Plmnb's Never Ending OSA Journey (Data)

[Plmnb]

Plmnb have you ever tried sleeping in a recliner? It won’t be the most comfortable thing to do but it should allow your head to just turn to the side to keep your neck straight. Only till the titration. I’m just trying to think of anything to lower those fl’s and RERA’s till your sleep study.

Oh, thank you Osiris for your help!  So kind of you.

Regarding sleeping in recliner, I haven't owned a recliner in many years.  Do you think tons of pillows stacked up behind me might work?  I visited a friend once who had tons of pillows on the guest bed.  I woke up the next morning practically needing traction, my neck and back hurt so much.  So I hesitate to use many pillows at this time.

[Plmnb]

It wold be interesting to hear a medical opinion on the cause of your periodic severe flow limitations. They are so pervasive that I'm certain it would show up in an induced sleep nasoendoscopy.  I have never seen a better candidate for that test,  Usually performed by ENT and uses twilight anesthesia during nasal endoscopy to identify the cause of flow restriction.

Hi Sleeprider.

I have been doing research on UARS since it was first mentioned to me and had sort of dismissed this applying to me because I don't seem to fit a lot of the criteria for the condition.  I am trying to Google different search terms to see what other conditions might cause my flow limit and RERA numbers and not having much luck.  Most of the results I see are in conjunction with UARS.  Do you have any suggestions on what to Google for?  Have you heard of any other conditions besides UARS that might be a reason?

Respectfully,
Plmnb

[Gideon]

Take your charts to your ENT to show him, and tell him that those that watch them have never seen them this bad. I would also grab someone else's as a comparison (write NOT MINE on it) and the Something BEHIND the eardrum comment.

Flow Limits are the symptom, not the problem, but they do imply that your 'structure' may (or may not) be abnormal. That is for the ENT to determine.

[Osiris357]

Another thing would be a foam wedge. You may be able to find one in Walmart or Target so you can have it tonight. Otherwise it’ll be days for shipping unless you spring for overnight shipping. I just had to pay for overnight shipping a few minutes ago because I crushed my heated hose this morning in a hurry getting ready for work. I thought I moved it out of the way when I first hung the mask on the hook I have on my wall next to the bed. I did not 

If you can’t find it in store and do overnight it should be on your doorstep tomorrow before you go to bed

[Plmnb]

Another thing would be a foam wedge. You may be able to find one in Walmart or Target so you can have it tonight. Otherwise it’ll be days for shipping unless you spring for overnight shipping. I just had to pay for overnight shipping a few minutes ago because I crushed my heated hose this morning in a hurry getting ready for work. I thought I moved it out of the way when I first hung the mask on the hook I have on my wall next to the bed. I did not 

If you can’t find it in store and do overnight it should be on your doorstep tomorrow before you go to bed

[Plmnb]

Just made first available appointment with ENT. Nothing available for BEFORE upcoming bipap titration sleep study. . I am on waiting list in case something opens up sooner.

Interestingly enough, probably just to me, turns out same practice that did my uvula operation a million years ago. That dr is still there!

[Sleeprider]

It's good to make the appointment and gives you the opportunity to request your doctor advise the sleep clinic to provide supportive information related to airway restriction for the use of your ENT. I assume they can see the same things we do in your charts in terms of the respiratory flow wave, and in particular the inspiratory wave shape. In other words, you want more than a summary report, you want to see the actual respiratory flow trace data. That would go a long way towards helping you communicate the problem to the ENT.

[Plmnb]

It's good to make the appointment and gives you the opportunity to request your doctor advise the sleep clinic to provide supportive information related to airway restriction for the use of your ENT.  I assume they can see the same things we do in your charts in terms of the respiratory flow wave, and in particular the inspiratory wave shape.  In other words, you want more than a summary report, you want to see the actual respiratory flow trace data.  That would go a long way towards helping you communicate the problem to the ENT.

Hi Sleeprider.




In case something gets messed up trying to get this data from the sleep doctor/new study, do these respiratory flow waves and wave shapes that you are talking about appear in the OSCAR charts? Are the FLOW RATE GRAPH and  the FLOW LIMIT GRAPH from OSCAR helpful to the the ENT or must it be graphs that come from the sleep study lab?

Appreciate your input as always.

Plmnb

[Plmnb]

Yet another question

Regarding CLEAR AIRWAY EVENTS.

I have been researching these events as I do have a few on various nights according to OSCAR.  Please correct me if I am wrong, but these events are basically CENTRAL APNEA?  At least that is what I am finding in my research.  I read here on Apnea Board that if these events are showing up in OSCAR they may or may not be a real problem.  The only way to tell if you are really having them is with your sleep study.

So I have just now reviewed my sleep study report and there is a section titled Respiratory Summary.  Rather than try to type it out I am posting an image of this part of the report.  Am I misunderstanding what this portion of the report shows, especially as it relates to the heading CENTRAL?  Actually, any additional information gleaned from this image is appreciated, especially if it is information that has not been reflected in the OSCAR postings.


[attachment=18226]

[ApneaQuestions]

Putting the report into words..

1) The first line tells you how many apneas you had when not in REM sleep
6 Centrals
2 Mixed
217 Obstructive
2) The next line tells you how many apneas you had in REM sleep
0 Centrals
0 Mixed
36 Obstructive
3) The third line simply adds these together and measures apneas through the whole sleep
6 Centrals
2 Mixed
255 Obstructive

Note: When I add the obstructives I get 253 not 255 so maybe they pulled the mixed ones into that total (??)

Moving down the page...

4) The total number of apneas was 263 averaging 47.2 per hour (My arithmetic says 261 but no need to split hairs here)
5) The total hypopneas were 6 averagng 1.1 per hour
6) The total central hypopneas was zero averaging zero per hour

Adding these together...

7) Apneas plus Hypopneas when not in REM sleep were 231 which averages 47.4 per hour of NREM sleep
8) Apneas plus Hypopneas in REM sleep were 36 which averages 51.4 per hour of REM sleep

Note: Throughout the night you will have experienced different lengths of time in REM sleep versus NREM sleep

Finally .. lumping everything together

9) You had 269 "events" (including all Apneas and Hypopneas in all sleep stages) which averages 48.3 per hour of all sleep types

When you look over to the right side, you can see how many of these seemed to cause some type of arousal.
Presumably detected by sudden brain activity etc. as you move to lighter sleep stages.
You can also see how many times per hour that happened on average for REM, NREM and total sleep time.

In conclusion: You score an AHI of 48.3 and there is not much Central Apnea and Zero Central Hypopnea

Does that help?