Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

[CPAP] Total Time in Apnea (TTIA)
#1
Rainbow 
Hi Guys Cool first post!

A request and then a big assumption: Everyone! Please list what you've done to reduce your Total Time in Apnea  (TTIA)?

I am willing to bet:
The real reason Apnea is bad is not mainly because it interrupts sleep. It is bad because of starving the brain and body of oxygen.

If that's wrong I'll go back to trying to reduce AHI.

To me, the AHI isn't that useful by its self - it doesn't tell you how severe the interruptions were except if it's a CA, OH, H. Coffee
For example:
Sleep period: 7hrs
Total no. of events (OH): 2
AHI: 2/7 = 0.23%
Event 1 duration: 00:14
Event 2 duration: 35:07

In the above example, the person would not have survived the night but would have an AHI of 0.23% Unsure

So to start I'd like to state some of my thoughts about ways to reduce TTIA.

1.Exercise (Not sure which is the best but swimming seems quite good) Also yoga if I can work up to it!

2.Breathing Exercises (looking into work by the iceman Wim Hof or pranic breathing techniques like Tummo)

3.Make the CPAP machine work as best it can (get decent masks, change filters regularly etc...)

I hope you enjoy the long post! Thanks

Also, it might be controversial but how do people feel about posting something like body mass index (BMI) or weight and body fat %?
It might be helpful to people to know how similar they are for their advice.

For example, I'm odd in that with a BMI of 22, weight of 85Kg and body fat ~~10%. Still have an untreated apnea of 35.2 / hour.
Some advice may be appropriate to me but not to other people...
Post Reply Post Reply
#2
Yes, you are wrong in saying that the only thing that is bad about sleep apnea is reduction of oxygenation. The disruption to sleep that apnea provides makes it so the body does not recuperate as well as it should during sleep. This makes it hard on many parts of the body. Chief among them is the heart. Then if you add insufficient oxygenation, it just makes a bad situation worse.

Sleep disturbed breathing (apneas and hypopneas are part of the sleep disturbed breathing problems) causes awakenings that impede your progress through the sleep stages to stages 3 or 4 which is where the most recuperation occurs during delta sleep. It is wrong to assume that if you make it to REM sleep you will have spent time in stage 3 and 4. I have seen a number of apneacs whose sleep test showed them going from stage 1 and 2 to REM sleep without spending any significant time in stage 3 or 4..

Actually the better indicator of your sleep quality is RDI which is AHI plus RERA per hour.

In answer to your other question What I have done to reduce my TTIA is to just reduce the total number of my apneas, which, in my case, has reduced my TTIA.

Best Regards,

PaytonA
Post Reply Post Reply
#3
(04-20-2017, 01:36 PM)PaytonA Wrote: Yes, you are wrong in saying that the only thing that is bad about sleep apnea is reduction of oxygenation. The disruption to sleep that apnea provides makes it so the body does not recuperate as well as it should during sleep. This makes it hard on many parts of the body. Chief among them is the heart. Then if you add insufficient oxygenation, it just makes a bad situation worse.

Sleep disturbed breathing (apneas and hypopneas are part of the sleep disturbed breathing problems) causes awakenings that impede your progress through the sleep stages to stages 3 or 4 which is where the most recuperation occurs during delta sleep. It is wrong to assume that if you make it to REM sleep you will have spent time in stage 3 and 4. I have seen a number of apneacs whose sleep test showed them going from stage 1 and 2 to REM sleep without spending any significant time in stage 3 or 4..

Actually the better indicator of your sleep quality is RDI which is AHI plus RERA per hour.

In answer to your other question What I have done to reduce my TTIA is to just reduce the total number of my apneas, which, in my case, has reduced my TTIA.

Best Regards,

PaytonA

Ok - I'm still a bit uncertain - AHI seems to tell you nothing about how badly starved your brain gets.
I copied this post to another forum - being new and excited helps! and someone replied with an example using their data:

"If I have 15 events at an average of 15 seconds each, that's TTIA of 4 minutes in a night when I slept 7 hours. You don't know what you are talking about!"

Now my problem with the above statement is that the person is looking at the data the wrong way - they're assuming a uniform distribution when they say 'an average of 15 seconds each'.
In their example, under the standard definition of an AHI event: the maximum length any single interruption could be is 100s or 00:01:40.

I haven't looked into RDI much but it still doesn't seem to put a shape to the data it represents.

RE the oxygen saturation vs sleep disturbance thing - has anyone studied it? there is an article on the health website (I can't post links yet, but search " Sleep Apnea May Damage Brain Cells Associated With Memory" on google and it should come up - it is from 2008 though.

it seems to me that both can be disastrous for the mind - oxygen starvation /  CO2 over-saturation likely to be point specific (as in the case in the health.com article) and sleep interruption likely to be being human related (other bodily processes interrupted).

