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Technically Treated - To my core Tired
#31
RE: Technically Treated - To my core Tired
good point, tarah...."I strongly disagree that tooth pain and tmj issues aren't related to SDB.  The reason people grind their teeth at night was once thought to be corrected by a retainer, and now we know that it is related to difficulty in breathing and is treated the same as apnea or UARS, with a CPAP/MAD/nasal breathing optimization."

....maybe I could add some observations too:

""Well last night was much better on paper with an AHI of 0.14 which was a single CA at 4:30 in the morning.......

Still tired, but i am 100% confident now that this is not apnea related and i have the data to show the GP that there is something else in play.

Thank you all for your help and input in helping me understand my OSCAR data and pointing me in the direction of where to look.........Less (or no) coffee, improve my sleep hygiene and now i have the confidence to take my data to the GP and show her that the Apnea is treated and something else is in play.

I did a better job of video recording last night......still a little too dark (need to figure that out) but i can clearly see arm and leg movements which correspond to blips in the flow data and leak rates.

So again you clever people, a massive THANKS!!!!!""
--------------------------------------------------------------------------------------- m

Hi, Geologeek

...based on my own therapy ( a case of mild apnea, UARS, RLS/PLMS....pretty much 100 % worked out on respiratory issues, still remaining something tough on RLS/PLMS), looking at your charts, as well as the prior good observations of our fellows in the Forum:

1- I would suggest less emphassis on AHI e more focus on arousals (trying to discriminate between/among causes, either respiratory-driven or other stimula); video recoding is good start up ( I have been calibrating my curves just by highly sensitive audio recording...very good results, lots of learnings);

2- there would be suggestion you are not OK yet on respiratory issues (arousals due to unflagged quasi-hypopneas, i.e, less than 10 sec events and or less 50%FR/arousals; and unresolved flow limitation/arousals, flagged or not).

3-eventually I could add something on your curves (TV, FR, RR, leak, pressure, FL are essential) full night context charts, as well as some 10min-duration windows, for further observations and suggestions. Main question: EPR = 3.0 would be enough, or you would need bilevel? to finally work out respiratory issues?....should remain non-respiratory driven, and/or other stimula arousals : maybe, beyond sleep hygiene,  medication would help.

4 - some of your issues above, could be due  still untreated UARS/arousals and (?PLMS/arousals)...... if not yet, and following tarah, take a look at this splendid book (and everything you can read from the author): Steven Park, Sleep Interrupted;

good luck
Mper
I am not a doctor. Nothing that I say here is medical advice
All my posts include only outcomes/learnings from my own/other therapies and medical literature



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#32
RE: Technically Treated - To my core Tired
(03-03-2020, 10:47 AM)Sleeprider Wrote: You're a geologist...keep digging!


 That made me giggle, so thanks for the endorphines.......


(03-04-2020, 04:25 PM)tarah Wrote: Hello!

You cannot use a nasal mask because you are not able to get enough air through your nose?  Is that correct?  Have you had someone take a look and determine if there are physical obstructions in your nose, like deviated septum or enlarged turbinates or polyps? If you google "Dr.Park UARS", you will find an ENT who talks extensively about the absolute necessity of being able to breathe clearly through your nose at night, and the devastating consequences on sleep architecture for those who can't breathe through their nose.  You know how tired people are when they have a cold and are all congested at night and have to mouth breathe all night and snore and toss and turn?  That is literally what is happening every single night if you can't nose breathe properly.  It's no wonder you are super fatigued!  Anyone would be!  That's not to say there aren't other lifestyle factors contributing here, but you have to address the known nasal issues and THEN see if you are still exhausted and sleeping like crap.



I strongly disagree that tooth pain and tmj issues aren't related to SDB.  The reason people grind their teeth at night was once thought to be corrected by a retainer, and now we know that it is related to difficulty in breathing and is treated the same as apnea or UARS, with a CPAP/MAD/nasal breathing optimization.


Thanks for giving me another avenue to consider.  I have not specifically seen anyone regarding my lack of breath through the nose, but i have had ENT and other specialities shove scopes and endoscopes up my nose and all have reported unremarkable findings other than eustachian tube dysfunction.........

But i will have a read about UARS and get back to my data.........

As to the tmj issue, again i will have a good read around that as i find it increadably awkward to sleep with my splint, and this too may be source of arousals

Thanks for your help


(03-05-2020, 07:04 AM)mper6794 Wrote: Hi, Geologeek

...based on my own therapy ( a case of mild apnea, UARS, RLS/PLMS....pretty much 100 % worked out on respiratory issues, still remaining something tough on RLS/PLMS), looking at your charts, as well as the prior good observations of our fellows in the Forum:

1- I would suggest less emphassis on AHI e more focus on arousals (trying to discriminate between/among causes, either respiratory-driven or other stimula); video recoding is good start up ( I have been calibrating my curves just by highly sensitive audio recording...very good results, lots of learnings);

2- there would be suggestion you are not OK yet on respiratory issues (arousals due to unflagged quasi-hypopneas, i.e, less than 10 sec events and or less 50%FR/arousals; and unresolved flow limitation/arousals, flagged or not).

3-eventually I could add something on your curves (TV, FR, RR, leak, pressure, FL are essential) full night context charts, as well as some 10min-duration windows, for further observations and suggestions. Main question: EPR = 3.0 would be enough, or you would need bilevel? to finally work out respiratory issues?....should remain non-respiratory driven, and/or other stimula arousals : maybe, beyond sleep hygiene,  medication would help.

