In anticipation of my BIPAP Re: New Thread

[ApneaQuestions]

RE: FLOW LIMIT:  Could not find any "car compactor" Flow Limit wave shapes. (I used ApneaQuestions compactor vs not compactor examples as my guide).  Extended periods of NO Flow Limits, with a few pockets of Flow Limits disbursed throughout.


Following on from my brief summary of your nightly chart..... yes....  this is what we expect. 
There were very few flow limitations and that means there will therefore be very few or even ZERO car-compactors.

RE: MASK PRESSURE:  However, did locate maybe a couple or a few isolated "double puff" Mask Pressure wave forms.  (Again, using ApneaQuestions examples).  But hard to be certain.  There does appear though to be changes to the Mask Pressure wave shapes around the time of raised FLOW LIMITS.  I have asked this before, did not get an answer, I think, but what is the significance if any, in the distance between the tip of one Mask Pressure wave form and the next?  Does this indicate a longer or shorter breath length or perhaps a longer or shorter time between breaths?  Why do the valleys(?) between some of the Mask Pressure wave forms appear flat? (I'm thinking that the longer the distance between Mask Pressure wave forms the flatter the valleys appear and this has do do with length of time?

The distance between one peak and the next is simply showing that the TIME between one peak and the next is LONGER. In other words, you are breathing more slowly.
That's what we expect to see when we are asleep... our breathing slows down and becomes "calm". 
When we are jogging.. we breathe rapidly.... when we are resting... we breathe slowly.
If the valleys are long and flat, this simply means that the machine is holding back the pressure waiting for the NEXT breath to start... once the breath starts.... the machine will detect this fact (called "triggering") and boost the pressure to assist with your inhalation.

RE: SNORE:  A category not previously discussed, but of interest to me at the moment.  (Without therapy I have horrid snores, as mentioned way back at start of my posting, the lab tech said she "could hear me from home").  I think I noticed in last night's SNORE graph that I did snore with the mask on, which I have not noticed before, although I'm sure this has been reported in previous graphs. The snores appear near episodes of raised Flow Limit readings and changes to the shapes of the Mask Pressure waves.  What does this mean?  I realize this does not represent a particularly interesting issue to you all, but I'm just curious about the physiological (?) connections.   

Snoring is nothing more than your soft tissue acting like the reed on a musical instrument.  As air passes over the floppy loose soft tissue, the tissue vibrates and plays a tune.
If the frequency was a lot higher, it would sound like a flute or maybe a tenor saxaphone... however, because the frequency is low.... it sounds like a tuba or a trombone or a whoopee cushion.
Of course, it's these soft tissues flapping around or getting stuck together that are causing the flow limitations in the first place.  Therefore it is not uncommon for snoring and flow limitations to go hand in hand because one is simply a side-effect of the other.

RE: WAVE SHAPE/FORMS IN GENERAL:  Please explain if there is any significance/reason for things like sharper tips, dips/valleys in tops of wave shapes, the length of the right side line or left side line (vertical) of a wave shape, etc.

We could talk for hours on this one.  The key here is to make sure you understand what the flow graph is representing. 
First and foremost, it is showing whether the breath is incoming or outgoing.  If it is above zero.. you are breathing IN, if it is below zero.. you are breathing OUT.
Let's just think about the inhalation.... (the discussion for exhalation would be similar but in the opposite direction).
The higher the value... the faster the air is moving.   The lower the value... the slower the air is moving.
If we start to look at various weird shapes, we end up saying things like.. "the air starts moving quickly.. then it slows down... then it speeds up again" etc.

An image that you saw several weeks ago on my thread does this kind of analysis in a paper where a researcher was looking for different "classifications" of breath waveforms
Here is the image: http://www.apneaboard.com/forums/attachm...?aid=18040
And here was my post: http://www.apneaboard.com/forums/Thread-...#pid323859

EDIT: Class 3 on that image was one example of the "musical" snoring caused by vibrations.

[Plmnb]

I think we should have you donate your airway to research scientists to learn from because it is pretty unique. Dr Barry Krakow would be fascinated.  The problem is our everyday medical system is not well suited to conducting research and solving problems like this, which is a big problem for you and your doctor.  As you learned, a sleep study is nothing more than standard protocol that does not change based on a patient's unique needs. It only looks for AHI and is useless in situations like your own.  As you move forward working with or without your doctor, that lesson needs to be remembered.

