[Treatment] Flow limitations and minor breathing changes

[kevinonasv]

I've been using the ASV for a year+ now. OSCAR says I have low AHI, but I still often feel super tired. A few questions-

(1) Is it normal to have these types of flow limitations?

(2) My breathing frequently get slightly irregular while sleeping - is this expected?

(3) Anything else I should check?

Thanks for the help!

[Phaleronic]

You not having too many flow limitations it appears to me as the graph's maximum FL is low, you have those two hypopnea events where the pressure began to move. There are other members here with more experience with ASV that I'm sure can help you. Overall I think the treatment looks solid from these charts, the only other thing I noticed is the 15 minutes of ramp-are you needing that?

Also, welcome to the forum Kevinonasv

[kevinonasv]

Thank you! . Yeah total % of time where flow limitations is high seems low?

It seems my treatment is "working," so I guess safe to assume that my fatigue isnt from apnea/UARS.

[Deborah K.]

Actually, your flow limits are very high.  I don't know how to fix that on an ASV, but I'm sure someone who knows about ASVs will come along to help you.

Also, to make things more clear you may want to add ASV after your machine description of ResMed Aircurve 10 on your profile.  Otherwise, folks will think you are using the bi-level machine, as I did.

[Dormeo]

The two zoomed-in views appear to show brief arousals. (Arousal breathing is deeper and messier-looking that asleep breathing.) It's normal to have arousals off and on during the night, and as we get older, arousals tend to become more frequent.

Did your sleep test include a measure of spontaneous arousals? Periodic limb movements?

[kevinonasv]

Ah good find... my sleep study showed a ton of spontaneous arousals. This is consistent with what I'm seeing in OSCAR where I see messy/deeper breathing probably every 10 minutes or so. Should I be concerned and/or try to eliminate these spontaneous arousals?

       


Also, in REM, I think sleep is supposed to get more messy. Would this qualify as an arousal as well?

   

Updated description to ASV, thank you. Yeah, I'm also confused by the pattern on flow limitations - it seems like it's spiking randomly, which is different than the flow limitation in the wiki is continuously at 0.25-0.30.

[SarcasticDave94]

On ASV, regarding the flow limits, it's a byproduct of the Central Apnea treatment that ASV does. Most on ASV will have some FL ugliness in the charts. I myself didn't have many for some odd reason.

Otherwise your chart looks decent. I would probably offer the suggestion that you'll want to wean yourself off Ramp. Admitted, this time it didn't miss events during the forced minimized therapy of 15 minutes. I found Ramp to enhance my CA while trying it and quickly cut it off.

[Dormeo]

In the zoomed-in view, just left of center, that looks like an arousal to me. I sometimes get brief arousals in the middle of REM sleep, so I know that's possible.

Calling an arousal "spontaneous" is a way of saying its cause is unknown. That makes it challenging to reduce them. Try your best to adhere to the sleep guidelines below. Because your study showed a certain amount of leg movement, you might also experiment with a weighted blanket to see whether that helps at all.

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.
• Establish a relaxing bedtime routine.
• Use your bed only for sleep and sex.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
• Limit exposure to bright light in the evenings.
• Turn off electronic devices at least 30 minutes before bedtime.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
• Exercise regularly and maintain a healthy diet.
• Avoid consuming caffeine in the late afternoon or evening.
• Avoid consuming alcohol before bedtime.
• Reduce your fluid intake before bedtime.

[SeePak]

I will add to Dormeo hygiene routine....

Practice breathing exercises before bed as per Patrick McKeown.

There is a couple other threads with his name as a search on this website which will help you find more information that Patrick offers.

Doing a couple of these breathing exercises has done so much for me I really truly cannot believe it except it is happening and it is so obvious.

NO more Fatigue
Not tired during the day
Sleeping longer and more solid
CPAP pressure has been reduced and NO EPR.
Anxiety has been totally reduced procrastination almost totally gone which is incredible for me!
All this after 10 days of finding out about this chap!
And others on the internet as well as on this website are raving about their success in a very similar manner.

Please post your results I would love to hear from you about them.

[SkySleep]

...

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.

These suggestions seems to be in conflict. For me, not going to bed until I'm sleepy prevents me from going to bed at a regular time. Can you elaborate?