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[Treatment] Treating UARS with CPAP and bilevel
RE: UARS and APAP
(10-30-2019, 02:55 PM)slowriter Wrote:
(10-30-2019, 02:48 PM)WillSleep Wrote:
(10-30-2019, 12:04 PM)slowriter Wrote: I ordered a CMS50I, so we'll see!

My Dreem 2 has spo2 sensors, but I have no access to that data currently. 


 On the CMS50I, cool.  I have never seen that one.  Will be looking forward to your assessment.

So how does the dreem take advantage of that data now?
... and what does the Dreem share with you about SpO2?

It doesn't currently expose spo2 data at all. Maybe it uses it behind the scenes in its algorithms?


Maybe.  I am intrigued.    If so might SpO2 be used as a confirming indicator to the ECG?

Or maybe they included the SpO2 sensors to work standalone but have not yet finished the testing sensor results and building the presentation layer.    


WillSleep

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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RE: UARS and APAP
(10-30-2019, 04:24 PM)WillSleep Wrote:
(10-30-2019, 02:55 PM)slowriter Wrote:
(10-30-2019, 02:48 PM)WillSleep Wrote:  On the CMS50I, cool.  I have never seen that one.  Will be looking forward to your assessment.

So how does the dreem take advantage of that data now?
... and what does the Dreem share with you about SpO2?

It doesn't currently expose spo2 data at all. Maybe it uses it behind the scenes in its algorithms?


Maybe.  I am intrigued.    If so might SpO2 be used as a confirming indicator to the ECG?

Or maybe they included the SpO2 sensors to work standalone but have not yet finished the testing sensor results and building the presentation layer.    

That's my hope, of course.
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RE: UARS and APAP
(10-26-2019, 08:24 PM)WillSleep Wrote: Measuring your lungs is the only way to know for sure what your ideal tidal volume should be ...

Am I right in assuming one of those cheap incentive spirometers would be a good way to test this, and that I would be measuring max lung capacity to derive the ideal TV?
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RE: UARS and APAP
(10-25-2019, 05:28 AM)slowriter Wrote:
(10-24-2019, 09:15 PM)WillSleep Wrote:
(10-24-2019, 02:03 PM)slowriter Wrote: So in comparison, here's PS 5.2, EPAP 6.2. 

TV 480, MV 7.13, which appears "normal." Unlike Sleeprider, I think my lungs are pretty normal.

At this point, I'm fine-tuning, but can someone explain what's going on with this wake up event? Is this breathing related that might suggest any settings tweak(s)?

I don't have anything to add on the wake up question but the screenshot looks really good.  

I noticed your I:E ratio is down to .46 (1.26/2.76) which is pretty low but your TV & MV look great and if your SpO2 was good all night and your getting enough oxygenation I don't see that low I:E ration as a big concern.  

How do you feel? / Was it a good night?

A good night is 8 hours, 1-2 brief arousals.

This was 6:51, with 4 arousals.

So not great.

What settings on the VAuto would impact I:E?

Beyond pressure, I currently have:

Ti min = 0.8
Ti max = 3.0
Trigger = very high
Cycle = high

Edit: looking back through my data, median exp time seems pretty consistent, but insp varies from about 1 to 1.35.

Wiki says sometimes these numbers are miscalculated/reported, so attaching closeup from same night.

(11-01-2019, 07:38 AM)slowriter Wrote:
(10-26-2019, 08:24 PM)WillSleep Wrote: Measuring your lungs is the only way to know for sure what your ideal tidal volume should be ...

Am I right in assuming one of those cheap incentive spirometers would be a good way to test this, and that I would be measuring max lung capacity to derive the ideal TV?

Yes, if you choose one of reasonable quality and capacity (I hear capacity is an issue with some cheap ones). 

Measuring TV might be the the easiest and also the hardest to measure because is more dependent upon patient judgement and self-discipline than any other of the Spirometer tests.  

Lol.  For an approximation you can use some good self-discipline and a perfectly round balloon.   I have chart to covert the circumference of the balloon to ~TV mL.  Or push the balloon into a bucket with tight mL measuring capacity and measure the mL of the water you displace.  


Clinical Measurement Procedures

1).  Use of both a high grade graphing Spirometer and helium gas diffusion methods to clarify Residual Volume, etc for the most accurate TV measurement.    Tidal Volume  (VT= IC-IRV) or (VT= VC-(IRV+ERV))  or  (VT= TLC-(IRV+ERV+RV))

2) Or skip the gas and apply a lot of self-discipline using a Spirometer. >>  So not that different from just doing it yourself for a good cheap approximate first pass.  


