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What causes this pattern of tidal volume?
#21
RE: What causes this pattern of tidal volume?
That TV roller coaster has always been there regardless of settings, mask etc. Better some nights, worse others. Outside chance of being rem related but really not sure what is causing it as the detailed views never indicate a clear central or obstructive nature, just odd breathing. Also sometimes is present at the beginning of night when either still or awake or transitioning to sleep which is biggest reason I doubt them (at least not being the complete picture anyways).
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#22
RE: What causes this pattern of tidal volume?
I can almost guarantee that the tidal volume issues at the beginning of a night are because I'm awake. Sometimes I watch a youtube video before going to bed with the mask on which will correspond with wakeful breathing.
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#23
RE: What causes this pattern of tidal volume?
That is what I have figured but I don't understand why this same style of breathing appears when both awake and at periods in sleep let alone have any ideas on how to improve it.

Diagnosing obstructive or central apnea is usually pretty easy. Imo this is something else more complicated influencing your breathing rather than being caused by your breathing although there have been the odd thing that make me question that like your tv/mv improving with nasal mask.

My outside long shot hypothesis breathing wise is that maybe restriction is exciting your nervous system and causing breathing style to be similar to awake breathing. Even if that is the case I don't know if the answer is trying to treat the breathing or the nervous system response.

Believe we have chatted about this in the past. Imo there are two types of "UARS". One caused by actual breathing effort issues, another caused by an over sensitive nervous system which I believe is more complicated. My current hypothesis that I have been trying to collect more data points for is the latter may be more effectively treated by treating things like digestive issues rather than breathing issues. This hypothesis is based on believing these treatments had more of an effect on my personal sleep quality and sleep breathing than cpap did.
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#24
RE: What causes this pattern of tidal volume?
I will investigate GI issues quite soon.

I will also try quiescence's use of clonazepam for sleeping as a central nervous system depressant. I will be very careful about my use to ensure dependency isn't an issue and that central apneas don't become an issue. 





I did want to ask a question about nasal congestion as I haven't been able to find a solid answer. My nasal congestion, especially in the evenings, is more or less treated, with one side being significantly better than the other. 

I'm wondering if this is normal as I'm still unable to fully breathe through one nostril, it takes immense effort to get even a partial breath. Another interesting part is that it seems to switch sides throughout the day so that I'm able to fully breathe through different nostrils as the day progresses.
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#25
RE: What causes this pattern of tidal volume?
Hi, Geer1, and ArmiKas;
_ as  points, I have been making, It looks to me ArmiKas has too many arousals/awakenings during REM stages;
_ a great deal of information could come from observations on  his dreams/nightmares and sleep quality: https://www.ncbi.nlm.nih.gov/pmc/article...po=17.5926
_ based on my case and hundredths observations of others on these web Forums and medical literature, going smooth through REM's stages is a very rare and difficult process. So many things can jeopardize it, like for instance stuff nose: https://onlinelibrary.wiley.com/doi/full.../alr.22099
_ on sleep stabilization itself, after everything OK with pressures, PS, Vauto fine tuned parameters, Mask, soft collar, hummidity, and getting virtually zero on flow limitations, there are people like me, who still keep having too many arousals/awakenings during REM. For me, who also have RLS/PMS, no doubt, very minor 0.4 mg of Clonazepam (for me, no issue with dependence, side effects, etc, except some 12 bad nights when I want to stop it) makes a huge difference in life quality: see what MD sleep specialist Rober J. Thomas MD says, about 2/3 (46 minutes onwards) on this Webnar for Resmed, also with participation of Barry Krakow; he says sometimes people do need some kind of medication to stabilize sleep:  https://www.youtube.com/watch?v=Syv7YcHb...z&index=63
_ I like this Geer1s idea of this second nervous-system associated type 2 UARS;
_ let us keep on trying improvements: two months ago, I was surprisinglhy diagnosed with sinus polyps/cysts, yet with no apparent symptons, except during driest months of the year, when sometimes I have some congestion. Currently, since some 7 days ago, I am performing and experience with fluticasone to see what happens;
all the best and good luck
Mper
I am not a doctor. Nothing that I say here is medical advice
All my posts include only outcomes/learnings from my own/other therapies and medical literature



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#26
RE: What causes this pattern of tidal volume?
That congestion swapping is pretty normal - we tend to breathe more through one nostril than the other and then swap. It's called the Nasal Cycle. It's because the body tends to send more blood to one side to warm the air which causes that side to swell subtly... but if you're sick, or have allergies or some other issue, then that swelling becomes more obvious and causes stuffiness on one side of your nose.

