Sleep HQ Chart Feedback

[RobertGeorge]

Hi Guys,

New to CPAP. 

Resmed Airsense 10 set to 4cm

I get 0.0 events, however just wanted some feedback re my breathing and/or these flow limits leading up to wake up's to see if any hints whats going on

My ONLY complaint re sleep is too many awakenings throughout night. Lab sleep study showed moderate apnea overall but on my side was only 4.5ahi. (so worse on back which i believe is super common).

Dr said i can most likely sleep on my side with no other intervention however nothing changed with my sleep when on my side all night so i got a CPAP to try. However only set on 4cm but still getting same sleep outcomes with the wake ups but no apnea or hypopnea that i can see (nor can resmed app, always 0.0ahi).

Any hints from these graphs? 

My nose is really bad. Waiting to see an ENT to see what they can do for me. Deviated septum and allergic rhinitis. Apart from that healthy. 

Withings sleep analyzer with apnea detection also showing 0.0ahi night after night (with or without cpap). 

Appreciate any assistance.

   

   

[HalfAsleep]

That looks to me like just 6 minutes of data, unless I’m imagining things.

Homework for you…

Download Oscar, get yourself an SD card, and pop it into your CPAP machine. Check out the protocol for laying out charts, and post a few nights of sleep. The Oscar download is on the board menu.

Most folks on this board aren’t familiar with SleepHQ, but Oscar. And all posters use the same layout. I reckon pretty much all posters can make sense of an Oscar chart. The standardization really helps, because posters can learn from each other, and help each other out.

IMO most users feel like they’re dying if their CPAP is set to 4, and from what you’re saying you’ll need some adjustments. IMO ignore the 0 AHI until you’ve attached some Oscar charts covering several hours, and have a chance for (other than me) posters to give you precise guidance.

[RobertGeorge]

hi mate,

yep its 6mins of data leading up to a wake up (two separate wake ups)

Thought maybe it'd be useful for someone to spot what woke me up?

Longest CPAP use so far was that night and was a total of 3.5hrs (i just cant get used to it yet). 

Here is an oscar screenshots of that night

if anyone has any hints that could explain why i woke up at 11:48pm and again at  1:28am that would be awesome .. perhaps they arent even breathing related wake ups but i suspect they are .. these two wake ups are examples of my whole entire sleep complaint so if someone could crack the reasons for these i reckon i'd get somewhere!  

   

   

[OpalRose]

I think it's easy enough to see that by using a low pressure of 4cm is putting you in "air starvation" mode.   Luckily, you are showing no Apnea events, but the Flow limitation is high. This can cause many arousals, some which you're not even aware of.  

The use of EPR helps tame the FL, but right now, you are not receiving any benefit from your setting of EPR 2, as it can't function with a pressure of 4.  You will need to use a bit higher pressure to utilize EPR.  

Set pressure at 7cm with EPR 3.  The gives you an EPAP of 4.  You should feel much more comfortable and sleep better.  

Please know that some wake-ups during the night are perfectly normal, and could just be a result of movement.  Sometimes, we roll over and take deep breaths.

Also, I'm hoping you get more sleep than the 3 hrs showing on your chart.  Watch your Sleep Hygiene habits and be sure your mask is comfortable.

[RobertGeorge]

thanks for the reply mate, much appreciated. 

I did sleep much more then that, last mask removal was it for the night, slept rest of night without it. 

would there be any chance someone could tell if this is UARS ? Not sure if enough information in those charts though for that?

I'm still unsure of my diagnosis. Lab sleep study found vast majority of events were hypopneas and some rera's but ive found information that depending what classification system is used rera's can be incorrectly marked as hypopneas.. confirmation bias is dangerous though so happy to be told silly thought, stop right here. 

I have none of the usual apnea symptoms .. zero snoring, not tired during day, no gasping for air, mrs never noticed me stop breathing, i dont go to toilet much overnight (zero or once), bmi 20.5. During sleep study my oxygen stayed above 90%, awake mean was 95%, nonREM 93%, REM 95%

My sleep complaint is i wake up 5 to 10 times a night, calmly and zero explanation as to why.. Somehow i still feel fine after 8hrs in bed.  I had the sleep study due to suspected restless legs and specialist suspected some breathing difficulties due to my nose but he didnt expect the AHI i got. 

i have a horrible nose and i feel like when i do wake up my nose is blocked. I have deviated septum and serve allergic rhinitis. 

If im understanding UARS correctly, resistance in the nasal passage can cause airway to partially collapse and result in arousal?

Would the 4cm pressure setting and no apneas/hypopneas while on cpap possibly be another indicator that this could be UARS and not apnea/hypopnea? 

I'm trying to arm myself with as much information as i can before an upcoming ENT appointment.

Reading through the traits and symptoms of UARS it fits me almost perfectly from my narrow but high palate, normal BMI, lack of oxygen drop & nasal obstruction. 

thanks for any assistance

[OpalRose]

Do you by any chance have a copy of your sleep study to post here?

[RobertGeorge]

Yeah sure do! Here it is

Another UARS trait I found was AHI under 5 but RDI over 5 which is what the study shows for me while on my side. Not sure how relevant though it is

Ive been sleeping on my side only since the sleep study and zero change in awaking unfortunately. 

   

[OpalRose]

The only thing on your graphs that point to wake-ups is the higher flow limitation during those times.

With the high Hypopnea count on your sleep study and the flow limitation that shows up on your graphs may point to UARS, I can't say for sure.

Is your ENT leaning toward surgery? Your deviated septum and severe allergic rhinitis may be the cause of your breathing issues. Let's hope your doctor can help.

[RobertGeorge]

Thanks for the reply mate.

Haven't been able to see an ENT yet, it's booked for July 

Got a CT scan via my Dr then he referred me to the ENT.

I guess ill just do nothing until I see the ENT. From what everyone Ive seen so far is telling me I'm an unusual case.

[Plmnb]

Hi RobertGeorge, This is Plmnb!  So happy you did join.  Told you it was a great place.

I am sorry you are waking up so many times during the night, I know how frustrating that can be.

It is definitely a great idea to be checked out by the ENT.  However, even if they find issues and correct them, it doesn't necessarily mean that it will solve your concerns all the way around.

I had uvulectomy, turbinates & deviated septum repairs done a zillion years ago and unfortunately these surgeries did not help.  I did see a different ENT a few years ago though and she said I have a Mallampati Class 3 tongue and naturally narrow nasal passages.  She also said I have a "tiny" hole in my septum, but that it wasn't anything to worry about. I might have to re-examine this with the doctors at Mayo Clinic when I see them in April.

Please keep us updated on what is happening with your sleep and again, 

Plmnb