I'm trying to learn how to read OSCAR data - can you add insights?

[Pugsy]

Air accumulates in my mouth even at 10cm. It does not create an issue, but when I open my mouth, its like I'm blowing out air that was sitting inside. I read this is normal, and unless it bothers my mouth, I should ignore it and this should not affect my venture to bump to auto 10-20 anyway, right?

It's common and normal and with time and experience you may get lucky and find that it fades away.
We call it chipmunk cheeks. Can happen with any mask...air goes up the nose and starts down the airway and tries to exit at the first open door which is the back of the mouth. Lips are sealed...cheeks inflate and hence "chipmunk cheeks"...it's hard to swallow the air so most people just open the mouth and let the air out and pressure is equalized. With a full face mask you aren't losing pressure therapy pressure so other than maybe being slightly annoying or waking you up...doesn't hurt anything.
People using a nasal interface mask can potentially lose enough air pressure to impact their therapy.

I used to have it early on in my therapy but I learned how to shut the back door so that air can't enter my mouth. I can open my mouth, stick out my tongue, blow raspberries and even talk....all with the mask and machine on and not have air enter my mouth from the airway. It's a reflex action that some people just learn. I can't tell you how I do it though. Wish I could because I could market it and make a fortune. Making a habit of keeping your tongue sitting in the roof of your mouth might help though. Problem is when we fall asleep the tongue gets lazy and drops down. The tongue makes a good door though...but obviously it's not tongue placement if I can open my mouth wide and stick out my tongue and air still doesn't enter the mouth.

The chipmunk cheek thing...happens with any pressures, even a measly 4 cm, ...not particularly worse with higher pressures so it shouldn't prevent you from making those pressure changes.

are you in the medical business/equipment business in any way? If you represent/sell/consult in anyway, I'd like to know and patronize that service if possible and when needed.

I worked in the medical field for over 30 years but I retired some time ago. I am just an old biddy who likes to help people and I use the cpap myself and I have experimented just to ease the boredom...and I have read a lot.
I started my cpap journey on a Respironics machine so I am familiar with them. Switched over later but I still own one Respironics machine. It's my travel machine.

If you want to donate or something in my name....your local animal rescue shelter....I am a big time animal lover and rescuer. Any help is always appreciated....even if it is nothing but old newspapers for bedding. I am not allowed to volunteer there....because I would be bringing more babies home and I have more animals now than I need.
But I do drop off supplies every now and then..get in quick and out fast so I am not tempted.

If you are going to by some cpap supplies online from anywhere...consider cpap.com. They pay the bills for this forum so that we don't have to have annoying ads all over the place.

[zonker]

I worked in the medical field for over 30 years but I retired some time ago. I am just an old biddy who likes to help people and I use the cpap myself and I have experimented just to ease the boredom...and I have read a lot.

"just an old biddy"?!?!?

no you are special and you need to know that. we are lucky to have you here.

not only have you read a lot, you've RETAINED it and make use of it in your help with people here.

[DustyDoozeer]

Hi, I'm still alive and thriving. I've been focussed on settling down on my cpap masks so I can baseline my charts and not have equipment fiddling/swapping change my charts. The good new is it is going well. I'll post on this thread soon (next week) once I collect charts and analyze them.

If you want to donate or something in my name....your local animal rescue shelter....I am a big time animal lover and rescuer. Any help is always appreciated....even if it is nothing but old newspapers for bedding.

If you are going to by some cpap supplies online from anywhere...consider cpap.com. They pay the bills for this forum so that we don't have to have annoying ads all over the place.

Pugsy, very kind of you, noted and thanks again.

[DustyDoozeer]

Analysis question: I've been watching videos on how to analyze apnea graphs and how CPAPs don't necessarily get them right.
Would you call this circled area an OA?

It seems to me it is not close to being flat-lined and there is breathing in and out. Thoughts?

Thanks.

[DustyDoozeer]

Right, good day all.

