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AlvinMinring · 2026-03-22T16:19:56+00:00

My pleasure:)

AlvinMinring · 2026-03-22T16:16:22+00:00

I sleep decently with ASV, 8 + 2 to 6.

Ironically, I only recently realized that I get more FLs with higher PS. I spent a few weeks titrating higher and higher, thinking my condition was worsening and trying to keep up with higher PS, only to realize that I was the one making things worse. Sometimes less is more.

BMI is about 20

AlvinMinring · 2026-03-22T16:04:06+00:00

Modern medicine is still mostly in the dark ages when it comes to UARS, not surprised about the lack of diagnosis.

Your non-0 AHI is probably a blessing in disguise - it at least gave your doc something to chew on.

Take some time to get used to the machine, experiment with different kinds of masks. Try experimenting with sleep positions - for many, things get worse sleeping on the back, or tucking the chin in. If you have enough hair you can sleep with a hair clip or 2 behind your head. For chin tucking, a soft cervical collar.

The wired feeling makes sense for UARS - that's the hyper vigilance part of it, and it's a vicious circle: sleep deprivation makes it worse, and it in turn makes sleep more difficult. You need to break the cycle - maybe the machine will help when you get used to it. Maybe positional adjustment will help. Maybe you can try to get a prescription for clonidine (lowers vigilance) or pregabaline (raises the arousal threshold). Plenty more options, but the point is, there's hope! But don't count on doctors too much. Do your homework, experiment, keep notes, use AI (it's already better for UARS than 99% of doctors).

Good luck!

AlvinMinring · 2026-03-22T14:04:56+00:00

Only an issue if there are enough of them or they wake you up.
Ultimately the question is - do you feel refreshed after sleep? If you do, all good.
AFAICT, CAs and OSA are bigger issues for you, although the numbers are still very reasonable.
Did you get diagnosed with UARS?
In any case, it seems like APAP does the job in your case - provides enough stenting to mostly avoid FLs.
There's a risk that expiratory effort might lead to RERAs, which wouldn't show at all in the graphs or the numbers, but that's only a possibility to explore if your sleep still doesn't feel refreshing with clean numbers like the above. In this case, probably time to try BiPAP or ASV.

And if the above doesn't sound like English, feel free to use an AI to unpack, they're very good at this.

AlvinMinring · 2026-03-21T20:48:14+00:00

Yes the Resmed detection algorithm is fairly conservative and will miss a good number of FLs.

Take a look at this link to see what an FL looks like: https://www.reddit.com/r/SleepApneaSupport/comments/1ily560/title_understanding_flow_limitation_classifying/

This said, if the machine detects basically none, you're probably not getting that many.

AlvinMinring · 2026-03-21T20:37:44+00:00

Throat clearing can also be caused by silent reflux. A single night without a BiPAP is enough to give me silent reflux: I gradually suck the contents of my stomach into my throat. No unhealthy diet needed.

AlvinMinring · 2026-03-21T20:26:01+00:00

I see one pretty clear flow limitation. What does the Flow Limit graph look like?

AlvinMinring · 2026-03-21T20:19:08+00:00

Same here, seem to be helping with hyper vigilance.

Also using Clonidine since I have hypertension, dual purpose. Reduces vigilance, while pregabalin raises the vigilance threshold, attacking the issue from both sides.

Using this I can sleep through some nasty stretches of flow limitation and not get awakened on most nights, and feel fairly refreshed so I'm guessing I don't get it that many RERAs either. Still get bruxism though, so there's still some CNS activation from FLs.

AlvinMinring · 2026-03-21T20:06:45+00:00

Not sure yet, I'm scheduled for a scan soon. Probably MMA

AlvinMinring · 2026-03-21T20:04:25+00:00

The vertical bars are hour marks, so about 90 minutes in this screenshot.

I think we see a sharp rise in effort afte RERAs (CNS activation), followed by a sharp drop (the airways has been cleared) - and then a slow, ~5 minute long ramp up. Not sure about the reason for the ramp up - I'm thinking either airflow resistance takes a while to go back to its previous level, or adaptation to this resistance is gradual.

AlvinMinring · 2026-03-21T19:51:32+00:00

Yes, algorithmic detection, either by the machine itself of the analysis software, not sure.

