Oscar Data. No events flagged but weird flow rate pattern during REM

[Ynot]

Hi, I attached photos of my Oscar data as well as the closeups of the flow rate during rem and outside of rem.

After a couple years of very poor sleep and insomnia, I had a sleep study, and was diagnosed with mild sleep apnea and moderate to severe UARS: (Only 6.2 AHI but an RDI of 23.3/hr (44.5 in the supine position), AHI in rem of 21.8/hr (4.1 outside of rem) (No apneas, only hypopneas). (Only about 3h of sleep).

These results lead me to believe that my sleep apnea is unusually “rem specific” compared to other people with the condition. And this is consistent with my insomnia prior to treatment which consisted of waking up after only about 5h of sleep and not being able to go back to sleep (more arousals during rem which become more common during the morning.)

I know flow rate is usually more volatile during rem, but given what I know and suspect about my sleep, I worry that my flow is not normal and indicative of disordered breathing. And I do not think that the machine is great at identifying more mild forms of disordered breathing.

The images I provided clearly consist of rem sleep indicated by the periodic flow limitation bundles spaced around 1.5 h apart, which correspond to the flow waves I attached.

As you can see, the flow is pretty flat and consistent outside of rem, and pretty erratic during rem.

As a side note, I am very tired and do not feel rested at all, and the flow wave pattern during rem does not seem to change with an increase of pressure. Also, I often have nasal congestion when I lie down which is associated with sleep apnea, not too sure how to prevent that (Face mask though).

What do you guys think? And let me know if you can't see the images I provided. 


Thanks!

[staceyburke]

It looks like to me that the flow limits may be causing the breathing.  I would move the min up 1 and make sure the EPR is 3 full time (it looks like it is but the left column does not go down far enough to see the setting).

[PeaceLoveAndPizza]

It is difficult to tell from the photos, posting images are typically easier to navigate. There may be some soft expiratory snoring going on as you can see the expiration, some flutter in the waveform, then an inspiration. Wash, rinse, repeat. Nothing really significant going on unless it is affecting your sleep quality. 

Follow Stacey’s advice and raise pressure to at least 9, if not a bit more.

[SarcasticDave94]

On OSCAR, when viewing those charts, you should be able to use your F12 key to screen capture. Then in the forum post area, in New Reply, you can insert a New Attachment. It'll place an image code inline with the post text.

[Dormeo]

On another forum, the suggestion has been made that the OP experiences palatal prolapse, perhaps especially during REM sleep. He's been advised to see an ENT doctor. He's also been asked to provide a list of medications and a scan of his sleep study, and to use sleephq and post some links.

I'd be curious what people here think about these ideas.

[PeaceLoveAndPizza]

Quite possible, but difficult to tell from the posted charts. it does not appear to have the cut-off to zero flow. Maybe others see something else there.

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

[Ynot]

Hi

I added screenshots of Oscar data. I have epr at 3 but my flow limitation is still high.What do you think?


Thanks

---

On another forum, the suggestion has been made that the OP experiences palatal prolapse, perhaps especially during REM sleep.  He's been advised to see an ENT doctor.  He's also been asked to provide a list of medications and a scan of his sleep study, and to use sleephq and post some links.

I'd be curious what people here think about these ideas.

I don't take any medications. i attached some better photos of the Oscar data

[Ynot]

Here are some oscar photos. Flow limitations are a little high even with epr 3

[Dormeo]

I think if you're still feeling sleepy and tired during the day, it's time to do two things. One is to talk with a sleep specialist about REM-specific problems. Another is to talk with your regular doctor about other possible causes of your daytime problems. He or she would be wise to test for problems in these areas: iron, thyroid, testosterone, Covid, Lyme disease, auto-immune disease, especially connective-tissue disease, deficiencies of vitamins B6, B12, and D.

[BoxcarPete]

Did you ever go see that ENT? I had AHI 5.8 overall with nREM=0 and REM=25.8 at my sleep study, mostly hypopnea (longest over 50s) but plenty of apnea in there as well. After three years of struggling with various stuff I went to see an ENT and it turns out that 50-70% of the open space in my nasopharynx was occupied by adenoid tissue. Bye-bye. He fixed the deviation of my septum, trimmed and outfractured my turbinates while he was mucking around in there, and I feel worlds better already after just over a week.

If you don't get scoped, you have no idea what's causing your problem and you'll be shooting in the dark trying to fix it.