Waxing/waning Oscar Charts - Printable Version

Waxing/waning Oscar Charts - Printable Version

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Waxing/waning Oscar Charts - Apnea23 - 04-21-2023

Hello,

Finally I have managed to get some data from Oscar demonstrating what I believe are periods of hyperventilation/hypoventilation.

These happen approximately 3 times per night in what I assume is a certain sleep stage as breathing is normal otherwise - each cycle is longer in duration than the last typically. Often it wakes me at 1am and every few hours after.

I have turned EPR/APAP/PS off entirely in attempts to minimise it, and fixed pressures of 6cm - 6.4cm seems to be the best I can get it.

This was periods of it last night at 7cm fixed. A little too high I think. Wellvue reported some craziness (attached) for approximately 50 minutes. At 6cm and 6.4cm Wellvue reported stable levels throughout the night - libido was fixed, morning elections. Last night was awful, headache today, foggyness, warm flushed cheeks (which have developed over the last 2 years).

I have much worse data I can provide from before my recent testing/adjustments but I don't know if that would be useful or not. It's the same thing but worse, with more actual short events due to excessive waxing/waning.

If 6cm - 6.4cm fixed with no EPR/PS has provided the best 2 nights sleep of my CPAP life so far recently in 2 years, where should I go from here?

The last 2 years I've used APAP 7cm - 9cm and 2-3 EPR with very low AHI (0-1) which was resolving wakefulness but still destroying my health with arousals, brain fog, increasing blood pressure, flushed cheeks, no libido and increased FSH levels and that wax/wane nonsense to a worse degree. Wakefulness was the only thing CPAP was helping with.

I think I'm almost on the right track now I've minimised these events significantly and found a fixed pressure that gives me dreams, boners and less brain fog but unsure what to tweak next (if anything).

Maybe I should just run 6.4cm for a few weeks and see how it goes? It's only the last cycle shortly before I wake that disturbs my sleep then, not the 1st and 2nd and 3rd.

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[Image: Screenshot-20230421-064020-Vi-Health.jpg]

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RE: Waxing/waning Oscar Charts - Apnea23 - 04-21-2023

I don't know if it's relevant but I was born pre term 8 weeks early and was on a ventilator for many weeks of my newborn life, and my lung collapsed spontaneously in my late twenties. I'm now 40.

RE: Waxing/waning Oscar Charts - Apnea23 - 04-21-2023

This may be better to understand and see.

Here I include the last cycle of the night when the problems are always greatest. The first image is the overview screenshot going in to the cycle and coming out of it, the rest are close ups of the entire period throughout.

You can see me regular breathing and then entering the stage which has variability and then exit it not far before I wake up for the morning. The whole variability period is approximately 1 hour.

Zero leaks, so I didn't include that graph.

RE: Waxing/waning Oscar Charts - Apnea23 - 04-21-2023

To add further, I am waking up covered in sweat since December - and if I don't use CPAP I will wake up covered in sweat many times each night and occasionally with my heart absolutely thumping.

Am I hyper/hypoventilating during my sleep with and without CPAP - and what settings on my Aircurve can assist with this?

I feel I'm almost there, if someone with better knowledge can tweak me in the right direction.

Current settings I have found to provide the best relief are:

Fixed pressure 6.4 with no EPR/PS
Fixed pressure 6.6 with no EPR/PS

My trigger sensitivity is currently set to high, everything else default.

RE: Waxing/waning Oscar Charts - Gideon - 04-21-2023

At this scale I see few issues. Many of your UF issues flagged arousals but all and all looks pretty good

You are talking about subtle issues and have provided a mile high view.

Post the advanced view full night and a couple of 3- minute views that you have an issue with and one of your "normal breathing.

