very small recovery breath (slight gulp of air or increase in inhale) after the flag. Sometimes recovery breaths are easy to spot and sometimes not so easy.