[CPAP] New to CPAP and figuring out how to begin while waiting for consult/tests

[jaswilliams]

We would need you to zoom in on the flow rate to comment on the flow a 2 minute section but bare in mind awake breathing is more irregular than asleep breathing and the flow rate graph is just that a graph of your breath flow.

Your numbers look very good and nothing jumps out at me that needs fixing with an AHI of less than 2 you need to be critically assessing how you feel

[Sleeprider]

Any pressure changes correlate to spikes in flow limitation, and in one case hypopnea. This is typical behavior for Resmed and is a part of the Autoset / Vauto algorithm.

[Pawther]

Hey all.

The main reason my sleep doctor wanted me to try a CPAP was to wait and see if I had a gasping episode where I wake up alarmed and sit up to catch my breath, and that way I could mark the time and compare it to OSCAR data to see if there is any correlation.

Well, that finally happened last night. I went to sleep, and within the hour woke up jolting up/gasping and wrote down the time, and it seems to match up exactly timing wise with the "clear airway" event in the images provided.

Wondering what this event means from OSCAR. I am well aware my data doesn't show a constant apnea throughout the night, the idea was to see if a CPAP could eliminate my random gasping episodes, even if they are more individual and not constant, because they are just so unpleasant and fairly regular in my life now, and some nights worse than others.

Some reading has told me it potentially points to a central sleep apnea that occurs long enough to wake me? My question is, if so, what settings could I change or improve on the ResMed S9 to see if I can remove the events from happening entirely with the help of the CPAP. Would that be raising the min and max pressure, or changing the EPR, etc?

[SarcasticDave94]

If your machine is equal to a VAuto, then PS and not EPR applies. And if it's CA you're dealing with, then you'd need to lessen or minimize pressure swings, possibly by lowering PS.

[Pawther]

If your machine is equal to a VAuto, then PS and not EPR applies. And if it's CA you're dealing with, then you'd need to lessen or minimize pressure swings, possibly by lowering PS.

Ah ok, thanks Dave, yeah it's in VAuto mode, I must have got mixed up because I saw you can switch it to CPAP mode if desired, my PS is currently 3.0, so I'll try lowering it further and see what happens.

[Sleeprider]

Your results are excellent and a change in settings would not normally be recommended. The event you highlight is of minimal duration, and seems to have precipitated from a single irregular breath. I can't speculate what might have caused that, but the idea we can manage such a small isolated event through settings is unrealistic. If you want to try other settings that's fine, but I would keep the changes small (0.2-0.4 cm).

[Pawther]

Your results are excellent and a change in settings would not normally be recommended.  The event you highlight is of minimal duration, and seems to have precipitated from a single irregular breath.  I can't speculate what might have caused that, but the idea we can manage such a small isolated event through settings is unrealistic.  If you want to try other settings that's fine, but I would keep the changes small (0.2-0.4 cm).

Ugh, I guess this begs a couple questions for myself or health in general then. 

I clearly don't seem to be showing any apnea issue from what experienced users can see here on OSCAR data, and yet these small, isolated events still continue to launch me upwards in bed out of sleep and have me catching my breath several times a week. Is that a thing? People without apnea who experience oxygen drops where their body wakes them up but don't have consistent events? As in it doesn't happen throughout the night to be diagnosed, but in the few isolated times it does happen, it hits really hard? I tend to think if I wasn't waking up abruptly and catching breath I probably wouldn't really care about the events.

I am wondering what else it could be outside of an apnea issue, or if the reality is I have to accept my "normal" from now on is going to be sporadically gasping out of sleep regularly, which is just hard for me to accept as healthy because they are so darn stressful and not fun to experience. That being said, it seems that may be the only option. It also felt like the best direct correlation for my high hemoglobin from my hematologist, but perhaps that is unrelated after all. 

[Sleeprider]

Perhaps, you could obtain a recording oximeter and see if oxygen levels really are the root cause. There are some threads currently on the Wellvue Ring and a discount code that make that unit look pretty nice. Anyway, it will show your SpO2 and pulse rate and help you learn if it relates to anything else.

Let me explain further. This event has evenly spaced, unrestricted breathing before and after the CA event. Both sides look like you're sleeping. There is no change in volume or rate of respiration. It just doesn't add up to the arousal you are describing. The full night graph does have something at 00:00 that might deserve a closer look.

[Pawther]

Perhaps, you could obtain a recording oximeter and see if oxygen levels really are the root cause.  There are some threads currently on the Wellvue Ring and a discount code that make that unit look pretty nice.  Anyway, it will show your SpO2 and pulse rate and help you learn if it relates to anything else.  

Let me explain further. This event has evenly spaced, unrestricted breathing before and after the CA event. Both sides look like you're sleeping. There is no change in volume or rate of respiration.  It just doesn't add up to the arousal you are describing.  The full night graph does have something at 00:00 that might deserve a closer look.

Ahh, good point, I may have just correlated by looking at ballpark range of how long I was asleep and when I remembered the wake up gasp happening. Maybe the 0:00 part is where it happened, not sure.

I did attach a more close image on the chart at that time code you mentioned, but yeah, that makes sense, if the gasping that happened I would have probably seen a spike after that flat line I'm guessing.

Thanks for your advice. That oximeter ring sounds like a great idea and worth it to rule out the O2 at this point.

[Sleeprider]

Check out what happens to your leak rate at the moment of that event. I think you may find the source of your problem. At some point between the CA event and 00:00 your leak rate went right to the edge of a large leak. I'm looking at 4 minutes of large leak before your arousal and gasping.