[Treatment] Treating UARS with CPAP and bilevel

[Gideon]

good choice and I agree that should not have a big impact.

[slowriter]

No, if it's too high, you'll get centrals but I don't think your mean tidal volume would be higher. Once the flow limitations are gone, your airways are totally clear and air flows easily but pressure can't make your airways bigger after all.

The relationship is that when you have flow limitations, your tidal volume is lower because the obstruction slow down the airflow. Remember that the tidal volume is the volume of air you inhale in one breath. If there is a big obstruction, you won't be able to draw as much air in your lungs as you would if your airways were clear.

Now, when your flow limitations are chronic (lasting most of the night), your median tidal volume will be lower. The median like the average is just a number to describe what was the tidal volume during most of the night. So if your median tidal volume is lower, it probably means you had more flow limitations that night and as we know flow limitations can be bad because they cause RERA and some researchers pretend that chronic flow limitations are not good even if you don't experience an arousal. Since pressure support reduces flow limitations, it should raise the median tidal volume until there is no flow limitation. 

The point I'm making is that the median tidal volume, at least in my case, can be a good indication of the amount of flow limitations I experience in one night so that's the first thing I check in the morning nowadays.

*Note that this is actually a simplification, pressure support not only opens up your airways but speeds up the air flow as well but the end result is the same, no flow limitation, so the same logic applies. 

Hope it makes sense. Hard to explain in a few paragraphs 

It makes sense.

My median TV seems to hover right around 500, but I'll take another look later.

[mper6794]

For now (I may change my mind later, in part depending on how this thread develops), I set the machine to stay on VAuto, but dropped the PS to 5.8, and the max IPAP to 11.8.

So effectively S (fixed) mode.

See what happens.

...for me, It is ok, as you are in the phase of getting data. Whatever PS and EPAPmin you choose is going be very useful for ultimateley fine-tuning the numbers you are going to need!

But still eager to see what is going on with your waveforms, particularly those stretches associated with ar/aw/wkps. 

Good luck

[slowriter]

For now (I may change my mind later, in part depending on how this thread develops), I set the machine to stay on VAuto, but dropped the PS to 5.8, and the max IPAP to 11.8.

So effectively S (fixed) mode.

See what happens.

...for me, It is ok, as you are in the phase of getting data. Whatever PS and EPAPmin you choose is going be very useful for ultimateley fine-tuning the numbers you are going to need!

But still eager to see what is going on with your waveforms, particularly those stretches associated with ar/aw/wkps. 

Good luck

Here you go.

   

[sheepless]

if periodic limb movement hasn't already been established, that flow rate looks suspiciously like the pattern I see in my flow rate that I have associated with my plm by my wife's reports and audio recordings.

[slowriter]

Here you go.

BTW, in previous nights, that period before that ~2 AM wake up would have been during REM.

In this case, not; it's light sleep.

[slowriter]

if periodic limb movement hasn't already been established, that flow rate looks suspiciously like the pattern I see in my flow rate that I have associated with my plm by my wife's reports and audio recordings.

I've not yet taken the step to video or audio record, but I find it highly unlikely that two separate sleep studies would both turn up no evidence of PLM, but that I would end up having it.

But I could be convinced otherwise. Do you think I should get a $25 infrared security camera, even with the above?

[sheepless]

it would seem odd not to have picked it up in the sleep studies. it may or may not be plm. it looks to be periodic breathing but the source of that periodicity can't be determined by machine data. only reason I feel reasonably secure in my assessment of my respiratory response to plm in the flow rate is because of my wife's reports and audio recordings. a camera would confirm or rule it out.

[slowriter]

True.

Alright, camera ordered.

[mper6794]

For now (I may change my mind later, in part depending on how this thread develops), I set the machine to stay on VAuto, but dropped the PS to 5.8, and the max IPAP to 11.8.

So effectively S (fixed) mode.

See what happens.

...for me, It is ok, as you are in the phase of getting data. Whatever PS and EPAPmin you choose is going be very useful for ultimateley fine-tuning the numbers you are going to need!

But still eager to see what is going on with your waveforms, particularly those stretches associated with ar/aw/wkps. 

Good luck

Here you go.

..Well, my friend, I wish not, however:

(1) amazingly periodic events;
(2) RR increasing associated; 
(3) leading to wake up; 
(4) during light sleep; 
(5) in a person with UARS!

Unless you are one those very luck guy, this textbook PLM's would not be PLM's. All my efforts and wishes I am deadly wrong!

PS: don't believe in lab studies for PLM. I have two of such studies: zero PLM in one; 97 (31/hr in the second). So, given the importance, I would suggest repeat your study.

Good luck