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Now using Oscar, a problem revealed?
#1
Now using Oscar, a problem revealed?
First of all, many thanks to the folks who have put in time to create Oscar. I downloaded it a short while ago. The installation appears to have gone smoothly and I am able to download and view my data.

I was thus able to look at my last night's sleep, which was one that included an event that occurs now and then but which I find rather distressing. Basically, while my AHI is under control and my compiance 100%, there are nights where I experience an arousal as though from suffocation. I usually experience a bad dream that is associated with suffocation, either exertion such as running away from danger, drowning or extreme anxiety/fear. I will awake feeling very short of breath, with a pounding heart and ringing in my ears. The images and emotions experienced in the dream also make me feel very anxious and/or depressed. This feeling can last for some time afterwards, though my breathing and heart rate eventually normalise.

This happened last night, so I switched my machine off a couple of minutes after the episode, so as to flag exactly when it happened when I look at the chart. My feeling was that each episode was caused by me holding my breath, rather than struggling to breathe, hence caused by a big central.

Looking at the chart however, it appears that the episode was actually a cluster of apneas, comprisong OA, hyponeas and finally, a central. This went on for around five minutes. No wonder I was breathless!

The only other thing that jumps off the chart for my untrained eye was a period of higher than normal leak rate preceding the event. How significant this is I don't know.

I will have a go at uploading the chart when I figure out how to do that but, in the meantime, does anybody have any idea what's going on when this happens, and whether I can tweak something to avoid it happening again?

I use CPAP, 12cm pressure, a humidifier and EPR 2.
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#2
RE: Now using Oscar, a problem revealed?
I hope this works. I resorted to a simple screenshot for the time being, zoomed in a little to highlight the 'event'. I could do the same for the other graphs, unless there's a better way.

   
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#3
RE: Now using Oscar, a problem revealed?
Steve, my guess is that you are sleeping in a position where your airway is impaired, eg with your chin tucked down to your chest. But that's a first-off guess.

To upload the image:
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#4
RE: Now using Oscar, a problem revealed?
OK, it looked like my post crossed with your edit and I didn't initially see your image.

So... it looks like the leak episode is pretty much finished before the apneas commence. I think the cluster if events is positional as I said above, and my further guess is that the leak caused you some irritation following which you changed position, possibly ending up in a position which efectively obstructed the airway.
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#5
RE: Now using Oscar, a problem revealed?
(04-27-2019, 11:24 PM)DeepBreathing Wrote: Steve, my guess is that you are sleeping in a position where your airway is impaired, eg with your chin tucked down to your chest. But that's a first-off guess.

To upload the image:

Thanks. Got it.

If it was a compromised airway, would you expect that to show up somewhere else in Oscar, such as flow rate or something?
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#6
RE: Now using Oscar, a problem revealed?
I think it is showing up - you can see that the flow rate drops rapidly to almost zero, following by a recovery breath (gasping for air) repeated several times.

There may be other reasons this is happening, but clusters like this are almost always positional in my experience.
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#7
RE: Now using Oscar, a problem revealed?
OK, so even though the device/software is calling hypopneas or centrals, they might actually be obstructives? Or is it that an obstructive can trigger a series of complex apneas?
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#8
RE: Now using Oscar, a problem revealed?
It looks like you fell into REM sleep around 1am.  Ending in really disturbed sleep and lastly holding your breath likely while tossing in bed giving you the Central and resulting in your waking up.  There appears to be some positional nature about it but I think it is more sleep wake junk.  Where you dreaming vividly at the end of that episode?
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#9
RE: Now using Oscar, a problem revealed?
(04-28-2019, 06:57 AM)bonjour Wrote: It looks like you fell into REM sleep around 1am.  Ending in really disturbed sleep and lastly holding your breath likely while tossing in bed giving you the Central and resulting in your waking up.  There appears to be some positional nature about it but I think it is more sleep wake junk.  Where you dreaming vividly at the end of that episode?

Whenever I have these episodes - arousals with thumping heart and feeling of suffocation - I usually have a vivid nightmarish or stressfull dream. I think it's my brain trying to make sense of the suffocation.

I hadn't considered positional apnea until you guys suggested it, but it's certainly a possibility. My pillow seems perfect to me in terms of comfort and mask use, as a side-sleeper, and I am not aware of waking with my chin tucked in. I am sometimes aware that I have my head tilted back a long way, so much so that I awaken with a crick in my neck. Would that restrict my airway in the same way?

I shall try to make mental note of my head position over the coming weeks.

Thanks again. Much appreciated.
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#10
RE: Now using Oscar, a problem revealed?
I was looking at the timeline, my first go-to when looking for episodic events during what is otherwise decent sleep and SA management.  I saw bonjour's post and see that he had REM in mind as well, and that is my guess also.  Look, in the first three or four hours of sleep, for roughly 90 minute intervals where REM typically has its onset.  From there, if the events coincide, it's probably associated with dreaming.  Later in the night the dreams can come more frequently, even after turning over for another quickie snooze.  I have dreamt in as little as 15 minutes in the hour prior to waking if I awaken to turn over and draw the covers up around my neck.  

C'mon....who doesn't do that!
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