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[Pressure] TheWallofSleep's Therapy Thread
RE: Help Calibrating APAP Pressure
sorry for the late reply. if the chart in post #100 is representative of your experience with vauto, you're problem isn't disordered breathing and asv isn't likely to be any better. the most likely cause of your ongoing issues is plm.

I've been having some really terrific improvement in my plm using a TENS/EMS unit on my lower back, butt and upper thighs. in fact, I haven't seen my typical plm flow rate pattern since I started using it a couple months ago. for $30 online it's worth a try.

TENS: transcutaneous electrical nerve stimulation
EMS: electronic muscle stimulation
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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RE: Help Calibrating APAP Pressure
We don't see many males with healthy weight of 128 lbs and height at 5'5., so tidal volume is not particularly low. Your physical makeup is certainly a departure from expected OSA morphology.
Sleeprider
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RE: TheWallofSleep's Therapy Thread
Per the OP's request, this thread has been re-named "TheWallofSleep's Therapy Thread".

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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: TheWallofSleep's Therapy Thread
i saw your weight and height when I was out and couldn't respond, I meant to earlier, Sleeprider's post reminded me.  
As he said your height and weight remove y concern for your tidal volume.

my appologies
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RE: TheWallofSleep's Therapy Thread
Thank you for renaming the thread. I will disregard tidal volume, I assumed I was a statistical outlier and it probably was not much more than that.
I have ordered a TENS unit tonight, I will experiment with it and see what kind of improvement I get. At some point, I would like to try another medication other than Gabapentin but I am hesitant to try some of the others.

As far as breathing goes, how do you classify the flat lines in the flow rate that are not marked as events. Many of them are just under a ten second duration. Are these characteristic of PLM or are they just a normal occurrence throughout the night?
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RE: TheWallofSleep's Therapy Thread
I cant be sure plm is a problem for you but it is such an obvious candidate it's worth addressing. your charts look good so my similar experience leads me to think chasing a pap solution will be fruitless.

I cant tell much about the breathing pauses pictured in post #100 because of the 30-odd second scale. plm breathing is best seen at a 7-10 minute view scale. it would help if you right clicked on the 'flow rate' title & added a zero line, to see more clearly the difference between inhale & exhale. meanwhile, 2 of them appear central to my eye. plm disturbs breathing & I think we often hold our breath against such insults, but this is speculation on my part.

or, they may simply be sporadic flow limitations not meeting the manufacturer's criteria to be flagged as apnea, hypopnea or flow limitation.

not much help I'm afraid. still, for a variety of reasons i think better managing plm will improve your sleep & resolve some of your ongoing complaints. if nothing else, it's useful to rule out this obvious potential culprit.

I hope your experience with TENS is as good as mine has been. I think it's been been a turning point for my plm but I have to temper my inclination to declare victory yet because I still wake up a dozen times a night (fewer than before cpap & getting a handle on plm but obviously still too many awakenings). so after minimizing the negative effects of apnea and plm and thereby extending my sleep sessions from minutes to an average of 2-3 hours at a time, now I have to dig still deeper to try and achieve the seemingly impossible dream of sleeping through the night.

the lesson learned is that crummy sleep can have multiple causes developed over a lifetime that may take time and effort the medical community is ill equipped to sort out.

not meaning to be preachy but a mantra i often dictated to my kids is 'perseverence is key'. as well as curiosity & creative thinking.

all of which is my laborious way of saying you're charts look good so imo it's time to look elsewhere to identify problems & their solutions.

I can feel my rls coming on (always a precursor to plm) so it's time to strap on my tens machine.

good luck!
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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RE: TheWallofSleep's Therapy Thread
I wish I knew how to answer it, I'm not a good chart trace reader.

Sheepless, you can treat your PLM with a TENS? Get the built-in TENS like my back SCS/spinal cord stimulator implant. Probably kidding.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: TheWallofSleep's Therapy Thread
a solution i havent considered dave, but I'd never considered (or heard of) tens either until someone mentioned it for back pain and i took a flyer on it. asking sarcastically: do you think medicare would spring for an implant for plm?
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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RE: TheWallofSleep's Therapy Thread
Probably about as easy to get it approved as the person with tons of CA on a diagnostic study attempting to get an ASV.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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RE: TheWallofSleep's Therapy Thread
Luckily, I was able to find a used ResMed AirCurve 10 ASV to try out. I used it for the first time last night but only for 1h52m. I was awake for about the first ten minutes, so it is possible that the first cluster of hypopneas is sleep/wake junk. The machine itself kept waking me up each time it raised the pressure dramatically. I have seen other threads that all say it takes time to adjust to the machine, and now I get in a very literal sense what they mean when they say to use the "blowback" method. I know this isn't a lot of data to deal with, and It is very likely that I did not even reach REM on this session, but about how much can I dial back the max pressure without compromising therapy? I did wake up once or twice and noticed the back of my mouth was a little sore, nothing alarming such as any sharp pains or anything, it just felt strained from the pressure.

If there is a better chart order or sizing for clarity for ASV, let me know.
Thanks


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