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How to stop FOT arousals?
#31
RE: How to stop FOT arousals?
Leave it on 13/10 so we can see what I:E does over a few days average then you can try a change to see if it has a definitive effect. You need 3 days minimum if not closer to a week to really know the effects changing a setting makes.
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#32
RE: How to stop FOT arousals?
(06-28-2021, 07:39 PM)Geer1 Wrote: Leave it on 13/10 so we can see what I:E does over a few days average then you can try a change to see if it has a definitive effect. You need 3 days minimum if not closer to a week to really know the effects changing a setting makes.

Ok I'll leave it on 13/10 tonight. Why does the I:E ratio ideally have to be 1:2? Will this help with lowering arousals?
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#33
RE: How to stop FOT arousals?
I've read through this thread and am most impressed that tidal volume is extremely low for a male, and the minute vent under 4-L/min. I think you would be better off seeing a pulmonologist than a dentist. At the very least, you need a pulmonary function test to evaluate why respiration is so slow and shallow.
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#34
RE: How to stop FOT arousals?
(06-28-2021, 09:20 PM)Sleeprider Wrote: I've read through this thread and am most impressed that tidal volume is extremely low for a male, and the minute vent under 4-L/min.  I think you would be better off seeing a pulmonologist than a dentist.  At the very least, you need a pulmonary function test to evaluate why respiration is so slow and shallow.

Why would be it problematic to have slow, shallow breathing? My main complaints are brain fog, cognitive impairment, fatigue, etc caused by RERAs from my UARS. 

I don't mean to be rude either but it seems rather ignorant to call my MSE Ortho a "dentist"; I came to him specifically because I wanted to undergo a life-changing procedure to improve my sleep and breathing, not because I needed my teeth cleaned.
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#35
RE: How to stop FOT arousals?
I can see a bit of a problem with the slower and shallow breathing as it's been highlighted now. It could be that you're not able to breathe in deeply enough for whatever reason, maybe including some Respiratory ailment that's underlying and undiagnosed. And a PFT (pulmonary function test) isn't that difficult. I do these yearly myself due to COPD. A PFT will not show up as part of a dentist's checklist.

As is, the orthodontist is defined as "a dentist who is qualified to treat irregularities in the teeth and jaws". And I'm pretty sure he's only, and gladly willing, to do that which you've suggested. This MSE may not be entirely what you're expecting, and it may in fact turn out not to help you like you think.
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#36
RE: How to stop FOT arousals?
(06-28-2021, 11:06 PM)SarcasticDave94 Wrote: I can see a bit of a problem with the slower and shallow breathing as it's been highlighted now. It could be that you're not able to breathe in deeply enough for whatever reason, maybe including some Respiratory ailment that's underlying and undiagnosed. And a PFT (pulmonary function test) isn't that difficult. I do these yearly myself due to COPD. A PFT will not show up as part of a dentist's checklist.

As is, the orthodontist is defined as "a dentist who is qualified to treat irregularities in the teeth and jaws". And I'm pretty sure he's only, and gladly willing, to do that which you've suggested. This MSE may not be entirely what you're expecting, and it may in fact turn out not to help you like you think.

"This MSE may not be entirely what you're expecting, and it may in fact turn out not to help you like you think."

What makes you say that? I am in contact with a lot of other people who are undergoing MSE and achieving great results - much better nasal breathing and PAP compliance. I'm not convinced the MSE will cure me by itself, which is why I'm thinking about undergoing MMA following MSE. But with both MSE+MMA that gives me a nearly 100% chance of achieving remission in my UARS symptoms.
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#37
RE: How to stop FOT arousals?
(06-26-2021, 07:31 PM)originofstyx Wrote: An ENT will just offer a soft tissue procedure, but I wanted to change the problem at the skeletal level which is why I am undergoing the MSE (Maxillary Skeletal Expander) procedure. I am working with a sleep and airway focused Orthodontist to expand my maxilla to improve my nasal breathing and increase the size of the oral cavity. Because the top of the palate is also the floor of the nasal cavity, expanding the palate improves nasal breathing and reduces airflow resistance at the skeletal level. The reason why I have a narrow palate is because I grew up with a "tongue thrust" and did not practice the proper tongue posture (resting on the palate) so my palate did not expand enough, impacting my nasal breathing.