Nah, seriously? If you are serious about this, he wouldn't really be interested...do you think?  Maybe...?  After all one of my "car compactor" charts is already being used as an example of terrible Flow Rate.  

Most repectfully,
Phoebe
Plmnb

[Plmnb]

Fabulous explanations of my questions in my initial post this morning as always ApneaQuestions!  

Lots to digest now.

Plmnb

[Plmnb]

So, bottom line for this morning...What can I do to get THIS feeling back?

It just happens to be my lowest AHI, (except for the anomaly of 0.67 when I only had like an hour of sleep), and I felt amazing during the day and into the evening.  I could even hang with my husband.  Even if this was only just under 3 hrs sleep.

[attachment=19128]

VS.

[attachment=19129]

Or I won't get a handle on things for good unless ASV?  Or we still have adjustments to make with the BIPAP VPAPauto?

sigh.

[ApneaQuestions]

Hey ApneaQuestions, ok, before you tackle my questions, I looked at the Flow Limitations from yesterday and the corresponding "car compactor" waves and would like to know why if I have Flow Limitation waves at all today, which I do, why do the Flow Rate wave shapes NOT become shaped like "car compactors"?  Is this because the Flow Limit HEIGHT is not as high, MAYBE, as yesterday?

Bingo! :-)    Elementary my dear Sherlock!
https://www.youtube.com/watch?v=lag22Hl2RQw

[ApneaQuestions]

.... Also, I believe I have determined that during the periods in the graphs where I appear to have the most difficulties, I see my chest and sometimes my stomach do weird movements....

Once again... there is nothing "weird" about your body.  :-)
Your body's primary pumping mechanism is your diaphragm. The secondary pumping mechanism is your chest walls expanding and contracting.
When the air isn't flowing well (or if it's not flowing at all)... your diaphragm will start pumping aggressively to get the air moving. Your chest walls will also expand and contract to try to get the air moving too. That's what you are seeing.
If that carries on for too long... your brain wakes you up and you get into your Yoga position to fix the situation for you.
Again.. just speculation... but it makes sense to me.
https://www.youtube.com/watch?v=hp-gCvW8PRY

[Plmnb]

.... Also, I believe I have determined that during the periods in the graphs where I appear to have the most difficulties, I see my chest and sometimes my stomach do weird movements.... 

If that carries on for too long... your brain wakes you up and you get into your Yoga position to fix the situation for you.
Again.. just speculation... but it makes sense to me.

I understand ApneaQuestions.  Also, though, Sleeprider suggested I look into Parasominia.  I have had great difficulty finding anything exactly similar, although this action, if not breathing related, might be similar to sleep walking as it relates to possibly being a form of Parasominia.

I have just joined a psych forum to see if they can help in this particular matter.



Plmnb

[ApneaQuestions]

I'm simply using Occam's razor here.

Maybe it's not so simple as "you are just doing the right things to fix your breathing"...
If I had more evidence such as wandering around the house in a sleep state or bed-wetting I'd consider other hypotheses.

BTW: I hope you mean "psychology forum" and not "psychic forum". ;-)

[Plmnb]

 Yes, a psychiatric forum.

And really, I found information that just suddenly sitting up in bed and staying asleep is related to sleep walking.  Except, I have not been able to determine if they mean with eyes open or not.  So I was hoping I could get an answer in the forum i found.  I will definitely be bringing this up to my sleep dr. on Wed as well as at my appointment with a new shrink at the end of the month.

Not sure you have seen my post on recreating my feeling better?    or I'm just being my impatient self.

Plmnb

[ApneaQuestions]

Related? What (if anything) does THAT mean? Update your post with a link and I'll go take a look. It might be fun.

EDIT: I didn't comment on the question "how do I repeat that good feeling?" because I don't think it's that simple.

I think this is more of a process of getting the flow limitations under control with the VAuto if you can and with an ASV if you can't.
In addition.. increasing your overall sleep time and avoiding breaks in the middle and fixing any positional issues if they are apparent in your videos (such as with a collar.. maybe).
Collectively, they should help. That single night's graph isn't telling me much about any magic silver bullet.