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Getting worse..
#31
COPD made all the difference for me. Sleep Doctor said no COPD. Pulmonologist said no COPD, but full workup anyway to see what was going on. Surprise COPD. Inhaler. Sleep like a high school kid now Smile

The turning point was when I told the Sleep Doc that I was having apneas before I was asleep. They are not apneas if you are awake
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#32
One of the most unusual flow patterns seen on the forum.
The inhalation pattern is very ragged. The hypo is flagged because, as you can see, there is a decrease in amplitude at that time -- you are still breathing; just lesser amplitude.

Here's what I'm thinking. At that time, your leak graph shows approx 24 LPM leakage (unintended.)
When you inhale, that's a positive pull on the blower unit. Maybe those ragged, flat topped, inhalation peaks are because the machine cannot maintain pressure during inhalation with that leak rate. If so, you have to fix the leaks. I really think you need a Full Face Mask.

It could also be that you have an anatomical issue such as a deviated septum that blocks inhalation through the nose.

I know quite a few vets who go outside the VA system; in fact, they prefer Medicare over the VA.

edit: COPD -- Maybe. But my understanding is that COPD tends to show up more during exhalation.
COPD is diagnosed by using a spirometer. Basically seeing how much air you can blow into a machine.
I would think your doc would have already done this test.
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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#33
(12-28-2015, 02:47 PM)justMongo Wrote: One of the most unusual flow patterns seen on the forum.
The inhalation pattern is very ragged. The hypo is flagged because, as you can see, there is a decrease in amplitude at that time -- you are still breathing; just lesser amplitude.

Here's what I'm thinking. At that time, your leak graph shows approx 24 LPM leakage (unintended.)
When you inhale, that's a positive pull on the blower unit. Maybe those ragged, flat topped, inhalation peaks are because the machine cannot maintain pressure during inhalation with that leak rate. If so, you have to fix the leaks. I really think you need a Full Face Mask.

It could also be that you have an anatomical issue such as a deviated septum that blocks inhalation through the nose.

I know quite a few vets who go outside the VA system; in fact, they prefer Medicare over the VA.

edit: COPD -- Maybe. But my understanding is that COPD tends to show up more during exhalation.
COPD is diagnosed by using a spirometer. Basically seeing how much air you can blow into a machine.
I would think your doc would have already done this test.
Nope my sleep doc who is an EMY and a friend, hasnt done a spiro on me. There's another pulmo/sleep doctor here in town that im trying to make an appointment with.

I have a couple FFM's here at home and hate them with a passion. I have never been able to fall asleep with one in the past. I will dig one out and try it tonight, just to see the patterns.

Mark


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#34
(12-28-2015, 02:47 PM)justMongo Wrote: ........edit: COPD -- Maybe. But my understanding is that COPD tends to show up more during exhalation.
COPD is diagnosed by using a spirometer. Basically seeing how much air you can blow into a machine.
I would think your doc would have already done this test.

Exactly, but insufficient exhale leads to insufficient inhale even though the brain senses it needs more. My thought was that it could be the cause of the raggedy inhales.

Maybe it is just the raggedy old goat. From the pics we all know which old goat is in great shape! Big Grin Big Grin

sBest Regards,

PaytonA
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#35
(12-28-2015, 04:05 PM)PaytonA Wrote:
(12-28-2015, 02:47 PM)justMongo Wrote: ........edit: COPD -- Maybe. But my understanding is that COPD tends to show up more during exhalation.
COPD is diagnosed by using a spirometer. Basically seeing how much air you can blow into a machine.
I would think your doc would have already done this test.

Exactly, but insufficient exhale leads to insufficient inhale even though the brain senses it needs more. My thought was that it could be the cause of the raggedy inhales.

Maybe it is just the raggedy old goat. From the pics we all know which old goat is in great shape! Big Grin Big Grin

sBest Regards,

PaytonA
A raggedy old goat I am for sure. I have an appt with the other Pulmo/sleep dr on 1/4/16. I went to him 4 years ago so im still in their system. If I have some COPD or whatever, I should find out then.

Mark

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#36
Oh, and I just got back from the gym. Did the treadmill and got the old ticker up to 101 and a nice sweat and didnt keel over so that's a good sign.

Mark
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#37
Mark:

The main thing is to stay cool and try not to worry.
This is probably going to come down to medication side effects and anxiety.

I know when you look back you realize all the tough times that you got through; we all had them.
You didn't get to be an MSgt by taking the easy way!
It's just harder to deal with as we get older.

If you feel like me, it seems like only yesterday I was young; and I wonder where did all the years go.

Kindest regards,

Mongo
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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#38
(12-28-2015, 02:42 PM)PoolQ Wrote: They are not apneas if you are awake

Technically they are apneas, just not sleep apneas. Apnea just means to stop breathing, either intentionally or unintentionally. There is even a sport where you put your head under water and hold your breath as long as you can, and the longest breath holder wins. It is known as "Static Apnea".

Ed Seedhouse
VA7SDH

I am neither a Doctor, nor any other kind of medical professional.

Actually you know, it is what it isn't.
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#39
A professional should interpret this for you. The multiple peaks in each individual inhale, especially after the hypopnea, suggests flow limitation and are series of effort increases during the inhale. The jagged top of the inhale looks like a snore, but could just be fluctuations in effort to complete the inhale. Not only that, but each exhale has two steps as well, a small one followed by the rapid main inhale.

I think this breathing pattern holds the reason why you continue to be tired, sore and have felt a lack of relief from CPAP. As I recall, you never had a proper titration study, so no one has seen your respiratory (polysomnograph) trace with CPAP, nor evaluated you for bilevel. If so, we don't know if this breathing pattern may be caused by CPAP, or if it exists in your breathing without it. Either way, you appear to struggle to inhale, and rapidly exhale to start the next breath.

You may benefit greatly from bilevel (BiPAP/VPAP) therapy that would help you breath more effectively by increasing inhale pressure, and decreasing exhale pressure.
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#40
(12-28-2015, 05:33 PM)justMongo Wrote: Mark:

The main thing is to stay cool and try not to worry.
This is probably going to come down to medication side effects and anxiety.

I know when you look back you realize all the tough times that you got through; we all had them.
You didn't get to be an MSgt by taking the easy way!
It's just harder to deal with as we get older.

If you feel like me, it seems like only yesterday I was young; and I wonder where did all the years go.

Kindest regards,

Mongo
Truer words were never spoken.

Mark

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