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UARS/FL (PLMS): Yellow/R Lights For So Many Lingering Folks_“Is Bilevel the Answer?"
#11
RE: UARS/FL (PLMS): Yellow/R Lights For So Many Lingering Folks_“Is Bilevel the Answer?"
...hi sheepless, I will be happy to do this later on.....for now, it is no possile

apologies
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#12
RE: UARS/FL (PLMS): Yellow/R Lights For So Many Lingering Folks_“Is Bilevel the Answer?"
slowriter, here are two shots from last night (although finding some relevant shots from nights without a plm med might be more instructive).  generally I can't tell anything about plm from the all night charts and not much about flow limitations.  I'm not as tuned into tidal volume as I could/should be so not sure about that. do you see anything?
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#13
RE: UARS/FL (PLMS): Yellow/R Lights For So Many Lingering Folks_“Is Bilevel the Answer?"
(10-10-2019, 02:55 PM)slowriter Wrote: How about some screenshots? I'm curious what you two see in, say the flow rate or tidal volume for the entire night view, in your own data.
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#14
RE: UARS/FL (PLMS): Yellow/R Lights For So Many Lingering Folks_“Is Bilevel the Answer?"
...some pictures...
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#15
RE: UARS/FL (PLMS): Yellow/R Lights For So Many Lingering Folks_“Is Bilevel the Answer?"
mper, nice charts. interesting. there's probably a lot more to see in there but offhand I notice you appear to have longer intervals between kicks than me. mine are usually 4 to 9 breaths apart and an episode usually lasts for minutes to 10's of minutes. looks like some of yours are single jerks(?) which I see occasionally in my flow but not near as often as strings of them. it would be interesting to collect similar flow shots from others with plm to see how similarly or differently it looks looks across a wider population.
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#16
RE: UARS/FL (PLMS): Yellow/R Lights For So Many Lingering Folks_“Is Bilevel the Answer?"
(10-10-2019, 03:44 PM)sheepless Wrote: Hi, sheepless
mper, nice charts. interesting.  there's probably a lot more to see in there but offhand I notice you appear to have longer intervals between kicks than me.........Yes, indeed, what I could say is your PLMS is a true periodic kicks all the way through. However, if you go deeper in literature on PLMS, you would eventually conclude the "PLMS" is just a umbrella name for so many options for moves, and, more important, PLMS does not restrict to legs, it may also occurs in upper limbs, such as arms, torso (torso rotation, very often in my case), chin, an so on...... mine PLMS is more like as if I bring my RLS jerks (Webster: jolting, bouncing, thrusting, spamosdic strong motions) to the bed. What I think I have (also with support on literature) is a kind episodes of jerks, within which I can sometimes observe periodiciy, like in some of curves I showed above. My episodes can either can come out of nothing, or can be triggered by respiratory-driven events.
However, you may be eventually more lucky than me: once it appears it would be easier to sleep through true PLMS like yours. Sleep through my jerks is hard, on the contrary!

mine are usually 4 to 9 breaths apart and an episode usually lasts for minutes to 10's of minutes.  looks like some of yours are single jerks(?) which I see occasionally in my flow but not near as often as strings of them.  it would be interesting to collect similar flow shots from others with plm to see how similarly or differently it looks looks across a wider population.
GL
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#17
RE: UARS/FL (PLMS): Yellow/R Lights For So Many Lingering Folks_“Is Bilevel the Answer?"
(10-10-2019, 03:08 PM)sheepless Wrote: slowriter, here are two shots from last night (although finding some relevant shots from nights without a plm med might be more instructive).  generally I can't tell anything about plm from the all night charts and not much about flow limitations.  I'm not as tuned into tidal volume as I could/should be so not sure about that. do you see anything?

Hi, sheepless. I am afraid I have not yet understood  how your untreated high FL would no be affecting you? Could you, please, post some two ten-minute windows on them (FR, RR, FL, TV, Pressure, leak curves)
good luck
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#18
RE: UARS/FL (PLMS): Yellow/R Lights For So Many Lingering Folks_“Is Bilevel the Answer?"
(10-10-2019, 02:37 PM)mper6794 Wrote:
(10-10-2019, 01:18 PM)sheepless Wrote:  ..." so as I read more about uars I kind of assumed being able to adjust min ps would accomplish same as vauto ps"...sorry, I know very little on ASV, so, in conclusion, ASV could work as a VAUTO, by adjusting PS and EPAP? 

..."on the other hand, reducing plm has dramatically reduced my flow limitations ...this is  very interesting. Medical literature, as per Barry Krakow'a book, based on many cases, indeed, suggest this may happen. For me, on the contrary, at least meds like Pregabalin 75 and Pramipexol 125, both increased U/RERA-FL (maybe due to non desired sedating effects) (see attached, a simplified graph, from a much more weird thing, of my 7-month on OSCAR: I HAVE DECIDED START PIGGYBACKING MY CASE, GRADUALLY, AS THIS THREAD EVOLVES; HOPE IT WILL WORK. I JUST WOULD NOT LIKE TO CREATE ANOTHER THREAD).