An ENT will just offer a soft tissue procedure..
...not entirely true, turbinectomies involve more than soft tissue changes.

Hopefully your airway focused Orthodontist is collaborating with ENT input and not acting solo.
Measurements of MSE or RPE or other MARPE procedures would I assume be planned in conjunction with, at the very least, CBCT, which would show the nasal passages and turbinates to good effect. If your palatal sutures are already fused then, and I speak in complete ignorance of this, you may only be achieving alteration of maxillary dental (buccal rather than lingual) orientation and headed for more Orthodontic applications to the mandibular teeth to maintain correct bite, but I am sure this will have been discussed with you well in advance.

Like everyone else here I sympathize with your plight and search for restful sleep. I applaud you for looking for solutions early on in life and not ignoring it like I did for far too long.
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#38
RE: How to stop FOT arousals?
(06-28-2021, 08:13 PM)originofstyx Wrote: Ok I'll leave it on 13/10 tonight. Why does the I:E ratio ideally have to be 1:2? Will this help with lowering arousals?

Your exhalation is long because you either have a central or restrictive breathing issue. Your nasal congestion and small airways have me leaning towards restrictive although the decrease to 3 PS and some of the results in your previous thread have been supportive of a central nature to at least some extent. Good old UARS, never easy to diagnose or treat because imo the restrictive breathing is only part of the issue.

Like Sleeprider I noticed your low TV/MV but am not yet sure of the clinical relevance. Your sleep study data didn't indicate significant oxygen desats so I wasnt sure if the low ventilation is an issue. I thought maybe you are just a small thin guy and with the restricted airways don't need/use much air. Low ventilation and oxygen levels could be causing the symptoms you mention although your sleep study didn't indicate that as being an issue. You have assumed your symptoms are caused by RERAs and UARS but that is not necessarily the case and you need to be careful about drawing those conclusions especially off of home sleep studies using watchpat as the main diagnosis. You did mention how you felt you had trouble breathing out against CPAP and moved to bilevel because of it, that could support theory you don't breath out against pressure well and perhaps your ventilation numbers are actually lower on PAP then during sleep study. About the only way to get an idea would be to use a recording oximeter but you would have to buy one if you wanted to test that out. 

Right now I would say lets get at one, maybe two more nights at 13/10 then we will try 15/10 to see the differences that makes on I:E and ventilation numbers and we will go from there.

While waiting I would be curious to know if you have any other symptoms that are unexplainable. Any digestive symptoms? Skin issues like eczema etc? Lots of these commonly occur in tandem with UARS.
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#39
RE: How to stop FOT arousals?
"I don't mean to be rude either but it seems rather ignorant to call my MSE Ortho a "dentist"; I came to him specifically because I wanted to undergo a life-changing procedure to improve my sleep and breathing, not because I needed my teeth cleaned."

layman > medical student > doctor (now a Dr) > surgeon (still a Dr) > neurosurgeon (still a Dr)
layman > dental student > dentist > orthodontist > maxillofacial surgeon etc

in the UK surgeons like to be addressed as Mr rather than Dr to elevate them above the rank and file!

didn't know that applied to the Dental fraternity as well! Bigwink
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#40
RE: How to stop FOT arousals?
My wife also has a below average minute vent (though not as low as originofstyx). She will be having a pulmonary function test in about two weeks. One of the goals will be to determine the arterial CO2 level. She does have good SpO2 but her pulmonologist wants to see if she has excessive CO2 as that might be a contributor to her fatigue levels.
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