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periodic leg movement
#71
RE: periodic leg movement
I litterally taped my lips, avoiding all the hair. Think of it as applying chapstick, only with tape.

Keep in mind the concept is not to keep the mouth shut, that jaw is just too strong to do that, but to seal the air in. I can almost always easily slip my tongue between my upper and lower teeth.
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#72
RE: periodic leg movement
A nice thin strip, ok. That makes sense. I've been going with the wide tape approach, but yes, no tape will overcome my overly used jaw.

Thanks,
D.
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#73
RE: periodic leg movement
sheepless, even if the only skin contact would be your lips it might be worthwhile to try a small piece to cover only them if you find some method for pressing the gel strip against them that will not slip down and relax inward pressure on the strip.

 My adaptation works well with lots of direct skin contact area below the line from bottom of earlobes to 1/4 inch below bottom of the nasal openings divider. 

I think retainer-to-gel-backing friction, together with the clinging property of the gel, keeps the retainer up where it is needed. But that may not be true and there may be other ways to maintain pressure against the lips and reduce slippage of your retainer.

If you get to the point where you want to try the gel strip, PM an address along with dimensions of the enclosing rectangle that would fully cover your  exposed lips. I have enough new material for up to a 2 x 4 inch sample .

Good luck finding some solution. Leaks drive you mad and steal sleep even if below 25 L/min--drove this FFM-prescribed mouth breather to find a way to use P10 nasal pillows and the bleep, "things that won't work" for my kind.

2SB
I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  

Of my 3 once-needed, helpful, and adjunctive devices I have listed, only the accelerometer remains operative (but now idle). My second CMS50I died, too, of old age and the so-so Dreem 2 needs head-positioning band repair--if, indeed, Dreem even supports use of it now.



 
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#74
RE: periodic leg movement
"You are taping the lips, not the beard anyway."

yep, that pretty much describes the problem! thin lips, virtually no exposed skin around them to secure tape to. won't stick to whiskers.
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#75
RE: periodic leg movement
Thanks to everyone contributing to this leg movement discussion. Which meds have you guys and gals had success with to help with dampening your PLMS movements? Any side effects noticed? Have you had luck with any particular supplements if your iron and ferritin were normal? Vit B-12, Vit E, Magnesium, etc? How do you monitor for success without a followup sleep study? 

Background: Age 65. 6'1" 190 lbs. BMI 25. My sleep study Periodic Limb Movements of Sleep (PLMS) index was 63.0/hr. Overall Arousal Index was 21.2/hr. My AHI was 13.5/hr (4 OA, 0 Central, 0 Mixed Apneas, 69 Hypopneas). Maximum event duration was 81 seconds. SpO2 nadir of 87%. Sleep Efficiency 73.1%. Sleep study had a total of 130 arousals, 25 associated with respiratory events, 56 associated with PMLS, and 46 were "spontaneous" arousals. 

Recently started on a ResMed AS 10 AutoSet and sleeping better now. AHI now less than 1.0, but I don't feel all that rested in the mornings. My sleep is still restless from tossing and turning all night. My prostate is normal, but my arousals make me feel like my bladder is full. I'm getting up twice to urinate. Soft collar has eliminated chin tuck clusters. I'm a mouth breather using ResMed F30i full face mask (cushion). Air leaks are minimal. Settings APAP, Min 8, Max 15, EPR 2. I would love to just sleep through the night and feel more rested. Need to address PLMS and arousals.
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#76
RE: periodic leg movement
I'm hoping others will jump in here.

pretty sure I've mentioned that my iron, potassium, magnesium etc. levels are normal so I haven't tried supplements; and that I've tried gabapentin & ropinirole, the latter providing partial but insufficient relief.

the ways I judge effectiveness are: monitoring my flow rate for a distinctive pattern I've learned is my respiratory response to plm; noting the number of awakenings; how I feel; reports from my wife; and audio recordings (video is better but I don't have a camera). at this point, mostly the flow rate because it's definitive for me.

watch for your autoset raising pressure against flow limitations. pressure won't overcome non_passive plm induced flow limitations and it may be disturbing your sleep. my apap pressure would reach the max setting or close & stay there, causing leaks & aerophagia, forcing me to stop the machine multiple times a night. with asv, pressure support would swing wildly & although I wasn't aware of it, I later learned that it was wiping me out.

let us know what you end up doing for your plm. I've found it hard to get the doctors I've spoken to much interested.
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#77
RE: periodic leg movement
With regard to Ferritin levels, normal (on my report) is listed as 30-500 ng/mL. My most recent studies have levels of 44 and 70. 

This article suggests iron supplementation for RLS patients if the Ferritin level is below 75 ng/mL. I am currently trying this but haven't noticed any difference yet (only been a few weeks).

I also tried a weighted blanket for the first time last night. Seemed to reduce my movement according to my wife, but my movement data (only captured the first hour due to forgetting to plug in my laptop) showed an increase in twitches, and my legs feel more tired (twitching against a heavy blanket is more work I guess).

I monitor using a bluetooth accelerometer attached to my leg (see this thread).
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#78
RE: periodic leg movement
My doctor worked me through the following:
- iron, it did not help.
- magnesium, it did not help.
- zopiclone (same receptors as benzodiazapene) - this didn't help. I didn't like the potentially addictive nature of it.
- gabapentin (typically used to address epilepsy) - this helps me
I started with two tables of 300mg each, but found it lept me too drowsy during the day, so I've settled on 1 tablet per day.
It allows me to get a solid 6 hours sleep whereas I was waking up every 90 minutes before.

I have the same bluetooth accelerometer, but as it is BLE, the signal is weak and drops out fairly easily. Still playing with placement of my PC to try and record a whole evening.

There was a discussion about raising minimum pressure as a mechanism to address PLM also. I tried this for three weeks, but it didn't seem to help. My numbers didn't change, I didn't wake up any more refreshed. I didn't sleep any more or less. And I found the extra pressure more uncomfortable. So I have gone back to my previous settings.

Regards,
Damian.
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#79
RE: periodic leg movement
(08-23-2020, 08:21 PM)kappa Wrote: This article suggests iron supplementation for RLS patients if the Ferritin level is below 75 ng/mL. I am currently trying this but haven't noticed any difference yet (only been a few weeks).

Thanks for the article link. I recently had my Ferritin tested, and it was only 19. I gave blood twice in the last year, and that lowered my Ferritin too much for this 65 y/o. Lesson learned. I'm now taking SlowFe iron pills with chewable Vitamin C which greatly enhances iron absorption. Food ingestion significantly interferes with absorption of the iron pill. Vitamin C is acidic and greatly enhances iron absorption. So...first thing in the morning, I chew and swallow one large "chewable" Vitamin C tablet with a little water chaser, and then I swallow the iron pill with a little water. It's important to wait at least 1 hour before eating breakfast, to allow for maximum iron absorption. I have not had any adverse symptoms from the slow release iron pill. My physician is going to re-test Ferritin in one month to see if Fe supplementation is working, and if so, I'll retest iron in 3 months. It will likely take months to replenish my bodies iron stores. Hopefully, the RLS will lessen with this treatment. I'm just going to assess by how I feel in general and whether or not I notice any less tossing/turning/leg movements at night. Thanks!
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#80
RE: periodic leg movement
fingers crossed! let us know how it turns out.
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