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Help me interpret my second Sleep Study results
#71
RE: Help me interpret my second Sleep Study results
Thanks, will look into POTS.

One thing to mention is that my lowest amount of HR changes happened a few days ago when I took a long bath before going to bed. Will try to reproduce to see if it was just a random correlation.
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#72
RE: Help me interpret my second Sleep Study results
Still Humidity 3 but heated hose off today. 

Stats look very similar, leaks again zero; maybe it was marginally easier to wake up, but there were some overlapping effects:

1. I woke up early w/ a stuffy nose and wasn't able to fall back asleep, so my overall time asleep was lower by an hour compared to yesterday.
2. Had to take the mask off more often b/c it tickled me from the humidity w/o heat.


[Image: G2X13AM.png]
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#73
RE: Help me interpret my second Sleep Study results
I used no humidifier and no heated tube today - woke up much more easily in the morning, so heating does seem to be disturbing my sleep. Humidity seems to neither really help nor hurt, so I might as well save myself the extra effort.

Even w/o humidity, I still had to take the mask off 4-5 times at night because my nose would tickle. What is people's trick against nose/chin/face tickling?

[Image: 21dXQd2.png]
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#74
RE: Help me interpret my second Sleep Study results
Not feeling as great today.

[Image: AatZAdt.png]

Some potential reasons:

1. I turned my machine off because my nose tickled and I had to scratch it and forgot to turn it back on for 15 minutes (w/o oxygen drops during the off time for some reason?!)
2. I again took my mask off because of nose tickling and forgot to put it back on. This time I started snoring and had oxygen drops. Thankfully my wife woke me up after 18 minutes. I went to the restroom and during those 7 minutes of full awake movement time my oxygen continued dipping including down to 80% for a full minute.
3. From midnight to 2am I kept having consistent oxygen drops after hypopneas/flow limitations that weren't recorded?! (Zoomed example below)

[Image: xBgkjnW.png]

Looking for solutions to the three issues:
1. Nose tickles: This consistently wakes me up ~1x per hour every night and that's only counting the times where I actually end up taking my mask off to scratch - probably micro-arousals beyond that.
2. Awake oxygen: My oxygen seems to drop even while awake.
3. Remaining flow limitations/hypopneas: Not sure why they are not scored, but is the way to go here to increase IPAP or EPAP?
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#75
RE: Help me interpret my second Sleep Study results
Hi YouTakeMyBreathAway, 

I have been following (or at least became acquainted with) your posts.  You have some similar sleep architecture as I do.  I wake often. I wear a full face mask. I am mostly bothered by nose tickles, dry mouth, awakenings.

For nose, I am especially sensitive to airflow over the nose mostly due to fine nose hair (exterior), sometimes the inhale tickles as the internal nose hair rubs against the very entry point of the nostrils. Resolving any obvious sources to tickle (those above), I still have relative humidity problems. When starting to wear the mask, I am suddenly tickled with no apparent reason. (by the way, face contact skin sensitivity is also a thing.)

Solutions:

eradicate problem nose hairs - often it is to shorten them by trimming.
ritual nose or facial external skin touching or rubbing to break the sensitivity cycle.
wearing mask for a few minutes to induce tickle and interrupt it by reaching under mask seal to touch/rub spot of concern.

Hope this helps. It is much harder to want to step thru solutions if you are waking from sleep, which obviously interrupts sleep, but also you may not be alert enough to conduct solutions.

QAL

p.s. there are sensitivities at or close to the mask cushion interface with the facial skin or hair that awaken me. I found that the face was sensitive to the flexing motion of the cushion on the order of tickling. This is resolved for the most part by using mask pad or cover.

p.p.s. a mask pad can use the inherent leakage to an advantage. because it leaks, it cools which soothes minor skin irritations. because it leaks, there is actually less flexing, and eliminates nearly all flutter - catastrophic loss of pressure (face farting) which is a significant sleep disruptor.
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#76
RE: Help me interpret my second Sleep Study results
Very interesting result today. 

I am a bit more tired and looking at my chart I had two sections of continuous small movements and oxygen drops and my camera confirms that I kept moving very marginally every few minutes during this time... I don't remember being awake.

[Image: Sy75kd4.png]
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#77
RE: Help me interpret my second Sleep Study results
Two things happened tonight:

1. Once again forgot to turn my machine back on after scratching my nose itch. During those ~30 minutes I had a couple of HR drops, but most notably my HR variance increased during the time. I'm starting to think HR variance is actually what I should be focused on now to continue optimizing my sleep. Any scientific way to track HR variance / set a threshold / optimize event flags in OSCAR?
2. Got out of bed at 7:30, but then laid back in bed to see if I could sleep a little more, but was fully awake for those 19 minutes at the end. I had worn my SpO2 ring fully awake in the past, but this is the first extended period awake w/ the mask as well. Look at that huge variance in minute ventilation with multiple dips to < 4.0 and the lowest being 2.8. Is that normal? The low respiration rate cause an SpO2 desat, too. (zoomed below) -- I wonder if I could be having Central Apneas/Hypopneas during the day?

[Image: 538Wgz5.png]

[Image: IwigKDG.png]
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#78
RE: Help me interpret my second Sleep Study results
Tried to replicate the taking a bath right before bed from post #63 and again got a lower Pulse Change (PC) average of 13.96/h and a fairly low SpO2 DROP (SD) of 1.20.

I guess the bath could be helping with either stress or allergies, with stress probably being more likely given its effect is that the main effect is on my heart rate. At the same time there were also meaningfully fewer mask-off events for scratching my face (6 over 10 hours vs usually 8 over 8 hours), so maybe allergies.

[Image: 1K2jNrQ.png]

Even so, couldn't help but notice that I still had a concentration of lower oxygen / oxygen drops right around 2-3 hours after falling asleep, which is where I ~always see one. Any meaning to that? Maybe that is the first time I hit a specific sleep stage? I'll also say that I was very tired today b/c I had slept less yesterday.

One last thing: Yesterday was the first time I had washed my face mask with Dr Bronner's Unscented soap instead of a generic unscented (non-castille) soap. I don't believe this should be it, because I also took my mask off when it was brand new and I hadn't washed it yet at all, but wanted to record it.
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#79
RE: Help me interpret my second Sleep Study results
So last night's numbers looked pretty good but I was still very tired and had to lie down to take a nap.

The nap had a relatively high amount of oxygen drops at 16.88 drops/h compared to the <5/h I had over the last few nights.

[Image: zox7DG1.png]

Given my oxygen drops which also seem to happen while awake, I wonder if my daytime sleepiness could be from some form of continuous hypercapnia - anyway to test this myself? I heard that high CO2 makes people sleepy.

Any thoughts on how I could optimize my BiPAP settings to get rid of these drops while sleeping?
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#80
RE: Help me interpret my second Sleep Study results
I applaud you for continuing to experiment with different things using OSCAR.  You may figure it out by doing this.  There is something called metabolic acidosis (and metabolic alkalosis).  Long story short:  a person can produce too much CO2 even when awake from their body's metabolic processes.  A simple blood test from PCP would determine this.  Caused by electrolyte imbalances.  Kidneys could be involved, etc.    

My gut feeling thinks seeing the Pulmonologist for a consult could unlock the key.  Bad allergies, mild COPD, etc. could contribute.  Just trying to help.  A capnography test (overnight home sleep test) can determine how much CO2 percentage wise you are exhaling.  It cemented my hypoventilation diagnosis and got me a home ventilator.  Not saying you have this, but may be worth asking PCP/Pulmonologist about also.
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