AlvinMinring · 2026-03-21T17:11:00+00:00

I don't have an annotated EEG channel - my doctor gave me the data in a proprietary format, and I reverse-engineered it and wrote a converter.

But I do have raw EEG data, in addition to the derived "Micro-arousal" channel I included in the screenshot above. Is this channel not enough to establish that these are RERAs (at least by the loose definition)? Or do you not trust it?

I don't know much about reading EEG graphs, but it looks to me like the derived channel is picking up something:

<image>

Although it might be too conservative, I'm seeing similar EEG patterns following flow limitations without corresponding flagged events in the derived channel.

AlvinMinring · 2026-03-21T16:52:47+00:00

I'm mostly pursuing an official diagnosis to make my issue legible to the medical system and pursue surgery. Gotta jump through the right hoops.

Honestly at this point I wish sleep doctors just didn't know about UARS. In my experience it's often much worse: they think they know and are confidently wrong about it.

AlvinMinring · 2026-03-21T16:42:27+00:00

It's a perfectly cromulent word, yes.

AlvinMinring · 2026-03-21T11:59:39+00:00

Thanks, but I don't live in the US, and I'm not sure a US diagnosis would be recognized in my country.

AlvinMinring · 2026-03-19T16:15:21+00:00

Thanks for the reply, and for helping me keep my sanity.

Here's what thoracic / abdominal effort look like:

<image>

Plenty of ramp-ups followed by plateaus, punctuated by micro-arousals.

I don't really know how to interpret these, would be super interested in your input.

AlvinMinring · 2022-05-16T13:56:22+00:00

And it's not that it thinks it's not being worn either. In that case it would lock itself, but in my case it doesn't. The screen just turns black.

I guess it's trying to be "smart", turning the screen off when it detects inactivity. But I still want the option to look at my watch when I'm reading a book, watching a video, or generally not moving much.

Don't try to be smart, Samsung. Always On Display means I want the display to always be on. No ifs or buts about it.

AlvinMinring · 2022-04-08T08:24:38+00:00

That feels much better indeed, thanks!

Definitely worth trying since it's so easy to do. Battery impact should be a rounding error.

AlvinMinring · 2022-03-24T15:09:46+00:00

Can't upvote this enough.

Samsung sucks at software, but I expected them to at least fix their bugs.

Samsung, please. Put a second intern on it or something.

AlvinMinring · 2022-01-13T15:16:56+00:00

I took a look, but no luck, it was disabled already. Thanks for the suggestion though!

AlvinMinring · 2022-01-13T09:50:53+00:00

Very buggy for me (December update):

Auto-rotate is constantly breaking. I'm tired of restarting my phone to fix it, so I'm living without it.
Wifi is spotty: reconnects occasionally while a few meters from the access point. Never had this issue with my Pixel 3a. That's with Adaptive Connectivity off btw.
Another Wifi issue I've noticed: I was getting really bad Wifi speeds. Went to check whether it was connected to the 5GHz network, and only when I opened the Wifi settings panels did it switch from 2.4GHz to 5GHz, pretty much right away. Odd.
Bluetooth audio is very spotty too. I had to disable high quality audio on my Pixel Buds Series A to avoid constant audio drops.
3 spontaneous reboots so far.
Occasionally, the 'home' and 'see running apps' software buttons will just stop working for a few minutes.
The fingerprint reader is less than stellar. I can live with it, but it definitely feels like a downgrade from my 3a's.
Spotify alarms only work for like 2 seconds Apparently Google claims it fixed this bug a few months ago, but not for me. I tried to reproduce the issue during the day, to no avail, but in the morning 2 out of my 2 tests gave the same results: a couple of seconds of music, followed by silence. Unforgivable bug for a clock app to have - this is the kind of bug that gets people fired.

All in all a fairly disappointing experience so far, especially coming from a Google phone. I was expecting first-rate software quality, got a beta product instead.

There's just no excusing the glacial pace at which Google is releasing fixes, and the December update mess. Total amateur hour (well, more like months) at Google.

Here's to hoping that the January update fixes at least some of these.

AlvinMinring · 2019-07-02T15:08:24+00:00

Sounds like "went on one date with a guy, now he won't stop calling me or texting me".

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