4 - some of your issues above, could be due  still untreated UARS/arousals and (?PLMS/arousals)...... if not yet, and following tarah, take a look at this splendid book (and everything you can read from the author): Steven Park, Sleep Interrupted;

good luck


Thank you for giving me a lot of food for thought!

I think Oscar will let me set some user defined events so i will follow your suggestions and look into the data a bit more,  I have an appointment with the sleep clinic in a couple of months so at least i have a little time to find if there are any correlations in my data.

Again thank you for your assistance, much appreciated!
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#33
RE: Technically Treated - To my core Tired
mper6794
1- I would suggest less emphassis on AHI e more focus on arousals (trying to discriminate between/among causes, either respiratory-driven or other stimula); video recoding is good start up ( I have been calibrating my curves just by highly sensitive audio recording...very good results, lots of learnings);

I've recently started using a sleep tracker to try and help me do just this as i am as sure as i can be that i dont get restorative sleep.......

I will need a better camera as the one i have isnt all it was cracked up to be unless its within a foot of my face or i have the lights on......so a bit pointless. New one on order.  Below is a screenshot of the other night sleep tracker data and i think it points to the fact that there are arousals of one description or the other.

   
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#34
RE: Technically Treated - To my core Tired
...in my experience, a low cost highly sensitive recorder (scratches, respiratory rytim, stop breathing, other noises, groaning, say something, touch button......) has been enough to calibrate my curves, so that I am able to classify (arousal, awakenings, wake ups) e sub-classify (1-respiratory-driven; 2- others, in particular, PLMS-driven followed by RLS quite often.
... it takes me only some 15 minutes daily to discriminate and counting my arousals.
....importance of this would be determine strategies for improvements, treatment, etc....
....if you post curves as I suggest above, I would eventually be able to guide you on this classifications...
.... later on I will eventualluy post some examples.

all the  best.
Mper
I am not a doctor. Nothing that I say here is medical advice
All my posts include only outcomes/learnings from my own/other therapies and medical literature



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#35
RE: Technically Treated - To my core Tired
I have attached yesterday evenings charts in a few places across the night.  I have not put last nights as there are several large half hour gaps in the data where i must have turned off or gotton out of bed without rembering.

your help is much appreciated.


Attached Files Thumbnail(s)
           
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#36
RE: Technically Treated - To my core Tired
just a few more


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#37
RE: Technically Treated - To my core Tired
(03-05-2020, 11:23 AM)Geologeek Wrote: I've recently started using a sleep tracker to try and help me do just this as i am as sure as i can be that i dont get restorative sleep....

Please post the make and model of the tracker you are using. I'm using an Alta HR and it is not as precise as the report you posted.

Glad to see you are getting so much great assistance from the great people here.

Thanks
My worst night on CPAP is 10X better than my best night without it  Eat-popcorn 
Good night Chesty, wherever you are..Semper Fi
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#38
RE: Technically Treated - To my core Tired
Almost all of these symptoms can be explained by untreated or inadequately treated UARS.  I don't see how it's possible from looking at OSCAR results to know if these types of breathing problems, if they exist, are being addressed.  What I personally see when I look at your charts is near constant flow limitations.  Maybe to some people, these aren't causing problems.  When my flow limitations looked like that, I felt half dead.
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#39
RE: Technically Treated - To my core Tired
I too have been diagnosed with depression, GAD and fatigue, and after spending far too much time on the medical merry-go-round, came to the conclusion that the depression was actually a symptom, not the cause. As a longtime sufferer of chronic pain (spondylitis, arthritis and fibromyalgia), plus fairly significant cardiac problems, I believe that possibly any chronic health condition, if not successfully diagnosed and treated (often the case with CFS and fibro), inevitably impacts on our mental health. It's easy to imagine that the 'wrong' set of ailments, which individually wouldn't cause a huge problem, can conspire to make you feel like crap and thus make your symptoms even worse. Not only that, the symptoms often overlap, making diagnosis and treatment very difficult.

For example, sleep deprivation is known to cause depression and depression causes fatigue ...

All the doctors I visited see things the other way around, that depression causes a cascade of largely psychsomatic issues such as pain and fatigue.

So I think it is entirely possible that your fatigue is not directly related to your apnea, but your other (possibly undiagnosed) issues.
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#40
RE: Technically Treated - To my core Tired
(03-05-2020, 03:12 PM)Geologeek Wrote: just a few more

Hi,

tarah, agree up on what you said, almost totally...

....charts would be not easy to go through yet (please expand vertically a little...put median reference lime in all of them). Even though, I could suggest:

1- Respiratoy-drvien, unresolved efforts, arousal/awaknening you at: 0;40....0;48....1;16;

2- Other issues-driven (PLMS? Catathrenia?), abrupt/sharp events at: 0;34...0;53...2;56...

3- E:I, TV too low, suggesting a Bilevel would bring better results on work out respiratory-driven flow limitations.....

4- maybe humidity too high for UK ?

....once you calibrate your curves, new insights would come up.....I am attaching some examples and interpretations, from my latest record, at december, 2th, 2019...


good luck


Attached Files Thumbnail(s)
           
Mper
I am not a doctor. Nothing that I say here is medical advice
All my posts include only outcomes/learnings from my own/other therapies and medical literature



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