01-27-2022, 01:53 PM
RE: 6 months of Bipap - very little improvement
You can often see arousals in OSCAR data as the wake breathing causes larger amplitude flow rate and RERA's usually cause recovery style breathing. Your flow rate chart is quite uniform other than some periods it gets a little ragged looking but those ragged looking periods appear like they may correlate which rem sleep which would be common (partial paralysis affects breathing). Stints of near constant flow rate like 8:20 to 9:00 are signs that things are well treated, if you were having 5 RDI (the low end of UARS) there should have been on average 3-4 arousals in that period. In short if you put a healthy person on CPAP I believe you would see a similar flow rate chart.
As you have noted "UARS" treatment often appears to be unsuccessful. My theory is that the breathing is often not the cause of the issue, this has been theorized by others as well as being due to an overactive nervous system. I am also hesitant in cases diagnosed by watchpat alone since it doesn't directly measure breathing issues and rather measures nervous system reactions, if an overactive nervous system is the cause of UARS in some patients it would bring into question the accuracy of watchpat for those cases (imo).
If you want to know if the CPAP is helping the best you can do is get an in clinic titration study done, they can monitor for RERAs and see if breathing appears to be an issue and if it is will attempt to titrate settings. Unfortunately there is no way to do this at home beyond what you already have done. In some UARS cases there are obvious RERAs we can see and try to treat but I don't see anything like that in the limited data shown so far. The borderline central effects your data shows actually is counter intuitive to UARS since UARS RERAs are often caused by high CO2 concentrations and centrals are often caused by low CO2 concentrations.
As you have noted "UARS" treatment often appears to be unsuccessful. My theory is that the breathing is often not the cause of the issue, this has been theorized by others as well as being due to an overactive nervous system. I am also hesitant in cases diagnosed by watchpat alone since it doesn't directly measure breathing issues and rather measures nervous system reactions, if an overactive nervous system is the cause of UARS in some patients it would bring into question the accuracy of watchpat for those cases (imo).
If you want to know if the CPAP is helping the best you can do is get an in clinic titration study done, they can monitor for RERAs and see if breathing appears to be an issue and if it is will attempt to titrate settings. Unfortunately there is no way to do this at home beyond what you already have done. In some UARS cases there are obvious RERAs we can see and try to treat but I don't see anything like that in the limited data shown so far. The borderline central effects your data shows actually is counter intuitive to UARS since UARS RERAs are often caused by high CO2 concentrations and centrals are often caused by low CO2 concentrations.
