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Unmarked Events and Periodic Flow Rate Spikes
#1
Unmarked Events and Periodic Flow Rate Spikes
I was curious if anyone could explain what is going on in the image below.     In the first section, I'm not understanding why I see a lot of unmarked events in Oscar, but assume it has something to do with the duration of the events.   The duration look like they should be marked though, where you can see the pressure pulse check start and go for a bit.

In the 2nd image set, I'm also not understanding why I'm having periodic large breaths.   I'd assume something is happening where a single breath draw and exhale randomly doubles in force?    I have no idea if this is normal or not.

Thanks for any info.


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#2
RE: Unmarked Events and Periodic Flow Rate Spikes
apnea is reported when pauses are at least 10 seconds long. it's a little hard to tell but it looks like the first one you posted is about 7 or 8 seconds long. I didn't measure out the others but suspect the same.

the occasional spikes are sighs.
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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#3
RE: Unmarked Events and Periodic Flow Rate Spikes
Thank you.  I was suspicious that was the case, but wasn't sure.   This image makes it more clear.   It kind of seems odd though, that a 1 or 2 second difference means the difference between a marked or unmarked event.   It also would have been interesting if I was wearing an 02Ring during this to see what was going on with the oxygen level.

I'm curious now what this does to REM sleep or oxygen levels.  I'd assume the unmarked events like I had would also knock you out of REM sleep.  Interesting stuff.   Thanks.


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#4
RE: Unmarked Events and Periodic Flow Rate Spikes
The medical world has defined Apnea as an event for at least 10 seconds with reduced to no airflow while asleep. If it's not 10 seconds, it's not Apnea. What you may have I'm not sure, but it may be helpful to include the entire OSCAR Daily Detail shot as well to give us a fuller, better context. If it's almost Apnea, Hypopnea, or lots of flow limits, then pressure edits may be called for to act against them.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Unmarked Events and Periodic Flow Rate Spikes
In OSCAR in Preferences on the CPAP tab there is a "Custom CPAP User Event Flagging" and you can set up your own user flags. I set mine to 50% for 7 seconds and 30% for 7 seconds. When you do this you see all the 7/8/9 second "sub-events".
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#6
RE: Unmarked Events and Periodic Flow Rate Spikes
one suspects, intuitively at least, that these less than 10 second pauses have a less than desirable and maybe cumulative effect. it goes without saying, though, that the longer the cessation, the greater the negative impact. somebody somewhere sometime in the medical/insurance communities concluded for some reason that less than 10 seconds isn't significant enough to note. so be happy they aren't 30 seconds long!
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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#7
RE: Unmarked Events and Periodic Flow Rate Spikes
My sleep apnea has gone out of control over the last year.   I've been on CPAP about 12 years now, where I started with a prescribed static pressure of 13.    I think I might possibly be having induced apena issues from taking the pressure up so high in an attempt to get a better AHI and less events per night.   Or, things have just gotten this bad for over time as I've gotten older. I've been fiddling with things non-stop for about 3 months after getting an AirSense 10.   Also, I'm not under a DME.   I've been on my own w/ a CPAP prescription (written to me) for about 10 years now.

*The 0% leak rate this night was due to a Bleep mask that I don't like and almost never use (seal usually also fails mid night, often).


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#8
RE: Unmarked Events and Periodic Flow Rate Spikes
Phil, I bet people can help you with your settings. But first could you reformat your chart and repost it?

* Turn off the calendar and the pie chart so more of the left panel information is visible.

* Stack your graphs this way:

Events
Flow rate
Pressure
Leaks
Snores
Flow limitations.

There is no need to include other graphs. You can squeeze all six of these in by grabbing the horizontal gray bars that separate the graphs and pushing them up a little bit.

BTW, in the zoomed-in views you posted, the majority of the posted non-events were you holding your breath rather than pausing between breaths. In general, if you see nice, regular breathing before and after the flat line, you may well have been asleep the whole time.

Over time I've found that the occurrence of minor changes in my breathing doesn't correlate with disruption of my sleep cycles.
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#9
RE: Unmarked Events and Periodic Flow Rate Spikes
The first thing I would try is turning EPR on, full time, either 2 or 3 depending which feels more comfortable. You can get an idea of what this change does by toggling it on/off while awake and wearing the machine, in short it will ease breathing effort slightly and improve ventilation.
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#10
RE: Unmarked Events and Periodic Flow Rate Spikes
(11-18-2021, 12:27 PM)Phil7 Wrote: *The 0% leak rate this night was due to a Bleep mask that I don't like and almost never use (seal usually also fails mid night, often).

Phil - What are using to clean your skin with on the bleep?
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