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Skypony's therapy-time to ask for help
#71
RE: Skypony's therapy-time to ask for help
Aside from 4 events lasting longer than 15-seconds, they seem fairly minimal. By minimal, I'm thinking of a comfortable time that a person can hold their breath. If you change the View Size from "4" to a "2" using the slider at the bottom of the Events tab, and click on an event listed, It will provide a 2-minute window that can better be analyzed in the Flow Rate graph. Click on some CAs to see if you took a large breath prior to the event. Once you have selected one event from the list, clicking any further events in the Events graph will maintain the 2-minute zoom window.
Crimson Nape
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#72
RE: Skypony's therapy-time to ask for help
FWIW I still see the need to go ASV. If you're concerned about oxygen levels and being stuck on straight CPAP, these both are fixed with ASV. I think you've more or less run out of tricks the APAP has, leaving you with untreated apnea. The ASV will treat CA, OA, H, FL, and I'd think oxy levels may rise some as your breathing is continual whereas now you aren't breathing some part each minute, and you'd also be on Pressure Support.
Dave

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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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#73
RE: Skypony's therapy-time to ask for help
sorry, I have to ask: how is a 10 second sleeping central apnea any less significant than a 10 (sleeping) obstructive apnea? not to single out anyone in particular - the idea that ca is relatively benign is common on AB - but why doesn't the rationale that a reasonable time to hold one's breath apply equally to obstructive apnea?

I understand ignoring waking ca (swj) and the occasional roll-over ca, and we accept a certain level of apnea (say, ahi under 5) of both types, and that apnea of any type is generally worse the longer they last, but I don't understand singling out sleeping central apnea as being in any way less significant than obstructive apnea of like duration.

I really want to understand the logic here; maybe I'm missing something?
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#74
RE: Skypony's therapy-time to ask for help
The OP has a majority of CAs and not OAs. Having both CAs and Flow Limits poses the problem that to treat one parameter, you will exacerbate the other.
Crimson Nape
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___________________________________
Useful Links -or- When All Else Fails:
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Apnea Helpful Tips

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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#75
RE: Skypony's therapy-time to ask for help
(11-17-2020, 02:44 PM)sheepless Wrote: sorry, I have to ask: how is a 10 second sleeping central apnea any less significant than a 10 (sleeping) obstructive apnea? not to single out anyone in particular - the idea that ca is relatively benign is common on AB - but why doesn't the rationale that a reasonable time to hold one's breath apply equally to obstructive apnea?

I understand ignoring waking ca (swj) and the occasional roll-over ca, and we accept a certain level of apnea (say, ahi under 5) of both types, and that apnea of any type is generally worse the longer they last, but I don't understand singling out sleeping central apnea as being in any way less significant than obstructive apnea of like duration.

I really want to understand the logic here; maybe I'm missing something?

Sheepless, I think this is a really interesting question.  There are two broad areas of concern for apneas, as I understand things.  One is disruption of sleep architecture; the other is long-term health risk. 

I don't know whether one kind of apnea is more disruptive than the other to sleep architecture, but I've been using a Dreem headband the past month, and I've been interested to see that my CAs rarely correspond with any change in sleep stage.  Of course, n = 1, and I'd love to see a real study of this topic.

About long-term health risk, there are desats, which I think would be the same no matter what the type of apnea, and there are other phenomena, like spikes in heart rate, adrenaline, and the like, which I can imagine would be more likely with OAs than CAs.  But again, I would love to know more about this topic.

Skypony's CAs might be treatment-emergent, so I still think it makes sense to see whether they can be reduced so more EPR can be introduced for the FLs.  Depending on how all of this goes, a bi-level machine or an ASV might be preferable in the future.  But there's so much to learn first, and meanwhile Skypony is getting sleep that feels more restful, which is great.
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#76
RE: Skypony's therapy-time to ask for help
responding to CR: thanks, yes, I understand that too but it doesn't bear on the significance or insignificance of sleeping ca or the relative significance of a 10 second ca vs a 10 second oa.

I think it's misleading to downplay the importance of shorter sleeping ca in this or any other case. if a happy medium between ca vs oa and/or flow limitations can't be reached, redefining the problem by ignoring 10 second to some artificially determined 'acceptable' duration ca isn't the solution, asv is. as an aside, ignoring exceptions related to relative quantity, a single ca is more harmful than a single flow limitation (by definition) so it may be more beneficial from a health and comfort standpoint to tackle the ca and accept the flow limitations.

folks may choose to accept more events than ideal for various reasons (like being prescribed an inappropriate machine), but IMHO they shouldn't do so believing sleeping ca is somehow more benign than oa.

I think this deserves more discussion but but I don't want to further distract from the OP's thread. maybe it's enough just to have highlighted the question. I see this a lot so I'm not picking on you, CR; I respect you and your work here.
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#77
RE: Skypony's therapy-time to ask for help
thanks for your thoughtful reply Dormeo. having suffered ca for decades, and now having mixed ca/oa, I know firsthand how deleterious it is. I just don't think duration of ca is any more useful a metric than duration of oa.
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#78
RE: Skypony's therapy-time to ask for help
I'm having a little setback.

It feels like my teeth don't align correctly and there is a little discomfort in my two front upper teeth. I suspect that it is caused by my chinstrap and/or mask. So I need to experiment a bit. I haven't had significant mask leaks since I started using the chinstrap every night but I'm going to eliminate it and try different masks again. Posting my OSCAR results while experimenting probably wouldn't give meaningful data.

I plan on posting my results again after I have the teeth problem resolved.
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#79
RE: Skypony's therapy-time to ask for help
Good luck with it!
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#80
RE: Skypony's therapy-time to ask for help
skypony,
Be sure your chinstrap doesn't pull your jaw backwards.  It should just pull upwards.  

Also, some folk inadvertently rest and/or push their tongue against their front teeth, which could push your teeth out of position after time.  You might be doing that without realizing.  Just something to be aware of.
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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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