[Health] Interpreting sleep study results, EERS enhanced expiratory rebreathing space

[mper6794]

..... forgot to mention great ENTS' last resource, the 5th, to treat UARS: surgery, which appears succeed in some 45/50% of the cases.

All the best

[slowriter]

Why did you change the settings? I thought you said you felt good at the previous one?

I don't know, just experimenting.

It seems like you're kind of stabbing in the dark, without an organizing theory.

You're CAs did indeed increase a fair bit without EERS.

I still think my suggestion above makes more sense, which is:

1. Titrate the EERS (6 vs 12 vs 18, or not at all) to eliminate, or virtually eliminate, CAs
   
2. Adjust, slowly, carefully, consistently, PS and min EPAP to fine-tune the rest
   

[slowriter]

Why did you change the settings? I thought you said you felt good at the previous one?

I don't know, just experimenting.

It seems like you're kind of stabbing in the dark, without an organizing theory.

You're CAs did indeed increase a fair bit without EERS.

I still think my suggestion above makes more sense, which is:

1. Titrate the EERS (6 vs 12 vs 18, or not at all) to eliminate, or virtually eliminate, CAs
   
2. Adjust, slowly, carefully, consistently, PS and min EPAP to fine-tune the rest
   

To be more specific, I would just stick with the current EERS setup for a week, and some stable min EPAP and PS, and then see where you're at.

[Sleeprider]

Joey, have we ever discussed using a high sensitivity for trigger and longer Ti Min?

[slowriter]

Joey, have we ever discussed using a high sensitivity for trigger and longer Ti Min?

I'd like to know what you're thinking here, sleeprider, as I still don't really understand under what conditions you'd change Ti min, and how you'd do it.

[JoeyWallaby]

I don't know, just experimenting.

It seems like you're kind of stabbing in the dark, without an organizing theory.

Maybe lol 

You're CAs did indeed increase a fair bit without EERS.

I still think my suggestion above makes more sense, which is:

1. Titrate the EERS (6 vs 12 vs 18, or not at all) to eliminate, or virtually eliminate, CAs
   
2. Adjust, slowly, carefully, consistently, PS and min EPAP to fine-tune the rest
   

To be more specific, I would just stick with the current EERS setup for a week, and some stable min EPAP and PS, and then see where you're at.

I agree, I'll stick with my current settings and EERS for now.

Joey, have we ever discussed using a high sensitivity for trigger and longer Ti Min?

No, we haven't. Trigger and cycle are on high. I've had Ti Min on 0.1 mostly to lower the amount of cofounding variables. I'm not opposed to raising it.

..... forgot to mention great ENTS' last resource, the 5th, to treat UARS: surgery, which appears succeed in some 45/50% of the cases.

All the best

Even I wanted to, I can't afford it.

_ First, I think would be worth going back to these my observations above.  You have taken measures, and are taking your therapy on your hands: this is great! 

_Your night above came in line with your diagnostic: you are an UARS sufferer. To treat this, as pretty much by protocol of great ENT's,  first thing would be take measures (position, mainly; collar, second; no sedating if possible, third; and, then, fourth: fine-tuned, balanced, EPAPmin x PS;

_Your EPAPmin x PS seesaw, pivoted on normal RR, are not balanced yet;

_Repeating myself: absolute majority of your CA's, if no all of them, in my opinion, are fake events on account of arousal/awakening-sleep transition, as well as unbalance EPAmin x PS. 

_For instance, your semi-quantitative plots and my interpretations suggest you would be on too high EPAPmin, and too low PS. A fine-tuning cycle could start at EPAPmin: 6.0 and P.S: 5.6, as I mentioned above.

_your respiration are going out of track with the EERS, as on the historic I sent you yesterday by e-mail (not possible to post here, limits....don't like go out of jus posting here). It backed perfectely on tracks this last night (as by e-mail I have just sent to you).

_However, as said before, I would not like to interfere on your experience with the EERS; I think could be of great value for others, eventually, in special cases of true serious drawbacks on Periodic Breathing, etc.

all the best

I'm not on any sedating medication. The cervical collar seems to help, there were at least two times in the sleep recording where I would have tucked my chin without the collar... and I know the tape helps from just looking at the leak rate with it vs without it. I feel like EPAP Min 6.0 is too low?

Why do you think, with the same settings, I had almost no events with EERS, while without EERS I had a lot of events? Is there something in the EERS charts that you don't like vs the without EERS charts?

EERS. EPAP Min 8.0 PS 5.0.


EERS lowered settings. EPAP min 7.4 PS 4.6.


No EERS. EPAP Min 8.0 PS 5.0.

[mper6794]

_hi, joey

_ I am afraid I have not making my point properly.

_ Let me try simpler: your CA's are just syntoms. Causes of them are REM/leaks-dependent (before you exchanged mask), untreated tens of arousal/awakenings-sleep transitions >> fake CA's , unbalanced EPAPmin x PS >> fake CA's, and tossing and turning >> fake CA's.

_ and, I think, if were me I would choose treat causes, rather syntoms;

_of course, you can choose treat syntoms, rather than causes, by using the EERS, at the cost of keep on going with and abnormal respiration along time, and with an untreated UARS.

all the best

[slowriter]

_hi, joey

_ I am afraid I have not making my point properly.

_ Let me try simpler: your CA's are just syntoms. Causes of them are REM/leaks-dependent (before you exchanged mask), untreated tens of arousal/awakenings-sleep transitions >> fake CA's , unbalanced EPAPmin x PS >> fake CA's, and tossing and turning >> fake CA's.

_ and, I think, if were me I would choose treat causes, rather syntoms;

_of course, you can choose treat syntoms, rather than causes, by using the EERS, at the cost of keep on going with and abnormal respiration along time, and with an untreated UARS.

I suspect most of the experts on this forum, who have much more experience than you or I, would strongly disagree with this.

I think your last statement, frankly, is irresponsible. You yourself admitted you have little knowledge of EERS, and no experience with it.

Just compare and contrast the same min EPAP (8) and PS settings (5), with EERS and without.

With EERS, it looks really good, with very low AHI, and hardly any reported CAs.

Certainly that's a good starting point.

Without EERS, a substantial increase in reported CAs.

What percentage are real or false positive is almost immaterial; he seemed to have slept better regardless.

[JoeyWallaby]

Going to bed now, so we'll be able to compare more with data in like 10 hours.

[mper6794]

Hi, Slowriter(thanks), Joey, everyone

_Just tried make my point clearer, maybe too reinforced. No ofense. Apologies, just in case.
_ Joey, the settings i mentioned would be just to start up a cycle, collecting data, and get fine-tuned parameters within maximum some 10/15 days.
Have a good night!

All the best