Unclassified Apneas

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Gidgemo
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Unclassified Apneas

Post by Gidgemo » Sat May 04, 2024 3:17 pm

Using an Aircurve 10 in Vauto mode, currently set min-15.4/Max 25.0 with PS of 4. First night set at this pressure. Mask is F&P Vitera. Because I am going thru a Bell's Palsy episode, I am wearing moisturing goggles and wearing a chin strap with the mask over it. Those are things I'd never normally do and it causes a large leak for almost the whole night. I had 1 Clear Airway event, 4 Hypopneas, and 4 Unclassified. I rarely got UA's in the past and even then it was 1 a night at the most. Any idea what these really are?
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Pugsy
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Re: Unclassified Apneas

Post by Pugsy » Sat May 04, 2024 4:39 pm

You were in the middle of a large leak for one thing.
You weren't asleep for another thing.
It really doesn't matter what they are if you aren't asleep because you have to be asleep for anything flagged to really matter.

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Gidgemo
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Re: Unclassified Apneas

Post by Gidgemo » Sun May 05, 2024 1:57 am

Thanks for the reply. Yes to large leak. Because of the fit, it had large leak 69.57% of the session. But i am pretty sure I was asleep. At same instance, I had an oxygen desaturation to 88%. I could be wrong.
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Pugsy
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Re: Unclassified Apneas

Post by Pugsy » Sun May 05, 2024 5:34 am

Believe what you want but you weren't sound asleep and that little dip to 88% for the O2 is probably just a brief loss of contact artifact. Asleep breathing is different from awake breathing (and you may not remember being awake) and awake/arousal related breathing is fairly easy to spot on the flow rate graph.

Real desats aren't that abrupt coming and going. It's a bit more gradual in the going down and coming back up than what your dip shows....like taking several minutes and not so short lived.

With 69% of the time being spent in large leak territory.....you got a significant problem with leaks that needs to be addressed. Fix the leaks and you won't see UAs get flagged.

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I may have to RISE but I refuse to SHINE.

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vandownbytheriver
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Re: Unclassified Apneas

Post by vandownbytheriver » Sun May 05, 2024 7:30 am

O2Ring artifacts normally show up in pulse, the O2 will stick to previous readings while the pulse will go high in my experience. No clue what O2 monitor you're using.

You mostly quit breathing for 30 seconds... yes, that's a real desat IMO. The machine did not call it a CA because there was some attempt at breathing by the graph. Evidently you did not meet the trigger level for inspiration... given the leaks (we don't have a leak graph) raising the trigger sensitivity is probably not needed if you're going to fix the leaks and this is a one-off event.

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onward60
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Re: Unclassified Apneas

Post by onward60 » Sun May 05, 2024 6:10 pm

I'm curious, Pugsy, how can you tell he's not asleep?

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Pugsy
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Re: Unclassified Apneas

Post by Pugsy » Sun May 05, 2024 6:34 pm

onward60 wrote:
Sun May 05, 2024 6:10 pm
I'm curious, Pugsy, how can you tell he's not asleep?
By the shape of the breaths in the flow rate graph.

Asleep breathing is very smooth, rhythmic and doesn't vary.
Awake/arousal breathing is very irregular when compared to asleep breathing. Easy to spot most of the time.
We don't take big gulps of air (seen on the flow rate graph) while asleep. So when we see irregular breathing we know "not asleep or not sound asleep".

Here's an example I like to use because it is so obvious.
I circled the asleep breathing in red. The other breathing not circled (including the flagged events) is arousal/awake breathing.

Image

and this is the same time segment but zoomed in a little closer to better see each breath.

Image

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

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Dog Slobber
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Re: Unclassified Apneas

Post by Dog Slobber » Mon May 06, 2024 9:41 am

This post serves as a good example of why people shouldn't post small snippets of their OSCAR screen shot.
  • Pugsy was able to recognise Large Leak because of the combination of UA and Grey Background. Many wouldn't,
  • We know with a lot of confidence, that the OP was awake (not awake enough to form strong memories, but likely awake) because the trace was volatile, *before* the screen shotted apnea.
  • It's possible there might have been another, prior to the event, but we can't see it because of the narrow view.
  • There might be other events and or information relevant as to the cause, but we can't see the whole picture.

