Choppy flow rate data

[ripnationstates]

Hello all, I have been doing CPAP therapy for almost a year now but have not felt much of an improvement in my fatigue throughout the day. I recently started using OSCAR to analyse and tweak my treatment, to see if I could improve my sleep. One thing I am unsure about in my data is that every night, my flow rate is very choppy (compared to many other people's data that I've come across- much flatter during non-rem sleep).

Here are two nights of data: https://imgur.com/a/nYmgezA
Even in periods of deeper sleep, I still get many arousals: https://imgur.com/a/a6QUj4X

Would anyone be able to suggest why this might be? I am worried that the interruptions to my sleep are what is causing me to feel constantly fatigued, so it would be great to try to fix it if it might be a problem. If anyone can help I would be very grateful!

[PeaceLoveAndPizza]

Excellent question! One of the white rabbits many of us have been chasing for a long time. I don’t have any answers, just the same questions.

Don’t get too excited about it. If it was not for CPAP helping correct apnea’s and OSCAR reporting abilities, you would likely not know the micro-arousals exist. I suspect that many have similar “spikies” and never know it. There are many articles and studies about sleep arousal disorders, which I’ll leave to those more knowledgeable to explain. 

Our challenge is with CPAP our main tools are pressures, triggers, cycles, timing, etc. We’re looking for a needle in a haystack. Of course, the quickest way to find a needle in a haystack is with a magnet. All we need is the magnet…

[Sleepy Quixote]

@ripnationstates

Looking at the charts it appears a lot of the spikiness correlates to clusters of flow limitations, resolving those may smooth the flow rate graph a bit. Since the flow limitations tend to be fairly clustered, is it possible you are encountering some positional apnea from laying on your back? or chin tucking? Since you have opted for a static pressure you might try bumping it up in small increments over several days for each increment and observing the effect on flow limits.

From the zoom, I have a question, when you had your sleep study was there any observed PLMs? PLMs also tend to spike up the flow rate graph too, usually in a cyclical pattern.

[ripnationstates]

Might it be that flow limitations and choppy flow rate occur simultaneously because of REM sleep? I have purchased a cervical collar to see if there might be any effect. 

My sleep study was in Japan and the communication was difficult, but no mention of it. I don't think I have any of the symptoms.

[Sleepy Quixote]

I personally haven't made a correlation between choppy flow rate and clusters of flow limitations with REM sleep. For me they are usually centered around sleep disturbances, positional issues. I have used a cervical collar in the past and it was helpful.