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

[Ynot]

Hi Fixit,

Very interesting. I’ve recently started using a collar and mouth taping. There was a clear change in my breathing. I could see that I was mouth breathing before because the amplitude of the flow increased substantially, often during rem. I think it also helped my flow limitation and TECSA a bit. I should be getting a headgear next week. I tried a nasal mask today and did not like it. I used mouth tape, but every time my jaw relaxed, air would come rushing to my mouth causing discomfort and aerophagia. This indicates that headgear might help as even with a collar and mouth tape, I realize I do extend my jaw a bit as I relax. I’ll try the nasal mask with headgear when I receive it just in case.

Thanks for sharing, very helpful.

[Ynot]

2 nights ago went pretty well. The sensitivity setting was at very high. It is the best night I’ve had so far. The breathing at rem looks much more consistent than before (attachment).The trigger sensitivity definitely helped. I had a central-like back to back hypoapneaish event (attachment) at around 00:39:00. The amplitude of the flow increases after that. I wonder if I changed position or if my breathing somehow adjusted. 

[Ynot]

Last night was not so great. Better than before still, but breathing at rem is more irregular (attachment). I had a bit of leak problems - the mask was not tight enough. I changed the pressure from 11.8ipap, 5.8epap, 6ps to 11.8ipap, 6epap, 5.8ps, which probably is the reason breathing worsened. Might also be a fluke like positioning etc. I felt quite tired when waking up. Even before looking at the data, I knew it was a worse night. I also had a bit of a sore throat. I guess I get a sore throat when I have flow limitations, even if I do not mouth breath (mouth tape). Included images of the same pressure, but no mouth tape (mouth breathing in the closeup attachment) and medium sensitivity, showing more severe TECSA. 

[Ynot]

Same pressure, closeup of mouthbreathing and TESCA

[Ynot]

Please let me know your thoughts, thanks

[Ynot]

Hi Ynot,

UARs is a good guess, has anyone here suggested that too?  Most sleep docs are inept is what I've found out here in the US, not so sure about Canada  

Yes my flow rate looks very similar all night long, and tidal volume and rr do not fluctuate as yours does, would really like to see you get this figured out

Could you please show me a screenshot of your flow, respiratory rate and tidal volume to see how it varies? 
Thank you

[Dormeo]

I don't have much to contribute, but I'll mention two things. One is that it's normal to have variable respiration rates during REM sleep. The other is that the recent charts seem to have a lot of breaks in therapy, and it appears unlikely, Ynot, that you're getting a good 7-8 hours of sleep per night. In your place, I'd concentrate a lot more on that than anything else at this point.

[Ynot]

Hi dormeo,

yeah, that is simply because I'm trying to sleep earlier which is causing some insomnia.

[Ynot]

the times are not accurate in oscar

[Fixit50]

It seems like you possibly have periodic breathing where the amplitude slowly raises and decreases to a near stop or hypopnea and then increases again. In your graphs, I saw a few instances of this. Is this regular for you, and does it continue for a large part of the night? If so, I wonder if you are presenting Cheyne-Stokes Respiration (CSR), a type of central breathing disorder usually associated with heart failure. The VAuto won’t detect CSR but the AirSence 10 will log it under periodic breathing. I’m not familiar enough with CSR to say you have it, or don’t have it, but if that increasing amplitude followed by decreasing amplitude is something you see a lot of, then I’d be very suspicious. Do you have any kind of heart history?