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Rubicon
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Re: Unclassified Apneas

Post by Rubicon » Tue May 07, 2024 2:57 am

Gidgemo wrote:
Sat May 04, 2024 3:17 pm
Any idea what these really are?
Sure do!

But first you have to answer me this:

How many fingers am I holding up?
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.

Gidgemo
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Re: Unclassified Apneas

Post by Gidgemo » Tue May 07, 2024 1:37 pm

Rubicon wrote:
Tue May 07, 2024 2:57 am
Gidgemo wrote:
Sat May 04, 2024 3:17 pm
Any idea what these really are?
Sure do!

But first you have to answer me this:

How many fingers am I holding up?
Not sure, but I am holding up one..

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Rubicon
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Re: Unclassified Apneas

Post by Rubicon » Tue May 07, 2024 1:55 pm

Gidgemo wrote:
Tue May 07, 2024 1:37 pm
Rubicon wrote:
Tue May 07, 2024 2:57 am
Gidgemo wrote:
Sat May 04, 2024 3:17 pm
Any idea what these really are?
Sure do!

But first you have to answer me this:

How many fingers am I holding up?
Not sure, but I am holding up one..
Why don't you just say "go fuck yourself"?

You can, you know.

I mean, if you had the balls...
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.

Gidgemo
Posts: 6
Joined: Sat May 04, 2024 3:06 pm

Re: Unclassified Apneas

Post by Gidgemo » Wed May 08, 2024 2:15 pm

Rubicon wrote:
Tue May 07, 2024 1:55 pm
Gidgemo wrote:
Tue May 07, 2024 1:37 pm
Rubicon wrote:
Tue May 07, 2024 2:57 am
Gidgemo wrote:
Sat May 04, 2024 3:17 pm
Any idea what these really are?
Sure do!

But first you have to answer me this:

How many fingers am I holding up?
Not sure, but I am holding up one..
Why don't you just say "go fuck yourself"?
That would be about as useful as asking me to guess how many fingers you are holding up..

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Pugsy
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Re: Unclassified Apneas

Post by Pugsy » Wed May 08, 2024 2:37 pm

Enough with the crap talk you guys.

Neither of you will like my solution so don't make me use my solution.

Thank you.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

Gidgemo
Posts: 6
Joined: Sat May 04, 2024 3:06 pm

Re: Unclassified Apneas

Post by Gidgemo » Wed May 08, 2024 9:29 pm

Pugsy wrote:
Sun May 05, 2024 6:34 pm
onward60 wrote:
Sun May 05, 2024 6:10 pm
I'm curious, Pugsy, how can you tell he's not asleep?
By the shape of the breaths in the flow rate graph.

Asleep breathing is very smooth, rhythmic and doesn't vary.
Awake/arousal breathing is very irregular when compared to asleep breathing. Easy to spot most of the time.
We don't take big gulps of air (seen on the flow rate graph) while asleep. So when we see irregular breathing we know "not asleep or not sound asleep".

Here's an example I like to use because it is so obvious.
I circled the asleep breathing in red. The other breathing not circled (including the flagged events) is arousal/awake breathing.

Image

and this is the same time segment but zoomed in a little closer to better see each breath.

Image
Not sure if this is enuff but attached 3 examples of the UA..at this point, its more for educational purposes for me (never really had UA's) because as you figured, fixing the max leaks seems to have made them go away :)
Attachments
un3.jpg
un3.jpg (525.7 KiB) Viewed 2021 times
un2.jpg
un2.jpg (521.03 KiB) Viewed 2021 times
un1.jpg
un1.jpg (530.11 KiB) Viewed 2021 times