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The thread on ResMed's SleepScore prompts a question about sleep onset
#1
After reading the thread "New ResMed app" about ResMed's Sleepscore device I request a critique of the simple minded method I use to estimate my "gross" sleep time (in addition to and aside from how I feel upon rising--which is affected by RDI's). 


No doubt what works for me--if in fact it does--may not be helpful for others. Further, this may be so obvious and commonly known that any reader would day "duh".

Anyway, I count the time my upper APAP pressure curve is flat at its lower limit AND my flow limitations are flat at zero as time I'm fully awake. This condition rarely occurs for any significant period of time other than for a short time when I first lie down for the night or upon my return to bed after a trip to the head.
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#2
A CORRECTION TO POST ABOVE:


 An edit that has disappeared corrected my error in using the word "upper" instead of "lower" in the phrase "the time my upper APAP pressure".  When I lie down awake the pressure is at the lower APAP pressure, 10.4 cm, and not the upper, 15.2 cm; further there are no flow restrictions indicated by SleepyHead. I'm saying the two concurrent facts, the starting 10.4 cm pressure with zero flow restrictions "say" I am fully awake.
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#3
The machine doesn't know if your awake or asleep. Also the flow limitations have no bearing.
Here's how I figure it it out. When was the last time I remember being awake and when was the first time I remember being awake. It shouldn't take a machine for you to figure it out.
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#4
I take my bedtime, which I try to remember to note as I place my masked head on the pillow for the first time, plus 20 minutes.  Often I'm much faster, but occasionally it takes me up to 30 minutes to drift off.  So, with about 20 minutes of 'standard error', I then go to my known waking time.  I ignore any waking moments in between that I can't remember; they don't count against me.

It is somewhat rare, I think, but I am fortunate in that I don't have to rise to take a pee....ever.  My siblings and my only parent, my now 88 year old dad, have to rise at least twice each.  So, unless I recall lying awake for a period, any brief waking moments that aren't salient 

I also use a Samsung Gear smartwatch that records sleep.  It records when I go to bed, but also seems to sense when I actually commence sleep.  It records breaks in my sleep, sometimes inaccurately, unfortunately, but it always records subsequent bouts of sleep if they take place.
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#5
This is true, WW, but all the sleep hygiene articles I've seen say to not have a clock visible in your bedroom...

But of course I do, and I don't make my bedroom as dark as the far end of a cave, either...

OTOH, using the machine's recording of IPAP and flow limitations is probably reasonably good and way more reliable than my sleep-fogged memory. Even my FitBit sometimes misses some hours sometimes.
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#6
I can see maybe using flow rate as a guideline but not sure how flow limitations would tell you anything?
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#7
(07-12-2018, 11:27 AM)Walla Walla Wrote: I can see maybe using flow rate as a guideline but not sure how flow limitations would tell you anything?

I'm guessing that some folks with constant flow limitations when sleeping could infer that no-flow limitations means they are awake and consciously breathing. But on the other hand, if they had sufficient pressure support when sleeping, sleeping and being awake would score the same by that metric. Dont-know
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#8
(07-12-2018, 11:27 AM)Walla Walla Wrote: I can see maybe using flow rate as a guideline but not sure how flow limitations would tell you anything?

Perhaps respiration rate might be a better choice; I haven't tried watching any of them to see which would be best.
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#9
sleep as android uses three methods for awake detection. don't know if I can post a link so search on app name, documentation, extended-features, awake-detection. one uses an algorithm to estimate wakefulness, another is when user make a habit of pausing the app when awake enough to do so and 3rd is using heart rate (need a monitor) plus actigraphy. I would think all of these are at least as accurate as the methods discussed above. heart rate plus actigraphy is said to the most accurate but can't measure wake periods less than 5 minutes. they also have an explanation for why they can't automatically determine when you fall asleep (but you can enter an average time that it will use).
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#10
(07-12-2018, 07:15 AM)Walla Walla Wrote: The machine doesn't know if your awake or asleep. Also the flow limitations have no bearing.  
Here's how I figure it it out. When was the last time I remember being awake and when was the first time I remember being awake. It shouldn't take a machine for you to figure it out.


Thanks WW. It is the consistent and singular lack of flow limitations when I first lie down that I see as the signature of being awake--knowing that I always am awake for period--10-20 minutes, typically, when I first hose up and maybe for 3-5 minutes after coming back to bed after a pee break.


Stom wrote:

I'm guessing that some folks with constant flow limitations when sleeping could infer that no-flow limitations means they are awake and consciously breathing. But on the other hand, if they had sufficient pressure support when sleeping, sleeping and being awake would score the same by that metric. Dont-know

2SleepBetta replies:


In my case, when asleep I have almost a constant drum beat of low level flow restrictions that don't rise to the level of obstruction causing significant pressure rises or 10 second, plus, obstructions. In the period when I know I have been awake there are virtually no indications of flow restrictions.  

It has not occurred to me until now, after your comment, that I might improve my sleep quality by boosting the low APAP pressure to iron out the low level flow restrictions even though my scored RDI's are low, frequently zero to a few tenths.



(07-12-2018, 11:44 AM)pholynyk Wrote:
(07-12-2018, 11:27 AM)Walla Walla Wrote: I can see maybe using flow rate as a guideline but not sure how flow limitations would tell you anything?

Perhaps respiration rate might be a better choice; I haven't tried watching any of them to see which would be best.

I cannot discern in any of the several SH graphs, respiration rate included,  any other sleep metric that changes significantly during that period between being awake and having fallen asleep.  The constant lower APAP pressure, as when awake, is always accompanied by concurrent absence of the low and high level flow restrictions. 


Many thanks to all for your replies. As suggested in the thread starting post, what I observe, as indicated above, is apparently only one guy's experience and it is unlikely, it seems, to be useful to others.

2SB
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