I looked a while back but did not yet see standup winner product.   

This article highlights some pros and cons of using incentive vs volume based Spirometers.   I thought the article was good to use to figure out what to buy and to better understand that Self-discipline is key to get a good read.  

http://www.scielo.br/scielo.php?script=s...5000700014


WillSleep


Shortest, simplest procedure I saw.
 
Experiment 1:  Measuring TIDAL VOLUME
Measure the amount of air exhaled or inhaled during normal, quiet breathing (TV)  The patient should sit by the spirometer, breathing quietly and normally for about a minute.  After inhaling a normal breath, places the mouthpiece between the lips (get a good "seal") and exhale in a normal, unforced way, into the spirometer mouthpiece.  The volume should be read and recorded from the horizontal scale.
 
Experiment 2:  Measuring EXPIRATORY RESERVE VOLUME
Measure the amount of air that can be forcibly breathed out after normal expiration (ERV). The patient stands, breathing normally for a minute or so, then, after a normal exhalation puts the mouthpiece between the lips, and forcibly exhales all the additional air possible.
 
Experiment 3:  Measuring INSPIRATORY RESERVE VOLUME
Measure the amount of air that can be inhaled following normal TV inhalation (IRV) Standing, the patient breathes normally for a minute; then breathes as deeply as possible. With the mouthpiece inserted, the patient then exhales normally, without forcing the air out. The IRV reading is obtained by subtracting the patient's TV from the reading recorded on the spirometer.
 
Experiment 4:  Measuring VITAL CAPACITY
Measure the maximum amount of air which can be forcibly exhaled immediately following a maximal inhalation (VC)   (VC = TV + IRV + ERV) . Standing, the patient slowly and deeply breathes in and out for awhile, then breathes in as deeply as possible, places the spirometer mouthpiece in position, and breathes out as forcibly as possible.
 
   

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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RE: UARS and APAP
The cheap one I was looking at is really similar to the volume one mentioned in that study. 

But max capacity is 5l, which I assume is less than my lung capacity (normal for men is supposedly 6).

But if that's not what we need to measure, might be fine.

I'm really just looking for an easy and cheap way to validate what my TV should safely be on the xPAP.  You mentioned originally capacity, which was why my question.
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RE: UARS and APAP
(11-02-2019, 07:48 AM)slowriter Wrote: I'm really just looking for an easy and cheap way to validate what my TV should safely be on the xPAP.  You mentioned originally capacity, which was why my question.

Maybe there's a way to use machine itself to assess this?
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RE: UARS and APAP
(11-02-2019, 08:01 AM)slowriter Wrote:
(11-02-2019, 07:48 AM)slowriter Wrote: I'm really just looking for an easy and cheap way to validate what my TV should safely be on the xPAP.  You mentioned originally capacity, which was why my question.

Maybe there's a way to use  machine itself to assess this?

That is exactly what I was thinking today.   How would be using the XPAP on lowest possible and the ramp turned provide any less quality of Tv TV measurement than an low quality 'incentive spriometer' which intentionally has solid back pressure.  

I might give that a whirl myself.

I think hard part is figuring out exactly how much breathing to do to get real, accurate Tidal Volume. At a precision of mL It would be pretty easy to undershoot or overshoot. Next we really care about Tidal Volume while sleeping not academic Tidal Volume so do the experiment lying down might be a wee bit more accurate than sitting up in a chair.

If we toss the notion that we are trying to get a mL precise measurement and accept that we are just looking for a approximation using the xPAP makes more sense. Lets give it a go.

WillSleep

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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RE: UARS and APAP
As a rule, I don't get OA events. I got two reported last night. 

I was assuming, though, that these would  be accompanied by FL activity? What makes this an OA vs CA (as I would have assumed)?

   
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RE: UARS and APAP
Hi,
For me this a false oa following an arousal.
GL
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RE: UARS and APAP
(11-06-2019, 06:50 AM)slowriter Wrote: As a rule, I don't get OA events. I got two reported last night. 

I was assuming, though, that these would  be accompanied by FL activity? What makes this an OA vs CA (as I would have assumed)?

It is classed as an OA as the FOT pulses of your machine decided that there was no clear unobstructed path to your lung so the reason to stop breathing was due to an obstruction
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