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What causes this pattern of tidal volume?
#31
RE: What causes this pattern of tidal volume?
(01-07-2022, 07:21 AM)Ratchick Wrote: I am very interested in Dayvigo. Thanks for giving me something new to research! Smile

It sounded interesting to me as well. Not sure how much of an effect it is having in my case but I don't really fight with insomnia anymore so its kind of an off label idea to see if it helps (I was curious if it might help with my bruxism symptoms but not so far). Just had an appointment with GP yesterday and he said he has seen it being used a fair bit recently, kind of the flavour of the month being something new that appears to help some people and not appearing to have as many dependency issues etc as some of the other options.
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#32
RE: What causes this pattern of tidal volume?
I did some research on the effects of benzodiazepines like Klonopin on sleep, and it seems to primarily benefit patients with primarily NREM arousals, while my sleep study tells me that mine are primarily during REM sleep. Not sure if there are any medications that support arousal reduction in REM sleep that you guys can guide me towards.

Also, If I manage to get another watch pat sleep study, should I request that it be used while using my BiPAP, or without it since I did a nasal surgery in September?
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#33
RE: What causes this pattern of tidal volume?
Also, I wanted to ask,

Is it worth it to get an appointment with Barry Krakow for 60 / 90 mins for addressing treatment options? I know he's renowned in the world of sleep medicine specializing in UARS but his prices for consultation seem to be high ($250 / $350).
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#34
RE: What causes this pattern of tidal volume?
(01-11-2022, 10:48 AM)AmirKas Wrote: Is it worth it to get an appointment with Barry Krakow

Short answer, NO!
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#35
RE: What causes this pattern of tidal volume?
@Crimson Nape, 

If you have the time to, could you please elaborate on why? The cost of having debilitating Sleep issues seem to be more than $350 in my case, but I would really appreciate your advice / opinion.
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#36
RE: What causes this pattern of tidal volume?
Note that the alternating nostrils thing is about managing your sense of smell. As we all know, when we encounter a new odor it is very strong and then within minutes you stop noticing it. By alternatively turning each nostril off and on your body resets the "noticing" part.

So if you're stinking up the place with farts you get periodic reminders without having to smell them constantly. Grin 

If you are next to that natural gas leak, the cycling gives you periodic reminders that you had better do something before you get blown up.
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#37
RE: What causes this pattern of tidal volume?
I don't know what Barry could add that we haven't already discussed. 

Another watch pat study is useless. Watch pat doesn't measure breathing directly and since your case is potentially affected by things other than breathing that could affect its accuracy I consider it a waste of time. Your in clinic titration study was far more accurate (and for the record indicated no breathing issues). Imo the only thing a watch pat test would be helpful for is if you wore it during an in clinic study to prove its accuracy (or inaccuracy) in your specific case.

If you want to spend money on anything more I would spend it on another in clinic titration study. Ask them specifically about the fluctuating TV periods and see if it happens that night and if they can explain why. Also make sure they are scoring RERAs (can't remember if that was the case in original one). The goal would be to document this breathing with the best equipment possible (PSG) and prove or disprove that it is caused by a breathing issue.

The only other long shot breathing option is to try ASV. ASV has the ability to fight those fluctuating TV periods but I have no idea if that will actually do anything to help your symptoms because imo there is no reason to believe those fluctuations are causing your symptoms. ASV will most likely worsen your aerophagia and potentially may not be tolerable because of it.

ASV is literally your only option left for PAP. You have exhausted all other options and tried different pressures, pressure supports, masks etc. You can continue to chase the rabbit further down the hole if you see fit but eventually you have to be willing to believe that breathing may not be the issue. If that means multiple PSGs or trialing ASV then do what you feel you must.
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#38
RE: What causes this pattern of tidal volume?
The roadmap towards recovery seems to be getting clearer. Thank you for summarizing that Geer.

I wanted to ask, just so that I can exhaust all options before ruling out breathing issues as a cause, what is the best / cheapest way to get my hands on an ASV. 

I’m located in the Bay Area if that counts for anything.
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#39
RE: What causes this pattern of tidal volume?
Search for ResMed AirCurve 9 or 10 ASV.
The 10 series has the smaller footprint with integrated humidifier while 9s have an external add-on humidifier. Otherwise they are similar in therapy.

Use Search Tempest or DOTmed to see what is available.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#40
RE: What causes this pattern of tidal volume?
If you can afford a consultation with Dr. Krakow, his experience and credentials are probably worth paying for. He also has the power to prescribe and to consult with your regular medical team in a way this forum can never hope to accomplish. We have a great deal of respect for his work, publications and advocacy in this field. Relatively few practitioners have shown those characteristics, and the consultation fee looks reasonable to me. As with most consultations, you may not receive a solution, but a recommendation for further diagnostics and evaluation. Also understand, Dr. Krakow has trained a team of professionals in his approach, and you may not actually end up discussing your concerns directly with him. If you decide to pursue this, I hope you will share your experience back on the forum in a separate thread.
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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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