_ “I've attached a screenshot from last night that is a good example a plm caused awakening”…yes, indeed, it appears the case. Very rarely, I have something similar to yours.

Goodk luck

SOME FOLLOWUP ON MY CASE:

Just to share something more on my case, I would like to share the semi-quantitative approach I adopted while dealing with my parameters’ settings, in, particular, to fine-tuning tailored (?) EPAPmin and PS for me (see attached graphs).

Based on my EPAPmin and PS, (see historic char above) one may see I experienced a great deal during these 7 months, not randomly, pretty much always I knew where I was going to. There were some accidents, of course, some more serious led to bumps of true CA’s (no shown).
 
Taking into consideration what I have learn thus far on this PAP world, I would like to share  some ideas and hypotheses:

_ don’t trust on the machine’s report; you would have to recount your events, flagged or not, daily. People with UARS and/or PLMS tend to awaken a lot, move a lot, so that absolute majority of flagged events are false, including CA’s, OA, FL (not often), snoring. Machine get easily crazy, jeopardizing your therapy, diagnose, tailored machine, and eventually leading to wrong decisions/steps, either taken or not.  

_ there would be significant problems and limitation with current rigid concepts of apnea/hypopnea (the 10s issue), flow limitation/RERA/UARS (the need for flat plateaued-type FR issue). For people with FL/UARS what would matter most would be the number of awakenings and their durations. Whatever phenomenon is behind such awakenings should be dealt with, for instance, one thing I have been calling, for my own use, as U/RERA (unflagged RERA), associated with TV reduction, increasing in RR and leading to awakening.

_ Tidal volume (in particular) and respiratory rate waveforms, maybe on the contrary sense of many folks here, would be unbelievable useful curves, at the same rank of flow rate in my opinion. I have audio-recorded and calibrated my waveforms with a very cheap device, leading to surprising and useful outcomes; some four nights would be enough.

_ I tend not to believe on long term wait for acquaintance to parameters and machine. It might happen something which does not work, say, in a maximum 1 week, would not ever work. I would like to have feedbacks on this, though, preferentially with some historic cases.

goodk luck
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#19
RE: UARS/FL (PLMS): Yellow/R Lights For So Many Lingering Folks_“Is Bilevel the Answer?"
"Hi, sheepless. I am afraid I have not yet understood how your untreated high FL would no be affecting you? Could you, please, post some two ten-minute windows on them (FR, RR, FL, TV, Pressure, leak curves)
good luck"

mper, I responded in my thread starting with "18 months of apap..." so not to bog your thread down with my case.
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#20
RE: UARS/FL (PLMS): Yellow/R Lights For So Many Lingering Folks_“Is Bilevel the Answer?"
(10-11-2019, 05:31 AM)mper6794 Wrote:
(10-10-2019, 03:44 PM)sheepless Wrote: Hi, sheepless
mper, nice charts. interesting.  there's probably a lot more to see in there but offhand I notice you appear to have longer intervals between kicks than me.........Yes, indeed, what I could say is your PLMS is a true periodic kicks all the way through. However, if you go deeper in literature on PLMS, you would eventually conclude the "PLMS" is just a umbrella name for so many options for moves, and, more important, PLMS does not restrict to legs, it may also occurs in upper limbs, such as arms, torso (torso rotation, very often in my case), chin, an so on...... mine PLMS is more like as if I bring my RLS jerks (Webster: jolting, bouncing, thrusting, spamosdic strong motions) to the bed. What I think I have (also with support on literature) is a kind episodes of jerks, within which I can sometimes observe periodiciy, like in some of curves I showed above. My episodes can either can come out of nothing, or can be triggered by respiratory-driven events.
However, you may be eventually more lucky than me: once it appears it would be easier to sleep through true PLMS like yours. Sleep through my jerks is hard, on the contrary!


GL

Hi, slowriter, sheepless, and all

Following up what have been discussing here and elsewhere on your threads, I have kept investigating on better characterization of PLMS, and have struck with AMAZING  VIDEOS, FROM A SLEEP CENTER in Arizona, I think. Dr. Hooper has classified PLMS ON FOUR GRADES, as illustrated in the following links:

I - https://www.youtube.com/watch?v=uRC5ow8v...z&index=52
II- https://www.youtube.com/watch?v=Vr-uds1Y...z&index=50
III- https://www.youtube.com/watch?v=D4RJswUb...z&index=51
IV_ https://www.youtube.com/watch?v=h4Meukfn...z&index=49

I have took advantage of this and tried to infer about my last night moves (attached)

Good luck
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