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Help on reading charts
#1
Help on reading charts
Hi


My AHI aren't bad at all, always below 5, often around 2, sometimes even better. But I am still not getting what I expect, and need, from this therapy. Have a lot of days with brainfog and very low energy.

I have been trying to study and understand charts, but I am really a newbie on this and would like some help.
I am posting several different charts here just to try to show what's going on.
What I think I realize is that my inhalation often show some kind of plateau. What does this mean? And what can possibly be done to prevent it?
Below is one chart showing some of these plateaus.
   

Here is another one with plateaus and weird exhalation (?)
   

More plateaus and double peaks
   

Would highly appreciate any feedback on what's going on, and if those plateaus/double peaks are significant.
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#2
RE: Help on reading charts
Those plateaus you're seeing are flow limitations. Rather than try to describe them myself, I'd suggest you read about it here: http://www.apneaboard.com/wiki/index.php...limitation
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#3
RE: Help on reading charts
Thanks

So by reading the link, one suggested way forward could be to use EPR (or A-Flex for Philips).
Here is a chart from a night where I did use A-Flex at highest level.

   

Would you say this Flow Chart looks better?
The flat line before inhalation starts, is that normal?

Thanks in advance.
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#4
RE: Help on reading charts
Take a look at your Flow Limitation (FL) on the left side of your chart.
This night is .28.
It's displayed different from your Phillips than my RedMed machine, but I think that number is a measure of each flow limit on a scale of 0.00-1.00. 
It's often stated here to aim for FL below 0.1, ideally below 0.03.

I think of flow limitations as little HAs - it's a slight restriction (aka limitation) in the flow of air to the lungs, not long enough or complete enough to be flagged as HA or OA.
Is it something that matters or just something we see?
Do FLs cause arousals?
Do FLs cause stress to the body?
Do FLs reduce the quality of sleep?
Can FLs be blamed for ongoing fatigue and brain fog in the presence of cpap use and low AHI??

Seems like reasonable questions, right?
Yet, there is hardly any research out there on flow limitations. 
I have been able to find a couple articles suggesting that high flow limitations with low AHI point toward the need for treatment with a BiLevel machine.

My personal sleep provider (NP) wasn't even familiar with the term, much less using it as a measure of treatment efficacy. 

General experience on this forum points toward,
Lower FL = feeling more rested.
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#5
RE: Help on reading charts
Thanks for the reply.
I thought the FL score was calculated just the same way as the CA, OA and H. Taking the number of events and dividing it by the hours of sleep. Looking back in my Oscar charts it actually seems to be like that.
The question is perhaps what is needed for OSCAR to score an FL event. Maybe I rarely reach that threshold, but hoover just below it most of the night. Which in my case would mean the score is low, but the total impact of all FL is severe.
As in the "area under the curve", or an average number of the Flow Limitation per minute during the whole night would be very high, even though I rarely pass the threshold for scoring an event.
Anyway, something is wrong and I want to find out what.
My AHI looks good, but I am like a zombie in the morning and it normally doesn't get better till in the afternoon, or sometimes evening.

What I find as well, which is really weird - but I think the correlation is there - is that the longer and better (subjectively) I  sleep, the worse I feel next day.
If I have a night where I sleep through the whole night, or only wake up 1 or 2 times and quickly go back to sleep, a night where I feel that I really sleep deeply through most of the night - I will feel like sh*t next day. Drowsy and "off".
On the other hand, when I have a night where I wake up several times, like every hour, and when I feel that I never really enter deep sleep - I will feel better next day. Of course I'll be tired, but I'll be "normal person tired". Just that, tired. Not brain-fogged and feeling like a zombie.

My layman's theory is that when I wake up multiple times, I avoid the sleep apnea (or at least the main negative impact from it). I wake up instead of staying in apnea. However, when I sleep all night, I may be sleeping - but it's crap sleep which just makes me feel like sh*t next day.

Anyone has any thoughts on this? Would be very interested to hear.
Adding a chart where this happened - I slept through but felt like crap next day.
   
Zooming in on some of the parts where the Flow chart narrows down:
   
And then another night with the opposite, sleeping poorly (waking up several times, not entering deep sleep), but feeling ok next day
   
Zooming in on a part which includes a segment with shallow Flow Chart, interrupted by a Hypopnea, and then higher amplitude in the Flow Chart:

   
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