I've been making non-trivial progress here:

• I've settled on the N20 mask, medium. Medium was key - it took my hurt marks away and there is 0 leaking to my eyes.
• I've consistently been getting < 2 AHI for a full week after that switch
• Not sure if its psychological or not, but I feel better every morning. I don't have a headache and I don't feel like I'm struggling to get by the day. I'll however state it was not as magical as I expected it to be- I still do feel confused/tired in the morning, but like I said, I think there is good improvement so far (I've been on CPAP for a few weeks now).
• As recommended in this forum, I switched from fixed 10 to auto 10-20. It seems the fixed pressure was more or less in line, based on what I am seeing each day, 90% sticks between 10.x - 11.x (on average). However, no harm in leaving it in auto. There _are_ certain days I see it going up further for short bursts.

Now onto my second attempt at analysis, I'd greatly appreciate feedback:

Overall analysis:
Let's start with a random day last week:



- Good improvement in overall sleep pattern, far less clustering than my previous reports
- At a macro level, do you see anything else you'd point out?


OA Analysis

Let's dive into a specific section of my chart, where the largest cluster of OA resides

• The first one there doesn't look like an OA to me, it seems like I was in a breathing cycle that was not close to being flat lined. So this may not be on OA. Would you agree?
• The second OA does look close to being flat lined, and I'd think this was an OA. Would you agree?

A random breathing analysis, because I can

Now this one is just to test my correlation skills/understanding. I'm not sure it has a practical value.

• I looked at my respiration rate and noticed it was dipping
• I saw around that time, the CPAP did a pressure test
• As a result, it bumped up my pressure
• My breathing went back up
• Good boy, CPAP
• Is this correlation logical (even if it doesn't necessarily imply anything)

REM correlation, because I have a dream

Right, I get that correlating REM sleep is hard to do and is a guess at best, but possibly a presumption and not completely an assumption.
So here goes:

• During REM sleep, your breathing _generally_ increases and gets irregular (because you are dreaming). Based on just that fact alone, the red blocks above could be _potential_ REM stage sleeps?
• The question I do have there is note the last block of irregular breathing that I outlined. Why did the CPAP not increase pressure? It did so in the other two irregular breathing episodes.
• And of course, this doesn't line up to my apple watch app, but granted neither are accurate.

Conclusion

• I'd love more insights
• I'd love your responses to my attempts

Thank you.

[Pugsy]

The machine doesn't respond to irregular rate in respiration at all.
Instead it responds to irregular flow rate during breathing...as in a compromised airway from a full or partial collapse of the airway tissues.
Respiration rate has nothing to do with it at all.

[zonker]

[*] Not sure if its psychological or not, but I feel better every morning. I don't have a headache and I don't feel like I'm struggling to get by the day. I'll however state it was not as magical as I expected it to be- I still do feel confused/tired in the morning, but like I said, I think there is good improvement so far (I've been on CPAP for a few weeks now).

i'll let my betters speak to the rest. i'll just respond to this by saying that it's been my observation from reading the forum and my own experience that this is typical of "recovery" using the therapy.

there are a few who take to the machine right away and jump out of bed ready to tackle each new day with vim and vigor. but most of us don't. that shouldn't discourage you in the least. things from this point on do get better. concentration returns. a bit more energy. no getting up in the middle of the night to pee.

all in all, it IS a dramatic improvement, but it happens very slowly.

good luck!

[DustyDoozeer]

no getting up in the middle of the night to pee.

Zonker, this was the money quote. I've stopped waking up at 3am to pee! I'm surprised you said that - it matches exactly where I am now. I suppose I am on my way to a better life!

The machine doesn't respond to irregular rate in respiration at all.
Instead it responds to irregular flow rate during breathing...as in a compromised airway from a full or partial collapse of the airway tissues.
Respiration rate has nothing to do with it at all.

Pugsy, thank you for your comments. Please don't take this as me doubting what you say - I'm just trying to understand:
Yes, I understand the machine responds to irregular flow rate. But let's assume that I have a compromised airway from a full or partial collapse of my airway tissues - would that not mean that at those stages, my rate of breaths per minute will fluctuate quite a bit because my lungs are trying to gasp around for air?

