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Sleep Test Results....IDK....
#21
One last point on the oximeter thingy. The wrist-held recording oximeter is great for nighttime use to see what's going on when you're asleep. But it's a bit bulky to carry around all day, especially when you're out picking the turnips. The little finger non-recording oximeter is great to carry around in your pocket, and see what's going on occasionally. Especially if you're getting winded or something. But it's not ideal for nighttime use unless you want to set an alarm and get up every little while. Which would not be ideal.

So I have both, for all the above reasons.

If you're not having any particular breathing issues, they're both overkill, although for not very many dollars the little guy in your pocket is kind of fun to keep track of what's going on.

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#22
(05-17-2015, 07:05 PM)multime Wrote: When you have your titration study don't forget to ask your doc many of the questions you asked us while going over your test results. I've found that no matter how good my PCP docs intentions are he still doesn't know enough about sleep disorders. This is why I would suggest getting a sleep medicine specialist as your primary care doc.

My pulmonologist isn't approved by my insurance to be a PCP but with my complex medical history my insurance finally approved a waiver to let my pulmonologist be my PCP. This took nearly two years to get approved and becomes effective on the first of the month.

Having someone trained will help to ensure you get the proper monitoring and treatment. For example my ICU records determined that I needed asv treatment. My PCP didn't even know what asv was. My PCP is the only person approved by my insurance to order long term treatment medical equipment. This is quite a problem when your PCP doesn't even know how to file the request with my insurance.

I'm giving this information to help you avoid some of these types of issues or to at least be aware they exist. It seems you have things well in order which is quite impressive for anyone starting out.

Again I wish you good luck.

Thank you Multime. You all have been so very helpful and generous with your time and your own lessons learned. I have found a doc who is certified in internal medicine, sleep medicine and pulmonary disease. The good thing is that he is in the CSHP my primary doc is, so there should be no problem is getting a referral to see him, if I even need a referral. Even if ins. doesn't require it, some specialists still want a referral from one's PCP. I'll see if he can be my primary care doc for the SA, since I like my regular PCP for regular stuff. Tomorrow I'm going to see if I can get an app't. for a pulmonary test because my "twitchy lungs" are really bothering me. Then I can seque into the SA stuff. It's all medically connected anyway. I wish you good health, Multime, and will post my own lessons learned as things progress along.Banana
"Freedom is the oxygen of the soul."
Moshe Dayan
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#23
(05-17-2015, 11:18 PM)kingskid Wrote:
(05-17-2015, 07:05 PM)multime Wrote: When you have your titration study don't forget to ask your doc many of the questions you asked us while going over your test results. I've found that no matter how good my PCP docs intentions are he still doesn't know enough about sleep disorders. This is why I would suggest getting a sleep medicine specialist as your primary care doc.

My pulmonologist isn't approved by my insurance to be a PCP but with my complex medical history my insurance finally approved a waiver to let my pulmonologist be my PCP. This took nearly two years to get approved and becomes effective on the first of the month.

Having someone trained will help to ensure you get the proper monitoring and treatment. For example my ICU records determined that I needed asv treatment. My PCP didn't even know what asv was. My PCP is the only person approved by my insurance to order long term treatment medical equipment. This is quite a problem when your PCP doesn't even know how to file the request with my insurance.

I'm giving this information to help you avoid some of these types of issues or to at least be aware they exist. It seems you have things well in order which is quite impressive for anyone starting out.

Again I wish you good luck.

Thank you Multime. You all have been so very helpful and generous with your time and your own lessons learned. I have found a doc who is certified in internal medicine, sleep medicine and pulmonary disease. The good thing is that he is in the CSHP my primary doc is, so there should be no problem is getting a referral to see him, if I even need a referral. Even if ins. doesn't require it, some specialists still want a referral from one's PCP. I'll see if he can be my primary care doc for the SA, since I like my regular PCP for regular stuff. Tomorrow I'm going to see if I can get an app't. for a pulmonary test because my "twitchy lungs" are really bothering me. Then I can seque into the SA stuff. It's all medically connected anyway. I wish you good health, Multime, and will post my own lessons learned as things progress along.Banana

Great to hear you've got a plan. If you really like your current PCP I would stay. Your insurance might allow a specialist to order everything through your insurance. Mine has to be done by only my PCP but your insurance might not care about this.

