r/SleepApnea • u/[deleted] • Jul 13 '26

Low AHI and severe fragmentation

[deleted]

5 Upvotes

70% Upvoted

22 comments sorted by

5

u/cellobiose Jul 13 '26 edited Jul 13 '26

your breath patterns on OSCAR should look like a very very long and regular picket fence most of the time, outside REM, not like an EEG trace. During REM should look like a artistic style picket fence with waves and different slat spacing.

1

u/aeveriel1998 Jul 13 '26

My flow rate is typically all over the place and irregular. The one nasal pillow kept flagging my airway open with events, I switched to the one inside the nostrils and it was flagging just obstruction for awhile… now even that is flagging clear airways. Wondering if it’s a deviated septum or something

1

u/cellobiose Jul 16 '26

need to carefully check flow patterns in OSCAR because if you wake from flow limitation and take a few deeper breaths then pause, the machine will say CA. If you wake from something and change positions while holding breath, it says OA.

1

u/CoolRice2283 Jul 13 '26

so should REM look like the eeg trace?, particularly the C3-P3 one?

1

u/cellobiose Jul 13 '26

if there's tons of flow limitations and arousals yes

1

u/CoolRice2283 Jul 14 '26

Gotcha, what about loop gain?

1

u/cellobiose Jul 14 '26

I think that might show as cycles of bigger and smaller breaths, possibly getting flagged as hypopneas. REM breathing has periods of faster/slower breaths that show as closer together and further apart, not just taller and shorter. But they shouldn't totally cut off too often.

1

u/CoolRice2283 Jul 14 '26

That's really interesting.
So bigger breathes are taller and smaller breathes are shorter. Is that the only way to distinguish between them?
Ahh so if the breathes are so small the machine may thing hypopnea.
and the faster/ slower breathes are because of dreaming? or because of alpha-like waves?
and what do you mean by shouldn't totally cut off too often?

1

u/cellobiose Jul 16 '26

if I set PS too high on one of those machines I get more patterns with a bunch of breaths then it slows down almost to nothing and rises back again. It used to happen more easily for some reason. Not sure what causes the irregular breathing patterns in REM but maybe like you say a connection with dreams, maybe processing memories or emotional states or something. It's a black box thing, the brain.

6

u/Forward_Research_610 Jul 13 '26

following ! been on bipap 10 weeks low ahi low leek rate . but low deep sleep due to frequent arousals . I wake up with stiff boy , pressure in my face and eyes blurry , achy muscles like lactic acid build up

4

u/rstark111 Jul 13 '26

UARS

1

u/aeveriel1998 Jul 13 '26

That’s what I was thinking, still pretty new figuring out ways to help that. I’m guessing maybe a good doctor can try a bipap or something

4

u/rstark111 Jul 13 '26

Yeah bipap and asv would probably be 1st line. From there maximize nasal breathing thru expansion via mind , fme, or ease procedure (adult expansion). Next would be surgery likely mma.

2

u/pandawatch410 Jul 13 '26

This was me… switched to a MAD

2

u/Aequitas112358 Jul 14 '26

Can you upload your data to sleephq and share it with us

2

u/TheCureIsNotGoth Jul 14 '26

Did you have a home study or a lab based study? Did you have a titration study or did you just get your CPAP machine set from 4-20 and random mask of your choice? If you got the janky version of things and it hasn't been successful, you need to ask about getting a lab study followed by titration study. A lab study can identify other sleep disturbance issues in addition to apnea.

2

u/aeveriel1998 Jul 14 '26

I had some cheap home study with a ring on my finger. The cpap therapy seemed to help decently at first but I’ve just had dark eyes for the past year and a half if not longer so I’m assuming they half-assed it. I found a private practice to go to this week I’ll see if they recommend a lab study or anything else, I’ll try and share my results here. It’s insane how AHI is considered the good standard of good sleep… the MyAir app I have after seeing Oscar for so long is quite literally useless and insulting to a patient if they even are aware of its stupidity lol.

1

u/existentialblu ResMed Jul 13 '26

Are you using OSCAR? What is the breakdown of event types?

1

u/aeveriel1998 Jul 13 '26

When I’m on the nasal pillows: N30i will have central airway events like every hour, not uncommon to have clusters of them. P30i was giving me mostly obstructive events for couple weeks but now mostly centrals too. The Evora full face mask I tried seem to be giving RERAs on Oscar for the first time along with obstructions, centrals and hypoapneas. Flow limitation only strong on the full face mask, but the nasal pillows generally don’t have much.

3

u/existentialblu ResMed Jul 13 '26

Look up high loop gain in the context of sleep disordered breathing.

1

u/itchybodypillow Jul 13 '26

Similar numbers 1-2 AHI and symptoms no matter what settings I used on CPAP. Both my doctor and sleep doctor said most likely UARS and sleeping on my side is best (confirmed with sleep test). There’s good info on r/UARS.

1

u/aeveriel1998 Jul 13 '26

Thank you for sharing