Hypopneas

[Guiniviere]

I don't think I am understanding Hypopneas very well, even though I have been googling a lot: just lately I have no OAs but several Hs (with AHIs around 1 - 2). Some of these Hs I can see from my Oscar charts are in wake periods. Are Hypopneas simply shallow breathing, or is there oxygen depletion with them? And the ones in wake periods? And, do they always cause arousals?

[Pugsy]

Obstructive Apneas......80 to 100% reduction in air flow that lasts at least 10 seconds
Hyponeas.....40 to 79% reduction in air flow that lasts at least 10 seconds. There is the potential for hyponeas to disturb sleep and cause oxygen level drops if you have enough of them close together.

Do you really think that there is that much difference between an OA that is an 85% reduction in air flow and a hyponea that is a 75% reduction in air flow in terms of what it does or can do to your sleep or your body?

Awake flagged events simply don't count one way or the other. If you see them flagged during known awake time they didn't cause the wake up but instead are a by product of the awake breathing irregularities.

Remember the machine only measures air flow. It has zero way to know if you are asleep or awake.

[palerider]

Are Hypopneas simply shallow breathing,

As far as your machine is concerned, yes.

or is there oxygen depletion with them?

Since your machine has no oximeter, unknown.

And, do they always cause arousals?

That's the idea.

[Guiniviere]

Thank you pugsy and palerider for your responses. You have made me think that I am maybe on the wrong tack concentrating on the depletion of oxygen as the reason for still being so tired and fatigued during the day. Perhaps it has more to do with the high number of Flow limitations and RERAS that I get lately: more sleep disruptions than arousals?

Came across this series of messages about Flow Limitation and it does seem to fit my circumstances

viewtopic/t91643/definition-of-flow-lim ... l?start=30

Last night, for instance, I had 10 FLs and 2 RERAs in 6 hours of uninterrupted sleep. No OA 1 x H

Your opinions much appreciated

[mper!?]

.... You have made me think that I am maybe on the wrong tack concentrating on the depletion of oxygen as the reason for still being so tired and fatigued during the day....Yes, It may be the case... Perhaps it has more to do with the high number of Flow limitations and RERAS that I get lately: more sleep disruptions than arousals?.... I would like to see your charts, first, even though I could suspect you are talking about flagged FL and RERA. From my experience, even after correcting flagged FL and RERA, still remain large number of non-flagged RERA (actually, majority of them, in may case; provoked by either by less-than-10sec FL or hypopneas, quasi-hypopneas, that is, less-than-10 secs events, and so on ) with strong potentical to arousal/awakening you. Arousals/awakenings are the stuffs to focus on (both number of them and on what they are doing on sleep disruption.
Last night, for instance, I had 10 FLs and 2 RERAs in 6 hours of uninterrupted sleep. No OA 1 x H

Your opinions much appreciated

all the best

[Pugsy]

When someone is still feeling tired during the day despite "good" numbers reported by the machine I always start with the basics.

How many hours of sleep are we getting and 6 hours simply isn't enough for most people.
Are those hours of sleep fragmented (remembered or not)?
Take any medications of any kind even OTC? If so, what?
Any other physical or mental health issues going on that might affect sleep quality or how we feel during the day?

[Guiniviere]

When someone is still feeling tired during the day despite "good" numbers reported by the machine I always start with the basics.

How many hours of sleep are we getting and 6 hours simply isn't enough for most people.

Last night's 6 hours without any remembered interruptions was a blessed freak for me. I usually only get between 3 and 4 hours and it has been so for years, and the Dreamstation/apnea machine has made no difference


Are those hours of sleep fragmented (remembered or not)?

Even my usual 3 - 4 hours are interrupted with wakeful periods

Take any medications of any kind even OTC? If so, what?

No, no medications. I use Olbas oil, https://www.olbas.com/olbas-remedies/olbas-oil/ for a decongestant


Any other physical or mental health issues going on that might affect sleep quality or how we feel during the day?

No, no other issues. I think I'd be a fairly normal 80+ yr old if only I could get a bit more sleep with a few less 'events' and wakeful periods. I do have to sleep on my back: with dual hip replacements, side sleeping seems to uncomfortably distort my pelvis.

[Guiniviere]

.... You have made me think that I am maybe on the wrong tack concentrating on the depletion of oxygen as the reason for still being so tired and fatigued during the day....Yes, It may be the case... Perhaps it has more to do with the high number of Flow limitations and RERAS that I get lately: more sleep disruptions than arousals?.... I would like to see your charts, first, even though I could suspect you are talking about flagged FL and RERA. From my experience, even after correcting flagged FL and RERA, still remain large number of non-flagged RERA (actually, majority of them, in may case; provoked by either by less-than-10sec FL or hypopneas, quasi-hypopneas, that is, less-than-10 secs events, and so on ) with strong potentical to arousal/awakening you. Arousals/awakenings are the stuffs to focus on (both number of them and on what they are doing on sleep disruption.
Last night, for instance, I had 10 FLs and 2 RERAs in 6 hours of uninterrupted sleep. No OA 1 x H

Your opinions much appreciated

all the best

I will post a chart for you, though I haven't posted charts before so it will take me a while to review how to.

I'm not understanding "correcting flagged FL and RERA

[mper!?]

I'm not understanding "correcting flagged FL and RERA

...sorry, I meant: after you have solved (by proper balanced EPAP and Pressure Support) your FL and eventual associated RERA (pretty much no more non-rounded inspirations in the FR graph, as well as lowering Max column to something < 0.1, and p95 always zero).

good luck

[Pugsy]

3 to 4 hours of sleep even if not fragmented is a prime recipe for not feeling so great during the day no matter how old we are.

Now as to why the poor sleep quality ....million dollar question. The list of potential culprits is miles long and sleep disordered breathing of some sort is but one item on that very long list. Is your poor sleep quality related to the FLs or RERAs....that's a maybe and to be honest a very slim chance maybe but not impossibility. I don't see 10 hyponeas and 2 RERAs over 6 hours all by itself being the cause though. Certainly not enough to cause oxygenation problems unless there is something else going on that is lung related.

Google sleep maintenance insomnia and start reading. This is something I have personal experience with myself and I know the cause and still struggle with it. Sometimes we don't know why and sometimes we do but it isn't always an easy fix even when we do know what causes it. At least we can cross medication side effects off the list.

Talk to your doctor about it...maybe some sort of medication either RX or OTC would be safe to try.

[Guiniviere]

Thank you Pugsy.

Google sleep maintenance insomnia and start reading.

Am wading through lots. Will post again if I find anything applicable to my particular situation, and try again to get a referral to a sleep specialist.

unless there is something else going on that is lung related.

A diagnosis of Emphysema, though only mild and do not need inhalers?