What causes this pattern of tidal volume?

[AmirKas]

I've started another round of taking Flonase today and will update you when nasal breathing becomes good enough to use a nasal mask. In the meantime, I wanted to get some suggestions for other ways to clear congestion.

For those who are using Neti Pots or other methods of irrigation, which ones do you recommend?

[Geer1]

Neilmed sinus rinse squeeze bottle style.

[mper6794]

Hi, AmirKas
_ yes, a I have this quite  same thing since ever, first OSCAR  chart, 2.8 years ago;
_ I also think I have seen similar pattern in tens/maybe hundreds of other cases in this Forum and others;
_ As I mentioned yesterday, in your therapy thread, at least in my case, I do interpret (based on several waveform analyses, approaches and calibrations with sleep studies, etc) those TV's patterns as corresponding very well with my REM stages; which are very disrupted by arousals (3 to 15 seconds; unconscious), awakenings ( > 15 seconds; may have conscious of), and interruptions/wake ups before finsihing the stages, right coinciding with peaks of bad/anguishing dreams/nighmares;
_ Actually, as I have mentioned in your therapy, such too spiked, not smooth, poor REM stages (see my recent picture below) are my main remaining drawbacks of a 4 year rather successful therapy;
_ those my arousals/awakenings, interruptions during REM, have been alliviated (better sleep nights) by using minor dose of Clonazepam (0.4 mg), since I have not found yet other way around to work out the problem.

all the best and good luck

[Geer1]

I have wondered about rem sleep but his patterns of this breathing are irregular and inconsistent with a typical rem sleep pattern of first occurring ~ 90 min into sleep, occurring ~ every 90 min and increasing in duration as the night goes on. Sometimes this appears to happen shortly after he falls asleep (or perhaps hasn't yet fallen asleep), sometimes has longer periods early in the night, sometimes short or long durations between them. Without EEG data supporting this is rem sleep I have a hard time believing it is all related to rem sleep (perhaps some of it is).

[quiescence at last]

I would really like to see your REM sleep on a close up, at no more than 15 minute snapshot. Have it be one that you recall nightmarish. You can select two or three of these dream wakeup 15 minute strips. That should put some better knowledge on record.

QAL

[AmirKas]

Hi everyone, have been quite busy with life and haven't had time to get on the forum. I'm still experiencing the same symptoms (obviously     ) 

I wanted to post a screenshot of my sleep stages during my titration study and watchpat test. It seems that I hit REM sleep around an hour after I fall asleep. Not sure how that affects your judgment regarding my breathing issues, but for reference, my AHI was more than doubled during REM sleep vs Non-REM sleep according to my watchpat. 

I went to a pulmonologist today who was absolutely useless in helping me figure this out. If you have any recommendations for doctors in the bay area that are great and consider UARS in their treatment, please let me know.

Watchpat:

   


Titration:

   

[Geer1]

Yeah your rem is fairly normal by those graphs. Titration data ends early but I believe related to strange sleeping location/conditions which is normal for those studies.

In order to get a doctor on board for UARS you have to be able to prove you have it. Your titration study indicated that you do not which is always going to make that difficult unless you can get another study that does show RERAs are present.

Have you been able to stick with the nasal mask and if so noticed any differences from doing so? It was looking semi promising of being helpful. I assume you have had some improvement during your time on here (data and posts have both improved) but perhaps hit a plateau?

I can't really think of anything else to do breathing wise. If you are still suffering from IBS, congestion etc I would find it curious if an antimicrobial gut treatment (using over the counter supplements) would have any effect. I do it every 3-6 months and it helps me each time but am usually hesitant to recommend it as I haven't figured out why I have to keep doing it etc. I believe it to be related to SIBO but not 100% sure.

[AmirKas]

I'm yet to see a GI doctor to get a checkup and prescriptions for my GI issues, but I will address it  as soon as I'm back in the US. I also am planning to use a meal prep service once finances allow to do an elimination diet, as having no car and no reliable access to a grocery store as a student is difficult as is. 

To be honest, I haven't been using the nasal mask as much as I should be, my excuse is going back home (a different country) which severely affected my nasal allergies. My Flonase is helping but nowhere near enough for a good amount of relief.

I hope I will be able to get used to the nasal mask since I always feel like I'm suffocating when using it. I did want some advice on analyzing how much my breathing syncs with the machine and would appreciate your (Geer1) help. 

If you're willing to help, please let me know how to proceed.




I also did want to share a recent piece of data when I switched my trigger settings to low, couldn't handle it, then medium. Not sure what to interpret from this data. 

Notice how erratic my tidal volume is, especially for the 2nd part of the night.

First Part - Trigger: Low

   

Second Part - Trigger: Medium

   



* I realize I should've posted this on my main therapy thread. Honest mistake and my bad.

[SarcasticDave94]

Maybe I'm looking at it wrong, but it appears that the roller coaster tidal volume trace spikes occurred with CA flags.

[Geer1]

Sync is really hard to analyze. More so based on feeling unless there are obvious issues like premature triggers on carsiogenic oscillations but I am not aware of anything like that in your case.

Most people seem to prefer a medium or high trigger sensitivity. If you set it too high it might feel like the machine is trying to force you to inhale before you are ready to do so. If it is too low you may feel that the machine is too slow to start increasing pressure and that you are already part way through breath. If nothing really feels odd in either way you are probably at a good enough setting.

Cycle is similar although most prefer medium or low. If too low it might feel like pressure is staying high when you are trying to exhale. It too high it might feel like pressure is dropping before you finish inhale and like the machine is trying to force you to exhale. Again if not feeling anything obvious probably on good enough setting.

I'll pm you something you can try for the digestion if interested. It is easy, just a few pills a couple times a day. Will be interesting to see if it has an effect and kind of best to do when not on an elimination diet so you know which is having the effect (that is one of my issues, I did my first round the same time I went dairy free and I am now more and more believing it was a combination of the two that gave relief. I have since proven dairy is an issue but makes a guy wonder if this other side of things is just as important since I have to keep doing it to keep feeling good).