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+--- Thread: arousals missed by the machine? (/Thread-arousals-missed-by-the-machine)
arousals missed by the machine? - logit - 02-10-2021
Hi,
My numbers look good but I've never really felt better after pap therapy. I see patterns like in my charts and I'm wondering if these could indicate arousals that aren't picked up by the machine. Thanks in advance.
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RE: arousals missed by the machine? - SarcasticDave94 - 02-11-2021
Maybe I'm missing some important bit of info, especially as we're missing a non zoomed chart for context. What I'm seeing is excellent therapy by the numbers. Now therapy adjusting should be only to pursue comfort, which seems to be what you're after. I'm not sure what a PAP machine ought to do for you during an arousal, especially given the very good appearing therapy regarding your data.
As I recall, a PAP machine responds to flow limitations, which affects Hypopnoea and full Obstructive Apnea. Another machine called ASV can combat Central Apnea along with the others. I could be wrong, but I'm not sure there's an expected response directed towards arousals.
Has all other sleep disruptions been addressed such as the basics like sleep hygiene, decent pillow and mattress, room conditions, and such like? Only mentioning these because as our sleep becomes better by Apnea therapy, those other disruptions come out to the forefront and will in turn need addressed. And do keep in mind that no events at all isn't the goal regarding Apnea therapy. I'm quite sure comfort will be lost if we attempt to get the PAP machine to flatten everything to zero. It's just not meant to work that way, and it's an unrealistic goal doomed to disappoint. The realistic goal is managing as many events as necessary to gain well rested sleep.
I probably didn't help much but maybe some bit that's helpful can be mined out.
RE: arousals missed by the machine? - 2SleepBetta - 02-11-2021
You might benefit from scanning this thread http://www.apneaboard.com/forums/Thread-AHI-1-0-now-but-still-tired-Is-it-UARS-RERA-arousals-or-FL-in-your-FR-peaks and this post in that thread http://www.apneaboard.com/forums/Thread-AHI-1-0-now-but-still-tired-Is-it-UARS-RERA-arousals-or-FL-in-your-FR-peaks . There are numbers of us who have reduced our AHI to the neighborood of 1.0, but complain about or just wonder about the quality of our rest. For example, there are old geezers like me whose body suffered OSA so long that we can't remember what great sleep we might have had many years ago. In my instance I see a lot of the markers of inspiratory flow limits that are not flagged by my VAuto.
The crescendo and decrescendo bursts of amplitudes in your flow rate curve, along with your few clearly visible "two eared" inspiratory flow peaks, suggest to me you are likely experiencing micro arousals from flow limits that are below the VAuto's detection threshold. I see one view of your FR curve is about three minutes. Try 1.5 to 2 minutes at the same vertical scale as your 3 minute views. Look at those views in conjunction with the materials in those posts about deformations in inspiratory flow rate peaks. My guess is the more zoomed view will show many unrounded FR peaks. Those indicate extra work you are doing to inhale as a result of airway restrictions. Some of those amplitdude bursts, I'm guessing mark arousals.
I've long delayed adding posts to that thread, awaiting whatever I might learn from adding the Dreem 2's sleep stage curves to my accelerometer's motions and position data curves, as those are portrayed in OSCAR. I am still striving to come to some useful conclusions about micro arousals which I believe my curves of flow rates, motions and sleep position reveal. I'm not satisfied with my results and am still struggling with necessary synchronization of three out of my four data logger clocks, which are not on UTC time, I'm still working on the problems, but not spending enough time to make a decision to continue or give up on that line of FR curve analysis. If the work won't yield a useful manual scoring system for unflagged signs of arousals I should give it up. The D2 has not yet contributed the little I hoped to get from adding its curves to the OSCAR mix.
If a manual scoring system were successfully devised, one could use it along with our subjective feeling of better sleep to evaluate selected drug, food, device, sleep hygiene or life style changes.
Good luck. Do post in that thread whatever you can add, question or challenge, that's why I started it.
RE: arousals missed by the machine? - sheepless - 02-11-2021
the pattern is suggestive of movement, as in periodic limb movement.