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Ardeo77 - Therapy Thread - Ardeo77 - 06-10-2023
To make a long story as short as possible, I started feeling brain fogged, anxious, tired and progressively more fatigued 8 years ago. Around that time I would wake up gasping for air, sometimes sitting straight up immediately. I never thought much about it until my overall health got worse over the past few years and decided I may want to look into my sleep. I have constant bags under my eyes and never feel refreshed; my partner also told me that I snore pretty loud. I also talk in my sleep and grind my teeth pretty bad. I got an at home study done because, well, im poor and dont have insurance, I got it done through lofta. They diagnosed my with mild OSA, but my AHI was only 1.7 and my AHI was 13. The lowest my oxygen got was 93. Lowest pulse 37 and max 94. Weirdly enough my numbers are worse sleeping on my left side, and then less surprisingly my back. However all sides were similar. These numbers really don't see bad, but I got a CPAP anyways. I tried neck braces, a MAD, high, low and in-between pressures, I tried different masks, mouth taping and so on. None of which did anything really, only slight improvements when getting to a decent pressure. However, one night I had a high pressure and sleep sitting up as much as I could. I woke up and felt all my symptoms, gone. I felt like I hadn't felt since I was a teen. I was doing nothing different during this time except for the sleep angle and pressure. I tried to replicate it but could not. I have been sleeping poorly again ever since. I also found I was getting more central apneas when using a higher pressure and sometimes a higher AHI. Too low, more problems too. I checked my Oscar data today and im not expert, but it seems normal, I think? I would assume this is all psycho somatic but waking up gasping for air, feeling tired all day, having bags under my eyes, un refreshing sleep and needing to nap most days doesn't seem like just stress. I'm posting some of my Oscar data, any info would be extremely appreciated.
Still symptomatic/weird flow rate? - Ardeo77 - 06-14-2023
[attachment=51493]I was using my machine as an APAP for years with no relief in symptoms. I was told by some people on another forum that I likely just needed to do the CPAP setting and to get my pressure up higher to 10 cm, compared to my previous of 7 to 12, as well as turn off EBR. I noticed I have really weird breathing in my flow rate, theres almost no normal pattern for more than a few minutes, however since uping my pressure it seems less erratic and more normal, but still have pretty weird breathing and symptoms, however less so since taking their advice. Im still working on getting acclimated to pressures slowly, by increasing my pressure every night by a little bit until I hit my target goal of 10. Im sure some of you will dismiss me but some people suggested I might have UARs and I think its possible, however I know Oscar doesn't interpret UARs well, or at all. If you could give some insights to my flow rate/data id be very greatful.
RE: Still symptomatic/weird flow rate? - Gideon - 06-14-2023
Welcome to the forum.
Both of those examples are arousals followed by your bodies response to them. The flat/zero expirations are you exhaling orally with a nasal mask, there is some breath holding later in the sequences as you are settling into what is likely a new position.
Regarding UARS I see nothing indicating that in the views you have asked us to look at.
Unfortunately I don't see a cause for the arousal.
Howany of these do you have in a night?
RE: Still symptomatic/weird flow rate? - Ardeo77 - 06-14-2023
Thanks Gideon, just curious, what would UARs look like? Im guessing high RERAs? My RDI on my initial sleep study was high. These events occur back to back, or just weird breathing over and over on my flow rate. Half the night or more. I see other peoples flow rate and it has a nice rythim, mines erratic most of the time, doesn't seem to have a good rhythm. Since I switched to CPAP from APAP setting, I noticed the breathing pattern became more normal throughout the night and my symptoms reduced. I have no idea whats going on with that.
RE: Still symptomatic/weird flow rate? - Ardeo77 - 06-14-2023
I also wanted to add since you mentioned oral exhalation, that I do mouth tape. Not sure if that makes a difference.
RE: Still symptomatic/weird flow rate? - Gideon - 06-14-2023
On the mouth tape. Your breathing is a closed system, everything you inhale must be exhaled. Where do you suggest that air went?
Yes high RERAS, which are characterized by a high proportion of flow limits which I don't see in the normal portions of what you have shown. In what you have shown it is the disturbance that is the issue and yes you have flow limits there as a result and continuation of the disturbance. If these disturbances are "frequent" they would need to be addressed, if not they can be ignored.
RE: Still symptomatic/weird flow rate? - Ardeo77 - 06-14-2023
Where do I suggest the air went? I have no idea, but maybe its escaping out the side somehow but it seems sealed when I wake up. I appreciate your input, I guess I just have no clue what the breathings about and why switching to a cpap setting and increasing pressure made them less frequent and reduced my symptom's. Id talk to a sleep doctor but have no insurance, Ill just have to keep experimenting I guess.
Heres a shot of my flow limit, if that helps
RE: Still symptomatic/weird flow rate? - Gideon - 06-14-2023
That flow limit looks bad but it has no scale and is out of context with respect to the other events. It is an increase in differential pressure between in hale and exhale that best improved that.
You are not showing an increase in the leak rate to line up with the lack of exhale.
RE: Still symptomatic/weird flow rate? - Ardeo77 - 06-14-2023
Sorry for not giving enough data/context. Maybe I have asthma or something else? Heres my report from last night showing more data.
RE: Still symptomatic/weird flow rate? - Gideon - 06-14-2023
Based on the periodic nature of your flow limits I would slowly bring in EPR, start atv1, Fulltime, and see if that helps your comfort.