Another point does occur to me just now though which supports my case - how long does a heart attack victim go without his/her heart getting oxygen? apparently, the in-hospital survival rates are something like 8% - it seems to me that is probably linked to damage caused quickly by the lack of oxygenation of particular sections of muscle...

I guess it would be unfair to create a condition in which this could be studied accurately - its clearly something we all benefit from avoiding!!

Thanks for your insight - my internal logic is completely fallible but rarely tested  Laugh-a-lot

Kind Regards,

OJ
Post Reply Post Reply


#4
Neither AHI or RDI concern themselves with the amount of time that you were in these breathing disturbances.

With respect to apnea there are 2 things to consider when it comes to reducing oxygen starvation to the brain. The first is obstructive apnea. All you have to do with OA is reduce the number of episodes and you will automatically reduce the oxygen starvation. The pressure that splints your airway open effectively will prevent most OAs and the few that might sneak through will be very short and not of any real concern. Central apneas aka clear airway apneas are not minimized by the standard continuous pressure. One would need a bilevel ASV in order to reduce the TTIA. It would also reduce the number of CA events.

Oxygen starvation and CO2 "over saturation" are the same thing. The body measures the oxygen saturation by measuring the CO2 saturation by sensing the pH since dissolved CO2 forms H2CO3 in the blood which lowers the pH.

Your friend from the other forum's example is a nonstarter anyway. If he had 15 events for the 7 hour night, that would make the AHI=2.14. That is about as serious as the 4 minute TTIA that he quoted which is not very serious at all for seven hours of sleep.

Yes AHI is not the whole story and that is why we look at graphical representations of data for a whole night. Yes there are other things to consider. That is why many of us use recording pulse-oximeters. That is why we try to deduce other things from the data that we collect. Also depending on the machine we use the data can be more or less accurate.

Best Regards,

PaytonA
Post Reply Post Reply
#5
(04-20-2017, 03:02 PM)OleJunk Wrote: RE the oxygen saturation vs sleep disturbance thing - has anyone studied it? there is an article on the health website (I can't post links yet, but search " Sleep Apnea May Damage Brain Cells Associated With Memory" on google and it should come up - it is from 2008 though.

Well, just set an alarm to wake you up every five minutes.  How do you think you'll feel by morning?  I don't think that breathing oxygen to assure your O2 levels were OK would help you much.

Apneas and hypopneas are known to disturb sleep.  That's enough reason to treat them because disturbed sleep patterns are bad for your health on their own, regardless of your oxygen levels.

Now I'm not saying that AHI or RDI tell you everything of importance, nor that you should ignore "total time in apnea" - they are all useful information and should be paid attention to.  Just don't ignore one in favour of the other - they all mean something.
Ed Seedhouse
VA7SDH

Your brain is not the boss.

Post Reply Post Reply
#6
Hi OleJunk,
WELCOME! to the forum.!
Good luck to you with your CPAP therapy, hang in there for more responses to your post.
trish6hundred
Post Reply Post Reply


#7
Think I just had the first sleep period with AHI=0.0 in my life. it was 2:46 long and I feel quite different!! Dancing
Post Reply Post Reply
#8
(04-20-2017, 12:27 PM)OleJunk Wrote: Hi Guys Cool first post!

A request and then a big assumption: Everyone! Please list what you've done to reduce your Total Time in Apnea  (TTIA)?

I am willing to bet:
The real reason Apnea is bad is not mainly because it interrupts sleep. It is bad because of starving the brain and body of oxygen.

If that's wrong I'll go back to trying to reduce AHI.

To me, the AHI isn't that useful by its self - it doesn't tell you how severe the interruptions were except if it's a CA, OH, H. Coffee
For example:
Sleep period: 7hrs
Total no. of events (OH): 2
AHI: 2/7 = 0.23%
Event 1 duration: 00:14
Event 2 duration: 35:07

In the above example, the person would not have survived the night but would have an AHI of 0.23% Unsure

. . . .


Also, it might be controversial but how do people feel about posting something like body mass index (BMI) or weight and body fat %?
It might be helpful to people to know how similar they are for their advice.


For example, I'm odd in that with a BMI of 22, weight of 85Kg and body fat ~~10%. Still have an untreated apnea of 35.2 / hour.
Some advice may be appropriate to me but not to other people...

You raise points that have troubled me for some time. I don't have time just now to stumble through posting images from Sleepyhead but will try to get to it soon.

