CPAPtalk.com

idamtnboy wrote:

Mary Z wrote:Lizistired, I'm confused by what you said. I thought an apnea was the cessation of breathing for 10 seconds or more. Where am I going wrong here? A hypopnea is reduction in airflow of 50 % for greater than 10 seconds. Thanks.

That's the official definition. It could have been 5 secs, 8 secs, or whatever. The general consensus is that 10 seconds was chosen as that is the threshold that clinical data shows to be the point where there is a measurable or significant adverse effect on the body. The generic definition of apnea is a cessation of breathing, but what is cessation? The time span of one normal breath, or two breaths, or ..... You get the point I'm sure.

tschultz wrote:Alex that's great to hear, I think you may actually now have therapy that works for you.

When you get a chance I do suggest you take a close look at your detailed data across several nights, especially the flow data when zoomed in on a 1 minute or 5 minute time scale and compare how things look on average as compared to when you are having an apnea even as well as when hypopneas have been flagged. Knowing how your breathing looks will help you to better understand things as time goes on and will help you determine if anything has changed significantly. It would be good to look at some of the data from before you got treatment straightened out as comparing this with your newer data may give you more insight as well.

I find that keeping a log of how you feel when you wake up helps when fine tuning things as well, but be cautious about jumping to any conclusion on just a single night's information. I am sure you will soon realize that the index numbers only tell part of the story, how you actually feel is much more important. You certainly have made significant improvements in your therapy with only a small adjustment in pressure and are well on your way to improving now that treatment is more effective. I do hope you start to feel it working soon as well.

I was told to expect the metabolism to start to settle to something more normal in the first month or so with heart and brain issues mostly repaired in 3 to 6 months. I know I have certainly seen significant changes in my energy level and overall mood in the past couple of months and now eagerly await things to improve further. Now that I actually have energy I am planning to return to exercising very soon and try to tackle the weight gain, which resulted largely (pun intended) from the untreated OSA.

idamtnboy wrote:

AJimen05 wrote:Can you explain a bit more about flow limitation? I'm not to knowledgeable about that. What does it mean and what am I looking for?

Good question. We've discussed it here before and essentially concluded it's a slippery indicator, hard to define clearly, and does not have a meaningful numerical value. In other words, we really don't know much about it, other than it is a measure of sorts of how much the upper airway passage is blocked. Here's a quote from a medical paper I just came across. "Flow limitation is a dynamic obstruction event characterized by the fact that inspiratory flow remains constant regardless of the increase in the pressure applied by the patient’s inspiratory muscles [10,11]." From what I find even the professionals in the business have difficulty characterizing it.

Of all the data on your Resscan screen, this is one you would be better off to ignore for the time being. After you've been in this game for 6 months to a year and have a more complete understanding of all the various aspects of your therapy, then come back and cogitate on it. Not to be flip, but by then you'll have learned enough that it makes some sense, or learned enough to know not to care about it! Or better yet, that graph may diminish to only a few short spikes.

But hey, the fact you care enough and are aware enough to ask about it is commendable!

Lizistired wrote:

idamtnboy wrote:

Mary Z wrote:Lizistired, I'm confused by what you said. I thought an apnea was the cessation of breathing for 10 seconds or more. Where am I going wrong here? A hypopnea is reduction in airflow of 50 % for greater than 10 seconds. Thanks.

That's the official definition. It could have been 5 secs, 8 secs, or whatever. The general consensus is that 10 seconds was chosen as that is the threshold that clinical data shows to be the point where there is a measurable or significant adverse effect on the body. The generic definition of apnea is a cessation of breathing, but what is cessation? The time span of one normal breath, or two breaths, or ..... You get the point I'm sure.

So he could stop breathing for 9 seconds, take a breath, stop breathing for 9 seconds, take a breath.... there would be no apneas flagged.
Just like if I have an AI of 4.0 in 10 hours of sleep. That's acceptable. But I know from my sleep studies that all of my apneas were in REM. So if I had 40 apneas for the night and they were all in two 20 minute fragmented segments of REM, an AI of 4.0 doesn't sound so good to me anymore.
The AI also doesn't tell me the duration of the apneas. They could be 10 second apneas, or 47 second apneas like Alex had.
He must feel 1000% better than before. I just want to point out some things he might want to consider when looking at his data.
(I relinked the image here since the other one is gone.)

SleepyT wrote:Well, AJ...well done! It seems as though you have "arrived" as the others have stated. I know you are relieved. Having your OSA under control is a life changer. I believe (as others do) you will become one of the experts here in no time...helping other newbies manage this disorder.

Remember to come back to this forum whenever you experience difficulties. Everyone is here to help! Continued good luck....

T.

AJimen05 wrote:

Lizistired wrote:Alex, something else to consider. You really need to look at your flow data. You can have back to back apneas under 10 seconds that won't be flagged. If so, you should be able to see them at 5 minutes, and then go to 1 minute to zero in on them.

Hey Liz,

Can you explain a bit more about flow limitation? I'm not to knowledgeable about that. What does it mean and what am I looking for?

Lizistired wrote:I assume that clusters of flow limitations are REM stage based on my PSG results. Might be wrong. I can't do anything about them anyway. That's the machine's job.