Please share all lessons learned because knowledge is power and we can use this knowledge to empower our selves.
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#24
(05-17-2015, 08:53 PM)retired_guy Wrote: One last point on the oximeter thingy. The wrist-held recording oximeter is great for nighttime use to see what's going on when you're asleep. But it's a bit bulky to carry around all day, especially when you're out picking the turnips. The little finger non-recording oximeter is great to carry around in your pocket, and see what's going on occasionally. Especially if you're getting winded or something. But it's not ideal for nighttime use unless you want to set an alarm and get up every little while. Which would not be ideal.

So I have both, for all the above reasons.

If you're not having any particular breathing issues, they're both overkill, although for not very many dollars the little guy in your pocket is kind of fun to keep track of what's going on.

"Great minds think alike", retiredguy.....good idea. I'd be fun to monitor after I drop down or go up in altitude, since I go down to 6,000' once a week or so.
"Freedom is the oxygen of the soul."
Moshe Dayan
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#25
By the way; how's the "King's" O2? Last time I saw him he was looking a little pale. Maybe it was the white suit.
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#26
(05-18-2015, 01:30 PM)retired_guy Wrote: By the way; how's the "King's" O2? Last time I saw him he was looking a little pale. Maybe it was the white suit.

Oh, that king! I don't think he needs to worry about O2 now...regardless of where he is!Cool
"Freedom is the oxygen of the soul."
Moshe Dayan
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#27
(05-16-2015, 09:44 AM)quiescence at last Wrote: Will CPAP be an effective treatment? Doubtful. More likely, if machine is the answer, it will be a more advanced "adaptive servo-ventilator" type.

QAL

QAL: What part of her sleep report are you basing this prognosis on?
Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#28
(05-15-2015, 08:54 AM)kingskid Wrote: Hyp stands for hypopnea. ... These are breathing events that rouse your autonomic system thus waking you up (you might not even know). You don't however have a cessation of breathing during these events.

Wikipedia seems to imply that rather than "rouse" you, the issue with hypopneas is that they disturb sleep by moving you from deeper stages to shallower stages of sleep, thereby depriving you of needed time in these stages, which is why you may not notice (because you may not have been completely "roused").

While there is no cessation of breathing, your breathing is shallower during a hypop, by definition. The common xPAP algorithm compares each breath to the two before it and the two after, and if the difference reaches a certain level (if the breath is comparatively shallow enough), that is when it designates that breath to be considered a hypop event.

There is a physical response when 02 sat drops, which is part of the feedback loop controlling respiration, and from one point of view that can be interpreted as a "partial arousal", but it does not fully wake you.

The autonomic nervous system, which modulates its function due to feedback cues, modulates respiration via the hypothalumus, rather than directly through the peripheral nervous system, where the ANS resides. There is no autonomic nervous supply to lungs or diaphragm, for instance.

And this is probably why arousal is involved. If the ANS was to be able to regulate respiration as part of the peripheral nervous system the same way it regulates digestion, or dilation of your pupils, for instance (both of which are fully-autonomic processes), the hypothalumus would not need to be involved, and sleep would not be disturbed.

"autonomic" implies "involuntary" or "unconscious". There is a necessary change in level of consciousness as a part of responding to low 02, implying that altering respiration to adjust to low 02 is somewhat voluntary and "semi"-conscious, and therefore not "autonomic".
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#29
(05-18-2015, 06:45 PM)TyroneShoes Wrote: While there is no cessation of breathing, your breathing is shallower during a hypop, by definition. The common xPAP algorithm compares each breath to the two before it and the two after, and if the difference reaches a certain level (if the breath is comparatively shallow enough), that is when it designates that breath to be considered a hypop event.

One's breathing must be reduced by 30-50% for at least 10 seconds in order to score a hypopnea. I believe that is normally more than one breath.

Best Regards,

PaytonA

Admin Note:
PaytonA passed away in September 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#30
Everything in the last three posts is quite technical and completely beyond me, but is quite interesting nonetheless. It must take quite a lot of learning to understand SA dynamics at that level.
"Freedom is the oxygen of the soul."
Moshe Dayan
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