Whatever the explanation for my many long TTIAs--some time back--I'd like sharp eyes and interpreters here to analyze the examples and some extremely long OAs. Yeah, your 35 minute apnea is to illustrate the point, but I think I've had nights where TTIA was in the neighborhood of 15 % of the slumber, with many OAs, as I understand the things, as long as, say 90 seconds (even one, the record holder, of 150 seconds if one ignores the one slight squiggle in its midst). Those numbers are off the top of my head but I do have a pretty good record, including SpO2 data, in SH and spreadsheet detail from about a year ago to show specifics.


I quit the sleep doctor who was satisfied with AHI<5 and compliance and not interested in me trying to do better. My PCF is a hose head nearing retirement, he says the long OAs must indicate  an A10 Autoset malfunction and I just need to get it serviced. Weeks before being put under for surgery my cardiologist sent me to a replacement neurologist (for mine who had retired) because of my CMT, as is mentioned below. I asked him if the Arnold-Chiari condition could be involved affecting my breathing (and how an anesthesiologist might handle me, if so). He was shocked and almost insulted by the suggestion, saying two times in the visit,  that he'd been in practice for 25 years and never . . . . blah blah. He went to the Mayo Clinic website I pointed him to when I suggested I had some  AC markers. I never went back, came through surgery fine. PTL.
 

I appreciate the collective expertise here on the Board, though didn't get much immediate play in an early post in December (was it in 2015 or 16?) that I think may have been explained fairly recently for someone else dealing with cheeks puffing and aerophagia (sp?). It was a case where a fluttering of the esophageal sphincter was suspected of causing jagged flow peaks between full exhales. Over extended periods in the past  I've had 4 or 5 prominent peaks between full exhales causing my apparent respiration rate to at least double. Sleep and PCF physicians had no idea or interest. (My concerns in these areas are partly motivated by a degenerative nerve condition that can affect breathing in addition to the foot drop and progressive numbness that starts at toe and finger tips and works its way up.) Anyway, you learn a lot here. It has improved my rest dramatically.




My BMI is 22 as well in my recent PAPing years, but it once was significantly higher. I infrequently see snores, and am surprised to see them from time to time, loners mostly, in significant gaps between or in  deeper valleys among flow limitations.
Post Reply Post Reply
#9
(04-22-2017, 05:52 AM)2SleepBetta Wrote: ..........
I appreciate the collective expertise here on the Board, though didn't get much immediate play in an early post in December (was it in 2015 or 16?) that I think may have been explained fairly recently for someone else dealing with cheeks puffing and aerophagia (sp?). It was a case where a fluttering of the esophageal sphincter was suspected of causing jagged flow peaks between full exhales. Over extended periods in the past  I've had 4 or 5 prominent peaks between full exhales causing my apparent respiration rate to at least double. Sleep and PCF physicians had no idea or interest. (My concerns in these areas are partly motivated by a degenerative nerve condition that can affect breathing in addition to the foot drop and progressive numbness that starts at toe and finger tips and works its way up.) Anyway, you learn a lot here. It has improved my rest dramatically.




My BMI is 22 as well in my recent PAPing years, but it once was significantly higher. I infrequently see snores, and am surprised to see them from time to time, loners mostly, in significant gaps between or in  deeper valleys among flow limitations.

The post you are talking about was back in 2015 and it went about as far as we could take it. A pulmonologist might know what all of the variation in that flow rate line is indicative of but I am not sure that any of us know.It sounds like you did some research and found the likely cause and now would like a cause for the cause. There might possibly be someone on this forum that has some knowledge in this area.....maybe but again I would recommend a good pulmonologist. If that does not work I would try Resmed to see if they have knowledge in this area or can direct you to someone who does.

Best Regards,

PaytonA
Post Reply Post Reply




Possibly Related Threads...
Thread Author Replies Views Last Post
  time for ASV? lionel197 26 1,226 10-22-2017, 08:36 AM
Last Post: Sleeprider
  ACCESS Machine Blower Time zzzZorro 3 133 10-11-2017, 02:29 PM
Last Post: Sleepster
  [Equipment] New sleep apnea patient here using oral device for first time liz81 17 1,223 08-23-2017, 09:11 PM
Last Post: Romster
  Time for a new machine ?? GrammaBear 8 348 08-10-2017, 11:33 AM
Last Post: GrammaBear
Question very casual relation between AHI and sleep time CPAPreturnee 2 245 07-31-2017, 02:53 PM
Last Post: CPAPreturnee
  Time and Date Wrong on Airsense 10 Autoset biyahero 23 1,470 07-27-2017, 12:06 AM
Last Post: biyahero
  [Diagnosis] Long Time to Get Prescription for Machine Vesimir 39 1,520 07-19-2017, 04:16 PM
Last Post: Vesimir

Forum Jump:

New Posts   Today's Posts




About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.

For any more information, please use our contact form.