When you have the time, I'd love for your comments on the rest as well.

[zonker]

no getting up in the middle of the night to pee.

Zonker, this was the money quote. I've stopped waking up at 3am to pee! I'm surprised you said that - it matches exactly where I am now. I suppose I am on my way to a better life!

heh. 3:30 was the time for me! and it's a common occurrence for those who suffer untreated sleep apnea. you'll see it discussed here from time to time when the newbies come in.

[Pugsy]

But let's assume that I have a compromised airway from a full or partial collapse of my airway tissues - would that not mean that at those stages, my rate of breaths per minute will fluctuate quite a bit because my lungs are trying to gasp around for air?

You are assuming facts not in evidence. My respiration rate doesn't really change all that much when I have apnea events. Neither does most other people either.
Just because a person breathes fast doesn't mean that the airway itself is compromised at all.
Maybe a bad dream...maybe a really good dream...

Now maybe if you had a truckload of apnea events and that caused a serious drop in oxygen levels then maybe the respiration rate would increase a bit as the body tries to catch up on its oxygen.
The area that you circled and questioned....far from a truckload of anything. The machine only increases the pressure with the airway is involved...with or without respiration rate being a bit off. Respiration rate itself means nothing to the machine.

Quit trying to overthink this stuff...it will be a lot easier for you.
Or not....your choice.

[DustyDoozeer]

Quit trying to overthink this stuff...it will be a lot easier for you.
Or not....your choice.

But those graphs and OSCAR. I want to know what else I can do? (The respiration rate part was actually something I picked up in this forum and it seemed to map to what I saw. The OA analysis was from the videos I linked to below)

a) Look at flow rate and look for clusters of sleep events - got that
b) What else? What other conclusions can I draw? There is a sea of information here. I've already looked at:
http://www.apneaboard.com/wiki/index.ph ... rpretation
and http://freecpapadvice.com/sleepyhead-free-software

Any other good threads?

[Dog Slobber]

But those graphs and OSCAR. I want to know what else I can do?

Why must you do anything?

Just because there is a lot of data and graphs, doesn't mean all of it is acted on.

[DustyDoozeer]

But those graphs and OSCAR. I want to know what else I can do?

Why must you do anything?

Just because there is a lot of data and graphs, doesn't mean all of it is acted on.

I'm not suggesting all of it should be acted upon. I'm simply trying to learn to interpret as much data as is logical. My hope is as I understand more, I'll learn to tune my sleep quality better. For example, I'm keeping notes on each day in the charts on my food/liquid intake and at what time (coffee/alcohol etc.) and trying to figure out if there are any consistent signs that show up in graphs that help me optimize these habits.

If there is data, there is no harm in trying to understand them.

[Dog Slobber]

If there is data, there is no harm in trying to understand them.

Sometimes there is harm.

People see patterns all the time and often they attribute causation where none exists. You did so in your previous analysis post.

A lot of the time, incorrect pattern recognition and causation is harmless, other times religions are created.

[DustyDoozeer]

If there is data, there is no harm in trying to understand them.

Sometimes there is harm.

People see patterns all the time and often they attribute causation where none exists. You did so in your previous analysis post.

A lot of the time, incorrect pattern recognition and causation is harmless, other times religions are created.

That is far too preemptive a comment. As an example advancement of Artificial Intelligence can save lives as well as take them. Any field in science can be used for harm or good. I am hardly at that stage now and am sure when I get to the point where I “act” I will be much further ahead. A part of learning is making mistakes. And given you went to religion we are talking of interpreting charts. Context matters. Especially for very abstract comments.

At this stage I’m learning and I plan to question everything. I’m also willing to listen to people who comment on my analysis and help me avoid wrong conclusions. I know Pugsy knows a lot more than me and I’ve read her posts where she does mention she doesn’t see any relation to respiration rate to REM. I have also read posts stating the opposite. At the end of the day I’m going to have to decide what maps to me.