The fact that its swapping means that there's not a one-sided issue going on, it sounds like it's just whatever is causing your congestion is still a problem, albeit less of an issue than before.
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#27
RE: What causes this pattern of tidal volume?
Yeah congestion is almost always worse on one side, for me it was usually the same nostril as well. I assume this happens because of physical structure and one nostril flowing better. I also think flow helps avoid some congestion so as more air continues through the one nostril it stays open more while the other closes up further. I believe the flow and humidity of PAP is what helps me sleep better with PAP and I believe it is because of its effects on minimizing congestion. If I sleep without PAP I always wake up with worse congestion and after a few days my nose starts feeling dried out. Prior to starting PAP I always had a dry crusty nose and no longer have that issue I assume due to flow and humidity.

Clonazepam has many uses in sleep but also many side effect and dependency issues. Most doctors won't prescribe it for sleep purposes unless you have obvious documented issues it might help. It is something you can do as a trial but there is another drug I just started I would recommend trying first (if you want to try some sleep aid medications). It is called Dayvigo and it affects a neurotransmitter called orexin which causes excitation/wakefulness. People with narcolepsy have naturally low orexin levels and it is the reason they fall asleep randomly. It is a newer drug but my sleep doctor who prescribed it said it is looking promising in some cases and has been studied for up to a year use and shows limited if any side effects, dependency etc (other than tiredness carrying into next morning etc). The next drugs she wants to try are some different antidepressants and antipsychotics (not for depression etc but because their effects on brain chemistry have known effects on sleep), she doesn't want to try me on any benzos yet for some good reasons.

I have only been on the Dayvigo about 3 weeks now and I think it has some effect. It hasn't fixed my sleep quality problems or fatigue but I do sleep through the night with fewer awakenings. My OSCAR data still shows arousals occurring but I think the Dayvigo helps keep some of those as micro arousals rather than awakenings.
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#28
RE: What causes this pattern of tidal volume?
I am very interested in Dayvigo. Thanks for giving me something new to research! Smile

If you mostly feel the congestion on one side, that would suggest that you might have some narrowing on one side or a deviated septum perhaps? Something structural that would make one side more "blocked" than the other by the normal cycling of blood flow.

I agree that breathing through your nose, if you can, with PAP is definitely good for congestion. I used to wake up ALL the time with a blocked nose struggling to breathe through it and with a dry mouth, drooling etc. Horrible. As long as I keep my soft collar on now to keep my jaw from dropping, I now have no dry mouth, no congestion etc... That's how I knew I needed a new collar when the last one got compressed and started letting my chin slip down. I started getting a stuffy nose even while the CPAP was on because I was mouth breathing again.
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#29
RE: What causes this pattern of tidal volume?
Hi, Ratchick, Geer1
_ pretty much same thing downhere:
(a) the Bilevel PAP helps a lot on avoiding total congestion (very rare in my case);
(b) slightly deviated septum to the left nostrill, which is the preferred for congestion, always;
© the Bilevel PAP, soft collar, and the full face airfit f20 (both hanging chin upward), tongue on the roof, taught me how to non-respiring through mouth (easily recognized in FR rate, I think) virtually , totally eliminated MB (25% worse quality according to Dr. Steve Park).

all the best and good luck
Mper
I am not a doctor. Nothing that I say here is medical advice
All my posts include only outcomes/learnings from my own/other therapies and medical literature



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#30
RE: What causes this pattern of tidal volume?
Yeah, I'm working on training myself with the tongue position thing. It's getting there, slowly but the collar helps so much and I'm okay with wearing that to sleep right now. Smile
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