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RE: In anticipation of my BIPAP Re: New Thread
RE: Plmnb - the journey continues now with ST-A.
And just to be clear these aren't flow limitations caused by a small, narrow airway (although that is present as well). At times something is practically obstructing your airway, it only remains open enough that you are able to take a highly flow limited breath rather than having an obstructive apnea.

This is part of my mask theory as maybe it is your tongue being pushed back but when this happens there is still a very small passageway for air.
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RE: Plmnb - the journey continues now with ST-A.
There is a way to mostly nose breath with a full face mask. For me at least I wear a soft cervical collar and it keeps my mouth closed and I only breath through my nose. If I didn’t I would wake up with dry mouth as I need a much higher humidity when I mouth breath. That would sort of simulate a nasal mask apnea questions. You may be on to something here because nasal therapy is the preferred way to go as it splints the airway better than pressure through the mouth. At least that what a lot of papers I’ve read have said time and time again.
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RE: Plmnb - the journey continues now with ST-A.
Scratch my above post Plmnb. I just read your post from a couple hours ago. I should read further.
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RE: Plmnb - the journey continues now with ST-A.
Thank you everyone for all the input!

Definitely interesting theories here.  I sure hope this three specialties doctor (Neurology/psychiatry/sleep doc) can help me.  I may be wrong about the date, it might be the 7th not the 4th.

I did call my regular sleep doc this morning and ask for the detailed psg reports.  At first they said I would have to pay for them if I didn't have them sent directly to the doctor.  I made my displeasure about this known and was put on hold for a bit.  Ultimately the receptionist came back on the line and said of course I could have the reports, come pick them up.  When I got there they were the same reports I already have.  The receptionist got on the phone to the sleep lab and explained what I wanted.  Supposedly, they may have deleted them because they are so lengthy and once the reports are finished they are not usually saved for long.  I won't know anything more until Monday when the sleep lab manager gets back from being out ill.

I have a notebook divided into sections for my case.  I printed two B&W photos.  One showing me in my classic "yoga sitting" pose, legs crossed, head lolling, elbow resting on left leg.  (This is the leg with the Meralagia.  Lots of literature on this on the web btw).  The other picture is me asleep, grabbing my left thigh with my hand, in obvious distress.

I am going to TRY to get video of me with my labored breathing, but I lost a lot of that video when I let my ring subscription lapse for a day.

I wonder which charts to bring???

plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: Plmnb - the journey continues now with ST-A.
not worth much now but a day or so ago I was going to ask if you'd ruled out the Meralagia or other pain as a reason for the yoga sleeping. I didn't because I figured pain is the kind of thing you & your docs would have thought of first & you'd say of course it's been considered & discounted. it doesn't sound certain yet but your description of the photos is suggestive of a potential cause. hope that turns out to be progress.
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RE: Plmnb - the journey continues now with ST-A.
Phoebe, could you check if your machine settings has an Auto EPAP option? Another member starting therapy on an international machine (Lumis 150) which has AVAPS has Auto EPAP on his. http://www.apneaboard.com/forums/Thread-...#pid336986 You might want to follow this.
Sleeprider
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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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RE: Plmnb - the journey continues now with ST-A.
If it is like Canada then the referring doctor should have copies of your detailed report.

Here is a screenshot for you. Assuming you were asleep these are ugly flow limited breaths leading up to a RERA. The slight blips into negative flow rate stopping your IPAP pressure (then restarting) are confusing to me, at first I thought it was due to Timax but it isn't.

   

Prior to the above image you can see how you were having decreasing respiration prior to recovery breaths in a sort of periodic manner, hypopnea after hypopnea. Kind of similar to how positional obstructive apneas present. 

   

Another example of RERA due to flow limited breaths. This time the little tic in breathing is due to Timax shutting down pressure prior to you finishing breath.

   

You could also show the example of where the flow limited breaths caused a RERA followed by mask removal that I posted earlier. 

Take your SD card and get them to review everything. There isn't much data to review and they likely won't trust the OSCAR data anyways but good to take some examples with you to try and get them to understand the problem. There are tons of flow limited breaths leading to RERA's in your CPAP data too and I imagine your Vauto data as well.
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RE: Plmnb - the journey continues now with ST-A.
I think the charts posted by Geer1 were before increases to Ti Min and a change in rise time. There may be other factors. I think the observations by Plmnbs RT friend were interesting. They confirm the physiology that would explain severe UARS, and what remains unknown is how the most severe flow limitation seems to switch on and off.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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RE: Plmnb - the journey continues now with ST-A.
You are correct Sleeprider, I wanted to see the effects of those changes but they weren't available in the data I was given.
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RE: Plmnb - the journey continues now with ST-A.
Howdy sheepless!

The Meralagia (which I had for only a little while back around 2003 and had forgotten about), did not bare its ugly teeth until a couple of weeks ago.  All that leaning and crossing my legs recently, has finally has gotten the best of me. Annoyed-and-disappointed  According to what I have been reading, it was only a matter of time.  If the new doctor can't get my apnea treatment to work or connect with my other sleep doctor to figure this out, I could end up needing surgery, which is a last resort.  The literature says this can be a short lasting, maybe 4 weeks or so condition.  But for that to be the case I'd have to stop the bad action.  I can't stop the bad action....BECAUSE I DON'T KNOW I'M DOING IT!   Oh-jeez   AND I WOULD NEED MY PAP THERAPY TO WORK AS WELL.  Oh-jeez

The progress here so far is that I'm pretty sure I can now rule out the "yoga sleep sitting" as a parsominia.   Laugh-a-lot (It was plausible though).



Sleeprider, I will check when I get home from work tonight.  probably won't be able to respond with what I find until around midnight.  

Later guys & gals.

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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