Lots of Events under 10 Seconds

Should I be concerned about events that are under 10 seconds? They typically occur during REM sleep, but there is a lot of them that are 5-8 seconds long. I imagine my AHI would be much higher if I counted these. Is this normal to have a breathing pattern like this?

You weren't sound asleep when those were flagged and if you aren't asleep then they don't count other than to point to not being sound asleep.
You have to be sound asleep for them to matter.
Now why you weren't sound asleep....we don't have any way to know from the data available.

Pugsy wrote: ↑

Tue Mar 05, 2024 9:22 am

You weren't sound asleep when those were flagged and if you aren't asleep then they don't count other than to point to not being sound asleep.
You have to be sound asleep for them to matter.
Now why you weren't sound asleep....we don't have any way to know from the data available.

I was sleeping though, my Apple Watch basically said I was in an REM sleep cycle. Im noticing lots of this mini events throughout the night when I was sleeping though they are not long enough to flag an event.

Well....I don't care what your Apple watch says .....you weren't sound asleep. Your individual breaths shown on the flow rate graph don't lie.

This is sound asleep breathing....yours doesn't look like this.



You asked for opinions and you got mine. You are welcome to wait for other opinions that might be more to your liking.

Have a nice day.

Trivium91 wrote: ↑

Tue Mar 05, 2024 9:17 am

...events that are under 10 seconds?

There's no such thing.

Trivium91 wrote: ↑

Tue Mar 05, 2024 9:46 am

my Apple Watch basically said I was in an REM sleep cycle.

If your Apple Watch said "Jump off a cliff" would you do it?

Pugsy wrote: ↑

Tue Mar 05, 2024 10:11 am

You are welcome to wait for other opinions that might be more to your liking.

Yeah, can't see where it's gonna be this one...

Pugsy wrote: ↑

Tue Mar 05, 2024 10:11 am

Well....I don't care what your Apple watch says .....you weren't sound asleep. Your individual breaths shown on the flow rate graph don't lie.

This is sound asleep breathing....yours doesn't look like this.



You asked for opinions and you got mine. You are welcome to wait for other opinions that might be more to your liking.

Have a nice day.

Makes sense, so you are saying that my breathing pattern changed BEFORE the pause in breathing, so it’s not the pause in the breathing that caused the micro arousal and therefore not an apnea event. Just a micro arousal I guess for whatever reason?

Rubicon wrote: ↑

Tue Mar 05, 2024 10:21 am

Trivium91 wrote: ↑

Tue Mar 05, 2024 9:17 am

...events that are under 10 seconds?

There's no such thing.

So anything that is less than 10 seconds is not significant even if I was in deep sleep? I’m just wondering as there are other mini pauses that I can analyze and see if the breathing pattern was stable before the pauses.

Trivium91 wrote: ↑

Tue Mar 05, 2024 10:35 am

Makes sense, so you are saying that my breathing pattern changed BEFORE the pause in breathing, so it’s not the pause in the breathing that caused the micro arousal and therefore not an apnea event. Just a micro arousal I guess for whatever reason?

Yep.

We don't know why the arousal happened but it happened. Might even have been related to REM stage sleep ending when it is normal to have an arousal or even full awakening that we may or may not remember. Google "sleep stages" and look at the normal hypnograms which all so an awakening after the completion of a REM sleep cycle. You will see what I mean.

I see that sort of thing all the time but then I already know that my sleep quality is less than ideal so it's not a big surprise.
I have other health issues that mess with my sleep. It is what it is. Contrary to what we want to believe ...not everything that messes with our sleep is apnea related nor can it be fixed with the cpap machine. I sure wish it were that simple.

These machines only measure one thing and that is air flow. They have zero way to know if we are asleep or not. They just measure the air flow (or our breathing) and they just call them like they see them...awake or asleep.
They can and will flag awake breathing ( or even minor arousal breathing ) irregularities as some sort of apnea event or even show minor irregularities (like yours with no flag).. Our awake/arousal breathing is very irregular when compared to asleep breathing and the machine just calls it like it sees it.

Below is an example I like to share because it is so clearly obvious. The asleep breathing I circled in red...the rest of it I wasn't asleep so it doesn't really matter what the machine flags since I wasn't asleep.



and this one is the same segment but not zoomed in so close.....all that ugliness after the red circled area means I wasn't sound asleep and thus other than it meaning my sleep wasn't so great...it means nothing in terms of the OSA or airway itself.



The awakening/arousal wasn't caused by anything related to the airway or my OSA. It just happened. I don't know that I even remember the awakening. Probably not though.

Pugsy wrote: ↑

Tue Mar 05, 2024 11:05 am

Trivium91 wrote: ↑

Tue Mar 05, 2024 10:35 am

Makes sense, so you are saying that my breathing pattern changed BEFORE the pause in breathing, so it’s not the pause in the breathing that caused the micro arousal and therefore not an apnea event. Just a micro arousal I guess for whatever reason?

Yep.

We don't know why the arousal happened but it happened. Might even have been related to REM stage sleep ending when it is normal to have an arousal or even full awakening that we may or may not remember. Google "sleep stages" and look at the normal hypnograms which all so an awakening after the completion of a REM sleep cycle. You will see what I mean.

I see that sort of thing all the time but then I already know that my sleep quality is less than ideal so it's not a big surprise.
I have other health issues that mess with my sleep. It is what it is. Contrary to what we want to believe ...not everything that messes with our sleep is apnea related nor can it be fixed with the cpap machine. I sure wish it were that simple.

These machines only measure one thing and that is air flow. They have zero way to know if we are asleep or not. They just measure the air flow (or our breathing) and they just call them like they see them...awake or asleep.
They can and will flag awake breathing ( or even minor arousal breathing ) irregularities as some sort of apnea event or even show minor irregularities (like yours with no flag).. Our awake/arousal breathing is very irregular when compared to asleep breathing and the machine just calls it like it sees it.

