Help with spotting flow rate RERA's

[apnea505]

Hey Guys, wondering if you can help me determine if im having RERA's that are disrupting my sleep quality. Im almost 3 weeks into therapy having previous severe symptoms but only mild apnea (6.6 AHI), due to the fact that I have mild apnea and my symptoms were very severe, someone mentioned I might have UARS. I do fit the bill for UARS, small jaw, overcrowded teeth (braces as a kid), though I dont have a receding jaw, my jaw is pretty normal I would say. Im booking for ENT as I do have some sinus congestion when I lie down at night, typically the waiting list is 6 months in Canada right now. I've been treating this with 2nd gen antihistamines and Flonase which does not eliminate it but helps, I suspect this is causing the bit of flow limitation I have. That said, im starting to feel better almost three weeks into therapy but im still waking up at night which is annoying, usually 4 times a night or so that im aware of. Granted that can be fairly normal ive read and increases with age. It's also possible that it's conditioning from 3 years of untreated sleep breathing disorder and it might take more than a few weeks to sleep through the night again and connect sleep cycles. Thats fine but I just want to rule out that Its not respiratory related. My sleep clinician has been no help, she said my results look great, textbook even. They have not touched the machine, they set it to 5-18. I manually set my pressure from 7-12 last week. I just increase my min pressure from 7 to 7.4 last night. I can see there are some not so rounded sections on the peak when you zoom into the flow rate, but majority of the breaths look pretty good I would say this not indicating UARS? Or at least if I did have it, the machine is effectively treating it? what do you guys think? I do have the option to buy a used Aircurve 10 for $1200 CAD with 2500 hours right now, I heard Bipap is better to treat UARS, though I;ve also read success stories of CPAP/APAP treating UARS also.  


I wokeup around 2AM, it's a habit that I always pee after 1 or 2 sleep cycles, though I didn't pee very much last night compared to before treatment. It's a habit from before I guess. Zooming in the flow rate graph shows nothing out of the ordinary that would suspect respiratory arousal at this time, at least from what I can see.  

https://postimg.cc/gallery/8TPS1y0

Min 7.4 Pressure
https://sleephq.com/public/a8a5d8f8-68a2...60ee5322c4

Min 7.0 Pressure
https://sleephq.com/public/3688cd8f-d01c...4e905c7058

Good flow rate examples for majority of night when actually asleep I would say:

https://postimg.cc/gallery/Hkpq2zy

[apnea505]

Sorry just wanted to add that the best I can tell is that I have some class 2 and some class 6 flow shapes in there based on the guide, but they are subtle and not every single breathe. Are these significant enough in my results to cause me to wakeup? Or is that normal to have those mixed in there? From what I can see though dont look nearly as significant to the ones shown in the guide.


https://www.apneaboard.com/wiki/index.ph..._The_Guide

[BoxcarPete]

I'm going to answer your question with an OSCAR screenshot from an event cluster of mine:

   

This is what it looks like if you have a problem with RERA; flat tops and double peaks progressively getting worse followed by significantly larger recovery breaths. I don't see any of that in your charts, though sleepHQ isn't as good as OSCAR and I didn't look at everything.

[apnea505]

Thats good news, I didn't really see much of that either in Oscar compared to your screenshot. I can't really find a reason for waking up from the data. The theory about having UARS is not proven of course. I mean with my low diagnosed events, it's still waking up every 10 minutes and oxygen dropping to 89%. Its possible that im just more severely affected by this compared to others, despite having more severe apnea episodes. OR I do have UARS and im being treated by the machine. Do you have UARS or just some Hypnoeas? My other theory for waking up frequently is just the typical wakeups that everyone has and the CPAP just raised my awareness enough to regain consciousness (and become aware of it). That said, I've been waking up like this ever since I started having sleep issues for a few years (and apnea episodes), so it could also be conditioning.