Full awakenings and wave form data

Can you tell when you were likely AWAKE by looking at the wave form data? I ask for two reasons.

1) I've been waking up feeling like part of the night has been really restless and full of tossing and turning without distinct discrete wakes, but just a vague sense of wakefulness---and this has been happening on both good and bad nights as far as my AHI is concerned. It is, however, something that definitely makes me feel the insomnia because that's what it feels like.

2) In looking at my wave form data, I often see a pattern where it looks like I'm breathing rather regularly (and no apnea or hypopneas), followed by less regular breathing with much larger amplitudes for a couple of minutes, and then sometimes immediately followed by an event or two that the machine labels as an apnea or hypopnea which is then followed by the more regular breathing that dominates the periods of the night when it looks like I was soundly sleeping. I know that it could be REM, but then again, I'm one of the weird ones that had (significantly) FEWER events in REM on all four of my sleep tests than NREM. And the timing of these things is not always where you might expect REM to be.

I know I need to post an example. I'm working on that. I should be able to post an example or two tomorrow or the next day. But I thought I'd ask the question anyway.

robysue wrote:Can you tell when you were likely AWAKE by looking at the wave form data? 2) In looking at my wave form data, I often see a pattern where it looks like I'm breathing rather regularly (and no apnea or hypopneas), followed by less regular breathing with much larger amplitudes for a couple of minutes, and then sometimes immediately followed by an event or two that the machine labels as an apnea or hypopnea which is then followed by the more regular breathing that dominates the periods of the night when it looks like I was soundly sleeping.

RobySue:
I get the same pattern at times and believe it is indicative of and arousal. Sometimes I know that I was awake at the time and others, the interval is too short for me to have come fully awake.

Here is an example from last night.



The part maked in green is the way this software marks "peroiodic breathing" and I call Cheyn-Stokes respirations.
I also get clusters of CSA's just after one of these events.

JDS74,

The stuff on your 1:45 line is pretty much what I'm talking about except that my events are just as likely to be marked as OAs instead of CAs most nights. And I'm still remembering significant "restless" periods and on bad insomnia nights I'm still remembering numerous awakenings. And often there's no event preceeding the stuff that looks like what you've posted.

Hope to post a wave form or two tonight, but it will have to wait until then.

RobySue:

The event starts for me at the extreme right end of the 1:39 AM line and continues onto the 1:45 AM line.

If you are getting OA's mixed in with CA's have you considered slooooowly titrating your EPAP min up just slightly to see if the OA's can be suppressed? I did that and got rid of most of my OA's without causing large increases in my CA's.

I did my titration at the minimum increment of 0.5 cm H2O and kept each level for a few days to see what happened.
I started with 5 cm and ended with 10 cm. The OAI in now consistently less than 1 without the CA's going crazy.

Talked to my sleep doc about the process and he was delighted with the progress. If you get along with your sleep doc, its probably a good idea to keep him/her in the loop.

Good luck.

Edit: fixed a couple of typos.

The PA and I have been dealing with both my insomnia issues and titration issues by doing a careful dance balancing my pressure settings with my answer to "How do you feel?" The answer on any given day, of course, depends on the interaction of the insomnia and the apnea on the night before. And right from the start of CPAP, aerophagia has been a major issue for me---and this with NO mouth breathing and NO leaks to speak of. So I'm reluctant to increase pressure at all if these events are often just post-arousal events that wouldn't be scored on a PSG because I'm "awake" anyway. So my question is: Might these events be post-arousal events that wouldn't be scored on a PSG because I'm "awake" even though the machine calls them OAs instead of CAs?

In my case, I could never detect awakening or arousal from the CPAP graphs. Here are two awakening occasions whereby I got up to go to the bathroom. Immediately after an awakening I switched off the CPAP. Going by the graphs I can't tell anything different from other times:




As to your post: 2) In looking at my wave form data, I often see a pattern where it looks like I'm breathing rather regularly (and no apnea or hypopneas), followed by less regular breathing with much larger amplitudes for a couple of minutes, and then sometimes immediately followed by an event or two that the machine labels as an apnea or hypopnea which is then followed by the more regular breathing that dominates the periods of the night when it looks like I was soundly sleeping.


I also have similar data of graphs. What does it mean?

I know that it could be REM, but then again, I'm one of the weird ones that had (significantly) FEWER events in REM on all four of my sleep tests than NREM. And the timing of these things is not always where you might expect REM to be.

IMO, you need to do EEG to check the REMs.

You might do what I did about 12 years ago when I suspected that I was suffering from sleep apnea, and that was to take a movie of myself sleeping. I mounted the camera on a tripod and let it go for 7 hours. The problem was to watch the replay for such a long time. So I stopped watching after two hours of replay.