RE: Waxing/waning Oscar Charts - Nightynite - 04-21-2023

Well if you’re waking up with sweat every night , I think you should talk with your PCP and get some blood work done. Thinking that the apap/cpap/bipap is going to correct something like that is just nothing but a guess or hope. Your body is telling you something and you’re still in the mindset it can be treated with a cpap machine. It’s time to look elsewhere. Keep us posted and I truly hope you find the answer.
I would look at the thyroid for a good start.

RE: Waxing/waning Oscar Charts - Apnea23 - 04-21-2023

I have had all blood work under the sun I can assure you. I have spent thousands eliminating everything health wise - CPAP therapy and my sleep is all that is left, and the obvious suspect.

My urine is also /very/ foamy, has been for ages and I've had my microalbum checked, it's not excess protein. However alkali in the kidneys can be in response to chronic hypercapnia and cause foamy urine. My doctor couldn't explain the reason as to why my urine was so foamy.

I've had an ECG all clear, liver/kidney/thyroid/crv/vitamins/iron/blood cell count all clear and much more. I've seen hormone specialists, had testosterone and other hormones checked, my liver scanned, honestly - there's nothing I haven't had in the past year trying to find a cause of my symptoms.

The only medical avenues left now would be a respiratory doctor to run a battery of tests and a type 1 sleep study. As I'm seeing results with reducing this waxing/waning, I'll persist with optimising PAP first.

I had a bicarbonate blood test this morning to test carbon dioxide shennanegans in the blood. I am trying to eliminate and rule out everything I possibly can and it's been a crazy year of health tests.

2 months in to CPAP my cheeks started to flush red and this has grown over time to a permanent flushing and my blood pressure climbed.

To be clear I'm not blaming PAP - I'm assuming my disorder just isn't optimally treated and is thus causing persistent symptoms.

If these cycles (please remember they were much worse prior to these recent adjustments when I used to use EPR3) aren't doing this to me, I'll be damned, because there is nothing else left.

Anyway as I said, the above represents some of the best of my sleep, not the worst or what I've averaged over the last 2 years . The worst is amplified with those cycles and custom flags significantly worse. I will have to post more Oscar data I guess.

All I'm asking is advice for reducing this waxing/waning further, as reducing this recently has /significantly/ improvined my sleep, arousels, the sweating and many other cognitive symptoms. The 2 nights recently with a fixed pressure of 6.4cm and 6.6cm with no EPR/PS were the only nights I slept almost through with an erection and libido for the first time in well over a year or more.

If that isn't a clue my therapy hasn't been optimal for me since I started in 2021 then I don't know what is. I maturbated like a horn dog the previous 2 days and my wife was very happy with the situation. That was the /old/ me before the past few years of libido/flushing/blood pressure/memory/cognitive symptoms.

This morning after the 1 hour long o2 dropping dance I showed above of last night at 7cm, absolutely awful in all respects. Headache, terrible cognition, warm flushed cheeks more than usual for the entire morning.

All I need now is help reducing this further, as reducing it is /working/ very well, except last night, obviously.

RE: Waxing/waning Oscar Charts - Apnea23 - 04-21-2023

(04-21-2023, 12:38 PM)Gideon Wrote: At this scale I see few issues. Many of your UF issues flagged arousals but all and all looks pretty good

You are talking about subtle issues and have provided a mile high view.

Post the advanced view full night and a couple of 3- minute views that you have an issue with and one of your "normal breathing.

Hi Gideon please see screenshots on post 3 - unlike my first post you can click and make them larger. I don't know what happened on the first post I'm afraid.

I will try to get more Oscar data tomorrow with some worse examples prior to reducing this stuff sucessfully (somewhat) in the past week. I'm not sure what advanced view is but I'll make sure to do it.

Typically what would you suggest to reduce this further?

Many thanks,

RE: Waxing/waning Oscar Charts - Apnea23 - 04-21-2023

The close up of the almost 1 hour long o2 dance from my o2 ring last night - this is when pressure I will assume was slightly too high at 7cm with no EPR.

