RE: In anticipation of my BIPAP Re: New Thread

[Plmnb]

 Math gurus!

[OpalRose]

Useful info from the "Beginners Guide to SH."

Med (Median) and 90% (or 95%) are statistical terms.

The median value for a given set of data is the halfway point: Half the data is AT or BELOW the median value; half the data is AT or ABOVE the median value.

The 90% value is the data value for which 90% of the data is AT or BELOW the value and 10% of the data is AT or ABOVE the value.

Both Median and 90% are explained very carefully in a blog post Average, Median, 95% numbers:
A guide to those who don't remember their introductory stats.

http://adventures-in-hosehead-land.blogs...de-to.html

[Geer1]

Some examples.

If you had median flow limitation of 0.1 then that means on average every single one of your breaths has 0.1 flow limitation.

If your 95% flow limitation is 0.1 then 95% of your breaths have less than 0.1 flow limitation and 5% of them have more than 0.1 flow limitation.

The reason 95% is used is because peak values are too easily influenced by a single breath etc.

Regarding COPD etc. I think the best method rather than asking if you have one specific lung disease is rather to make them aware of the flow limitation and RERA issue and ask whether or not there are any lung issues (COPD etc) that could be causing intermittent flow limitation like issues during your sleep.

[mper6794]

 Morning guys and gals.

Sleeprider, I just checked my machine and it does not have the therapy setting AVAPS.  I don't think it has the AUTO EPAP setting either.  

mper6794, as Sleeprider said, interesting article on the COPD angle.  Figure 8 does have the similarities in wave forms to mine, although it is an intermittent similarity.  It looks nothing like last nights readings for instance but does to other nights I have had.

For instance the last few nights MASK PRESSURE wave forms are not flat topped.  And the FLOW RATE forms are not "car compactor" in shape at all. 

EDIT:  If it were asymptomatic COPD wouldn't the spiro test detect an issue? 

I have been playing with my settings on my own and once I get another night in I will present a chart and the settings I have the machine set to.

I guess I should do some web hunting on COPD and differences between daytime COPD and night time COPD?  I guess I could also ask at this next drs. appointment about this angle.

Thank you Geer1 for the chart suggestions.

Plmnb

....Yes, Spiro should detect (when was your last test? 2003?). It might be worth.
....I used to think my close relative's COPD (40-year smoker) was minor, until recent Spiro (and images) test ands, in additon to preliminary Autoset curves. Now, I know, it could be asymptomatic, except for minor cough, gradual poorer sleep over the years, snore, increasing trips to toilet at night, dificult control very high blood pressure, daily anxiety, panic, depression from time to time, morning headaches, nightmares, clamps, .....
....pneumologist only prescribed bronchiodilators !!, even PSG showing curves similar to yours (and paper above)....It would not be time cor PAP's yet (AHI < 5.5!!). Going to see new pneumologist and starting using PAP with my ?guidance?  

all the best

[Plmnb]

Hi mper6794.

Wellll....hmmm 

Regarding the Spiro test, I have had two recently, by two different doctors.  One in 2018 and one at the very end of this past year.  They haven't said a word to me about it.  And as I have said prior, my lungs look good as far as I know from imaging tests.

As for the rest of what you list, certainly some similarities.  As we well know, doctors don't always get things right.  For example, I complained about pain in my back that would come and go from the time I was around 10 years old.  VERY long story short I was finally diagnosed with gallstones on my 30th birthday by a foreign ER doctor.  I ended up having to have the BIIIG surgery, including my appendix which also showed signs of having issues.

Absolutely your info is food for thought.

Plmnb

[Plmnb]

Hey guys.  Does this apply to me in your opinions?

FLOW LIMITATION: AN OVERVIEW


Should I bother bringing this article to my upcoming dr. visit?

Plmnb

[Sleeprider]

We rarely observed it in your results. Your problem seems to be inspiratory flow limitation.

[Plmnb]

Ok, thanks.  I’ll look that up instead.  Ya never know.  I feel like I’m digging for gold!

Phoebe

[Plmnb]

Ok, this article says MILD in the title and mine was diagnosed with SEVERE, but still.......


The role of flow limitation as an important diagnostic tool and clinical finding in mild sleep-disordered breathing

Section #2 talks about Detection of IFL.

Does this article help me help the dr?



Plmnb

[ApneaQuestions]

Well yes... the article is an introduction to Flow Limitations and the importance of looking for them especially in relation to RERAs.

However, we hope your doctor already knows this stuff and if he doesn't.. do you want him to learn on your dollar?

The article is also raising awareness amongst the sleep-lab folks to persuade them to look for these things and to report RDI index. 
Once again, we hope they already know to do this and that they are already counting RERAs and giviing you a RDI index in your sleep study report.

In short.. the doctor and the sleep-labs should already know this stuff and your office visit time may be wasted teaching the Doc things they should already know and hopefully they DO know because your previous visit was talking specifically about these topics

$0.02

P.S. Did you notice those flow waveform classifications showing up again from the paper I pointed you to many weeks ago?