Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

arousals missed by the machine?
#1
arousals missed by the machine?
Hi,

My numbers look good but I've never really felt better after pap therapy. I see patterns like in my charts and I'm wondering if these could indicate arousals that aren't picked up by the machine. Thanks in advance. 

           
Post Reply Post Reply






Donate to Apnea Board  
#2
RE: arousals missed by the machine?
Maybe I'm missing some important bit of info, especially as we're missing a non zoomed chart for context. What I'm seeing is excellent therapy by the numbers. Now therapy adjusting should be only to pursue comfort, which seems to be what you're after. I'm not sure what a PAP machine ought to do for you during an arousal, especially given the very good appearing therapy regarding your data.

As I recall, a PAP machine responds to flow limitations, which affects Hypopnoea and full Obstructive Apnea. Another machine called ASV can combat Central Apnea along with the others. I could be wrong, but I'm not sure there's an expected response directed towards arousals.

Has all other sleep disruptions been addressed such as the basics like sleep hygiene, decent pillow and mattress, room conditions, and such like? Only mentioning these because as our sleep becomes better by Apnea therapy, those other disruptions come out to the forefront and will in turn need addressed. And do keep in mind that no events at all isn't the goal regarding Apnea therapy. I'm quite sure comfort will be lost if we attempt to get the PAP machine to flatten everything to zero. It's just not meant to work that way, and it's an unrealistic goal doomed to disappoint. The realistic goal is managing as many events as necessary to gain well rested sleep.

I probably didn't help much but maybe some bit that's helpful can be mined out.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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.
Post Reply Post Reply
#3
RE: arousals missed by the machine?
You might benefit from scanning this thread http://www.apneaboard.com/forums/Thread-...r-FR-peaks and this post in that thread http://www.apneaboard.com/forums/Thread-...r-FR-peaks .  There are numbers of us who have reduced our AHI to the neighborood of 1.0, but complain about or just wonder about the quality of our rest. For example, there are old geezers like me whose body suffered OSA so long that we can't remember what great sleep we might have had many years ago. In my instance I see a lot of the markers of inspiratory flow limits that are not flagged by my VAuto.

The crescendo and decrescendo bursts of amplitudes in your flow rate curve, along with your few clearly visible "two eared" inspiratory flow peaks, suggest to me you are likely experiencing micro arousals from flow limits that are below the VAuto's detection threshold. I see one view of your FR curve is about three minutes. Try 1.5 to 2 minutes at the same vertical scale as your 3 minute views. Look at those views in conjunction with the materials in those posts about deformations in inspiratory flow rate peaks. My guess is the more zoomed view will show many unrounded FR peaks. Those indicate extra work you are doing to inhale as a result of airway restrictions. Some of those amplitdude bursts, I'm guessing mark arousals. 

I've long delayed adding posts to that thread, awaiting whatever I might learn from adding the Dreem 2's  sleep stage curves to my accelerometer's motions and position data curves, as those are portrayed in OSCAR. I am still striving to come to some useful conclusions about micro arousals which  I believe my curves of flow rates, motions and sleep position reveal. I'm not  satisfied with my results and am still struggling with necessary synchronization of three out of my four data logger clocks, which are not on UTC time, I'm still working on the problems, but not spending enough time to make a decision to continue or give up on that line of FR curve analysis. If the work won't yield a useful manual scoring system for unflagged signs of arousals I should give it up. The D2 has not yet contributed the little I hoped to get from adding its curves to the OSCAR mix. 

If a manual scoring system were successfully devised, one could use it along with our subjective feeling of better sleep to evaluate selected drug, food, device, sleep hygiene or life style changes.

Good luck. Do post in that thread whatever you can add, question or challenge, that's why I started it.
Post Reply Post Reply
#4
RE: arousals missed by the machine?
the pattern is suggestive of movement, as in periodic limb movement.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
Exclaimation CPAP Machine Choices - read this before you accept a new machine SuperSleeper 167 183,730 02-19-2021, 02:17 PM
Last Post: Sleeprider
  Normal number of spontaneous arousals? tiredmikey 3 378 12-09-2020, 05:38 AM
Last Post: karp
Arrow AHI < 1.0 now, but still tired? Is it UARS, RERA, arousals or FL in your FR peaks? 2SleepBetta 7 965 12-02-2020, 08:17 AM
Last Post: Zackio
  EEG and other ways to detect arousals? BB63 21 568 08-06-2020, 06:57 PM
Last Post: kappa
  Arousals/Awakenings with CPAP chrisiscitrus 9 367 08-04-2020, 09:24 AM
Last Post: chrisiscitrus
  Unpleasant arousals increased since I began APAP StevesSp 3 380 05-06-2020, 05:50 PM
Last Post: StevesSp
  Flow Rate Graph, Mini Arousals - Experts Needed hallra 49 1,581 05-04-2020, 04:40 PM
Last Post: sheepless


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.