(04-22-2021, 05:05 PM)SarcasticDave94 Wrote: Yep that supposed titration was like a joke. Starting at 6, ending at 6 with apparently no changes. Even blind squirrels can see that isn't a titration.
OK that aside, what do you feel you lack as is? Are you feeling like your therapy is working OK? What do you want to improve?
I have to disagree with that. No apnea. No hypopnea. No RERA's. They tech did their job to the tee based on titration protocol which is to start at low pressure and increase as necessary to deal with these issues.
The only thing less then desirable in data posted so far was some flow limitation which we are waiting for more data on to see if it improves at the new settings. Flow limits as most of us know are controversial as to whether they need to be treated or not. Considering her blood oxygen level remained very high the entire study and she had no RERA's I see no reason to think breathing issues are causing her symptoms as they aren't causing arousals or desaturations.
There are two things from the titration study that indicate some other potential issues though.
The PLM numbers are significant but they were only associated with a handful of arousals. They are probably a symptom of something that may be causing the tiredness but I am guessing are not the cause of tiredness.
The biggest thing that caught my eye is moderate alpha intrusion. That means awake style brain waves (alpha wave) are showing up in sleep. This is common in Fibromyalgia. In fact if you induce alpha wave intrusion on a persons sleep they can develop Fibromyalgia like symptoms (there are studies on this). This is likely the cause of tiredness imo.
The comment about considering peripheral neuropathy for the PLM is interesting. Especially since there are recent findings that Fibromyalgia appears to be related to (if not caused by) small fiber neuropathy.
Imo path forward is as follows.
Ask doctor to do Iron and B12 tests (if not already done).
Ask doctor to see sleep doctor/neurologist about the PLM and alpha wave intrusion.
If you have other fibromyalgia like symptoms mention them and the relation of Fibromyalgia to alpha wave intrusion (not all doctors are aware of this).
Post results so we can see if the increased pressure helps flow limitations and determine an ideal pressure range for you.
Once we determine an ideal pressure range stick with it and let the machine work.
Don't go down the CPAP rabbit hole so many people do chasing perfect breaths etc thinking it might solve all your symptoms. There is evidence of other issues at play so look into them before you consider trying to treat breathing further.