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[Diagnosis] Clear airway questions
#21
RELATIONSHIP between snore rate and leak rate
I was wondering if anyone can clarify if there is any relationship between snore rate and leak rate.  I see that I have snore markers and they seem to come
at the same time as leak rate goes up.  I don't understand what comes first; the snore or the leak?  I also see that most times the flow rate spikes and the respiratory rate at the same time....  does the snore cause these other spikes....

Any comments appreciated.   My AHI was zero and I didn't have a very good night....   Spontaneous arousals?

Thanks for your time......


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#22
RE: RELATIONSHIP between snore rate and leak rate
Unfortunate for you, this chart goes to show the numbers by themselves do not create a good night's sleep. My first suggestion is base any and all setting adjustments on how you feel. I'm not suggesting any adjustments, just pointing out what to base edits on if they would be needed.

I would tend to believe the snore comes first, possibly by fractions of seconds before the leak spike. I don't really have hard evidence, it's just that I'd think snores may be from throat restrictions, similar to an actual obstructive apnea would be caused by a restriction.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#23
RE: RELATIONSHIP between snore rate and leak rate
thanks for your quick response Dave.  Is there anything else that stands out here?  I do notice that when a snore occurs there
seems to be a corresponding spike in the flow rate and respiratory rate.  would this cause an arousal in your opinion?

thanks again for your help......
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#24
RE: RELATIONSHIP between snore rate and leak rate
Welcome.

Given that you've indicated you didn't sleep in a well rested fashion, I would say yes this scenario can cause arousals. At a minimum, there is something that's disrupting the rest you need.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#25
RE: RELATIONSHIP between snore rate and leak rate
I wonder if the snores are dinkum, or an artefact of the leak? The machine doesn't have a microphone, it just measures rapid oscillations in what should be a stale flow of air. I'm not sure if this is the case with nasal pillows, but a full face mask can generate "face farts" when it leaks, and these sound much like a snore. (And probably have a similar effect on the flow rate).

I notice that the snores and leaks are extremely short-lived and unless they are causing arousal could probably be discounted. It might help to zoom in close so we can see on a breath-by-breath basis exactly what's happening.
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#26
RE: Clear airway questions
Mratcliff, I combined your most recent thread with your previous therapy thread because I advised you start using the bilevel function of your machine.  You contacted me by PM (actually Supersleeper who forwarded it to me) and said, you had very few events, but didn't feel rested. 

In your original posts, you were using a fixed pressure of 20 with no pressure support and were experiencing some CA events, and very fragmented therapy.  More recently your implemented my recommendation from earlier in this thread, of 18/14 bilevel pressure and had zero events, and much less fragmented therapy. In your PM you said,

Quote:thanks for your great advice.  I did change my pressures lower and switch to bipap mode.

Would you look at my last night results attached to the thread "Relationship between snore rate and leak rate".
I wonder if anything jumps out at you.  Although my numbers are zero I did not have a good night.  The problem
is I don't know what a good night should look like on the chart.

I thank you for your help in advance

My response continues below the charts.

[Image: attachment.php?aid=20986]

[Image: attachment.php?aid=21180]


Your newer results show progress.  I want to first say, please keep your questions on the forum to a single therapy thread. The history is essential to allowing us to help you and understand what we have tried, and where we need to proceed.

So what have we learned?  We learned we can continue to reduce pressure.  With pressure at 20, you had CA events, yet your tidal volume and minute vent were much lower.  Flow limits and snores are zero, so we are on the right track.

Normally I don't make such radical changes in a single move, but, I'm going to suggest again, much lower pressure to get yuo towards greater comfort. Please reduce pressure to EPAP 10 and IPAP 14.  This is a drop of 4 cm, but is certainly in the right direction considering the zero event rate and excellent respiratory stats at 18/14.  Be sure the comfort feature "EasyBreathe" is set to ON.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#27
RE: Clear airway questions
thanks again to everyone helping with posts.....

to Sleep rider I have two questions -

1.  Do the spikes in flow rate or respiratory rate indicate an arousal?
2.  What do tidal volume and minute vent mean?    at what numbers are we shooting for....

I am sorry, I know this is elementary for you guys, just trying to wade my way through it all....


I would like to mention again that I wear a Tap 2 oral device with CPAP, have been for eight year...
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#28
RE: Clear airway questions - additional
I have a question on another subject and am not sure if I should start a new thread or not, but here goes...

I was wondering what effect acid reflux would have on CPAP therapy.....  recently I have been having problems
with my stomach (reflux) and this seems to correspond somewhat to my sleep problems....  will the reflux
cause a problem with my breathing on CPAP?  anyone who has dealt with this problem before I would appreciate
any input....

The tricky part for me is I do not have heartburn.  I guess its silent GERD....


Thanks....  also please let me know if I should be starting a different threat for this....
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#29
RE: Clear airway questions
Hello Mratliffe,

Acid reflux is often related to sleep apnea as the vacuum caused when our airway blocks can pull stomach acid into the airway. CPAP may help alleviate the issue somewhat.

A great book on this is "Sleep, Interrupted". Written by an Ear, Nose and Throat specialist, it is a fabulous read.

Regards,
Damian.
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#30
RE: Clear airway questions
I have severe chronic GERD/acid reflux from a hiatal hernia. CPAP therapy can make GERD worse, the acid reflux symptoms are somewhat random. I've gotten relief from it by sleeping on the left side in most cases. I have found I need to stop eating at least 1 hour before I lay on the bed. GERD had been more troublesome earlier in my apnea therapy. I have also noticed coffee, mints, and chocolate make it worse as well.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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