Below is an example I like to share because it is so clearly obvious. The asleep breathing I circled in red...the rest of it I wasn't asleep so it doesn't really matter what the machine flags since I wasn't asleep.



and this one is the same segment but not zoomed in so close.....all that ugliness after the red circled area means I wasn't sound asleep and thus other than it meaning my sleep wasn't so great...it means nothing in terms of the OSA or airway itself.



The awakening/arousal wasn't caused by anything related to the airway or my OSA. It just happened. I don't know that I even remember the awakening. Probably not though.

Thanks that makes a lot of sense. They saying people shift positions around a dozen times a night and don’t remember, so that could also cause a disruption in breathing. What other sleeping issues do you have? I will say I elevated the head of my mattress 6 inches but it didn’t seem to make a difference.

The 10 second thing to earn a flag...that's the line in the sand that the medical profession came up with (they had to have something) to earn a flag. Less than 10 seconds and no flag gets earned. Now is there really that big of a difference between 9 seconds and 10 seconds???
Of course not but even if you were sound asleep and the reduction in air flow only lasted 9 seconds....no flag.

Under 10 seconds is much less likely to cause a problem...like O2 drops or something like that. Hold your breath for 10 seconds....does that cause you any problem? It won't cause a desat. And unless you have some other sort of respiratory issue messing with your oxygen levels it won't cause any distress.

Anything under 10 seconds just gets ignored.

Now it wouldn't be impossible for a string of arousal/awake breathing to be caused by a real apnea event of some sort and have it continue until you go back to soundly sleeping but you have to look at whatever preceded the onset of the arousal breathing....but all subsequent arousal breathing just points to not sleeping soundly.

The arousal/awake breathing is just a symptom of poor sleep quality but not always the cause of the poor sleep quality.

If someone sees a LOT of arousal/awake breathing then they need to look for potential causes outside the apnea itself.
I have some pain issues that I know wake me up and usually about 75% of my AHI is related to arousal breathing flagged events.
I might remember a half a dozen awakenings (change position etc) but if I wanted to dig deep into the flow rate I might see 20 or 30 or more segments of arousal breathing that I don't have a memory of. I don't look very often because I already know what I am going to see and to be honest there's not a whole lot I can do about what happened last night. Water already under that bridge sort of thing.
Now if I know I had a leaky mask night then I would work on trying to reduce the mask leaks in an effort to prevent further mask leaks disrupting my sleep. I had one of those nights last night....minor leaking woke me up several times. Doesn't surprise me because I know I cheated a bit with my mask application and I knew it might come loose. My fault. Tonight I won't cheat and hope I do better.

Trivium91 wrote: ↑

Tue Mar 05, 2024 11:24 am

What other sleeping issues do you have?

Right now 2 main issues causing sleep maintenance insomnia (not so much sleep onset insomnia...look them up as they are 2 different things) and messing with my sleep quality.

1...Pain...old woman with bad arthritis in the back and pelvis....fixing this problem is a work in progress...sometimes I win and sometimes the pain wins.

2...life's Stress...that's a tough one because we can't always shut off the brain as much as we might need to or want to. My mother recently died and last week one of my dogs died. Seems like it is always something causing the mind to run amok and 90 mph.

Oh...and a 3rd trouble maker....not enough hours of sleep (even crappy sleep) because of the other 2 main issues.
If I don't get at least 7 hours of sleep of some sort I feel like total dog crap even if the AHI is well below 1.0.

Pugsy wrote: ↑

Tue Mar 05, 2024 11:30 am

Trivium91 wrote: ↑

Tue Mar 05, 2024 11:24 am

What other sleeping issues do you have?

Right now 2 main issues causing sleep maintenance insomnia (not so much sleep onset insomnia...look them up as they are 2 different things) and messing with my sleep quality.

1...Pain...old woman with bad arthritis in the back and pelvis....fixing this problem is a work in progress...sometimes I win and sometimes the pain wins.

2...life's Stress...that's a tough one because we can't always shut off the brain as much as we might need to or want to. My mother recently died and last week one of my dogs died. Seems like it is always something causing the mind to run amok and 90 mph.

Oh...and a 3rd trouble maker....not enough hours of sleep (even crappy sleep) because of the other 2 main issues.
If I don't get at least 7 hours of sleep of some sort I feel like total dog crap even if the AHI is well below 1.0.

Yeah I’m struggled with sleep maintenance insomnia myself over the past three years, though falling sleep is usually pretty good for me. I thought for the longest time I had adrenal fatigue from too much stress but turns out it was sleep apnea and UARs. Only two weeks into APAP therapy so I’m hoping for more sleep improvement. I also bought a bia sleep mask which is in kickstarter phase, it’s like an eeg that measures brain waves and uses neuro feedback via bone induction speakers to improve sleep on real time. I’m hoping it helps with some of the sleep quality issues.

Sorry to hear about the death in your family. I’ve got a lot of family issues aswell, my mother in law currently moved in with us due to failing health, so that has been hard.

I can totally relate to needing 7 hours of sleep. I’m basically just waiting until I can start excersize again, at one point I was so exhausted I was almost bed ridden. I gained weight and that made the apnea worse. Though at the time I thought was adrenal fatigue.

I was wondering if there is a way to see if my UARS is properly treated with the APAP just by looking at the flow rate. My flow limit has improved a bit more since increasing my min to 7. I still have events that are over 0.10 but not too many and my 95% is basically zero now.

Here's a study that tries to establish what a normal rate for brief arousals is by age:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564772/

It has its limitations, but a good take-away is that brief arousals are a normal part of sleep.