[Image: Screenshot-20230421-211032-Vi-Health.jpg]

6.6cm and 6.4cm with no EPR the previous 2 nights a very different story.

I think it's clear my sleep and treatment of it has not been correct for a long time despite 0-1 AHI, and my list of symptoms are a direct result of historically trashed sleep cycles, possibly connected to endless o2 swings throughout specific sleep stages.

Anyway.. babbling again.

RE: Waxing/waning Oscar Charts - Apnea23 - 04-23-2023

Update -

After the night of 7cm pressure were I believed it was too high and I had co2 crazyness for an hour, after looking at the Oscar data there is a flattening of the flow rate very often, and now I understand what an arousal looks like I can see them clearly when it happens now.

Clearly during REM stages this is more significant for me and the flattening is worse - combined with the variable breathing during these sleep stages I can see why EPR was making things worse. The spikes were spikier, the swings swingier.

The facts seems to be - I still haven't found enough fixed pressure yet.

Here's something interesting -

Last night I tried 6.6cm again since I had one of the best nights sleep recently on it and enabled APAP to see if it increased pressure when I needed it now I'm using mouth tape and have no leaks. Instead I woke up at 1.30am with a REM arousal, pulled my tape and mask off as I was that P*ssed off I slept the rest of the night au natural, no PAP - and had the most REM I've had in over a year, 2 hours+ according to Fitbit and Muse S headband. However, I woke up drenched in sweat often for the rest of the night and red as a beetroot in the morning, more so than ever. My wife was shocked how red my face was.

Today I was determined to understand flow rate, arousals etc so read everything I needed to know from the Oscar Wiki.

I looked today from last nights Oscar data and saw my flow rate gradually flattening and getting worse leading up to the 1.30am arousal, but there were no flow limits that Resmed reported, so therapy went sideways as it didn't bother to increase my pressure in response to the flattening flow until the damage and disruption was already in full swing. I am not happy.

Studying my historical Oscar data today from 2021 it's clear APAP (Dreamstation and Autoset) are simply not capable of detecting or caring about the flattening and worsening of my flow rate and reacting in good time before mini events and arousals, even the Autoset which is supposed to be super responsive. It's all too late. They wait until things get out of hand and the flow rate is getting crazy. What good is that.

Anyway - I will be increasing the fixed pressure with no EPR more so tonight up to 8cm, a full 1cm bump up from 7cm.

The highest I have used fixed before without EPR was at 8cm when I wasn't mouth taping, and the mouth leaks were clearly effecting the therapy then, so I may as well start at 8cm with no leaks and see how I get on.

I shall report back tomorrow.

I truly believe I'm almost there now.

I think there's a lesson here - APAPS don't give a crap about your arousals or flattening flow rates and waxing/waning unless it meets their threshold. They will happily trash entire sleep stages 3x nightly, greatly effecting your cognition, blood pressure, libido. Sending you on your way to cardiovascular disease and dementia if you feel awake and believe the sleep scores they give you, despite arousals and a growing list of symptoms.

Especially if it's your REM stages getting trashed and disrupted. Given the last and longest REM stage is likely the most important REM stage according to the science, this is the one that will get trashed the *most* when pressure needs are highest in the early morning - but if you don't meet the flow rate threshold despite your flow flattening and tidal swinging all over, your APAP isn't doing a thing during it until it's too late.

More babbling, I can't help it until this is fixed.

I'm not happy I have had crap therapy from APAP since 2021, specifically entire trashed REM stages.

There's no wonder my blood pressure is borderline, my libido and morning erections don't exist and I'm taking stimulants for ADHD now - diagnosed in December last year due to it getting /so/ bad under APAP therapy.

This is how quickly sleep apnea escalates health and cognitive problems when the APAP machines are mainly designed to stop o2 desaturations.

Try inventing algorithms that stop entire sleep stages getting trashed, specifically REM since that's where we're at our most vulnerable with jaw drops, higher pressures needed generally etc.