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[split] Sheepless [PLM]
#11
RE: [split] Sheepless [PLM]
I have sufficient confirmation for one pattern but not this one, but there are enough similarities to lead me to suspect this one as well.  

3 screenshots from last night.  one longer duration view compressed so you can see how the waxing waning pattern with events morphed into the plm pattern I am sure of (audio and my wife's reports).  the other 2 shots show the beginning and end of the episode - 2 similar but distinct patterns - culminating with a mask off awakening.  the two patterns are frequently seen together so I suspect the waxing waning is a 'softer' version of the plm pattern insofar as it follows a similar routine with greater inhales followed by sdb of one kind or another, events or flow limitations.  I see many more events with the waxing waning pattern.  

one possible monkey wrench in my theory.  although I see this pattern with some frequency, it's been particularly visible in the last few days that I've been experimenting with higher min ps.  pressure in these shots is fixed (in effect) at 6 over 8-14  oddly, higher ps has resulted in more flow limitations, along with pretty dramatic increase in ca, which isn't so unexpected.  the ca could pressure induced or be my response to movements.  as you said, video might put the speculation to rest.

anyone have a recommendation for a video camera?


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#12
RE: [split] Sheepless [PLM]
"Note that the Flow limits are at the end, not the start despite similar pressures."

I don't understand this sentence, what the flow limits are at the end of, and the meaning of "despite similar pressures" unless you mean my settings are such that they are in effect fixed & therefore have no obvious bearing on, well, any differences in flow.

I would say the flow limited breaths followed or occurred concurrently with a movement and in this case my respiratory response was to hold my breath or trigger an obstruction (in my more typical pattern, obstruction or flow limitations are often associated with a moan/groan in protest of the movement), compared to my known pattern which produce mostly flow limited breaths between larger inhales I associate with movements. in the examples we're looking at, the more sinusoidal breaths preceding the flow limited breaths may be recovery breathing or they may in fact be a 'softer' response to the movement like the sharp inhales that precede the flow limited breaths in my more common pattern (like the one at the end of the time period in the screenshots above).
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#13
RE: [split] Sheepless [PLM]
Yes that's it.

What happens is you are breathing 'harder' than you need to be which is flushing CO2 out of your stystem. as you approach your apneic threshold the breaths get smaller, until you reach your apneic threshold and stop breathing. This initiates a low volume breath that gradually increases untill you are breathing 'hard' enough to start dring the CO2 levels down.

Your disturbances are at the end of the cycle, where your body may be reacting to the low breathing with PLM during the last part of the cycle.

IMHO. if you eliminate this breathing pattern, start by decreasing EPR/PS, your PLM will be substantially reduced. I think the CSR is driving the PLM, not the other way around.
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#14
RE: [split] Sheepless [PLM]
you may be right at least to the extent this pattern seems to be more prevalent with min ps at 6 than 5.4.

unfortunately though, I still have some of this pattern & lots of the more of my typical pattern no matter what setting and modality I've tried to date.

interesting to consider the movement as effect rather than cause. that's not consistent with my experience or how I interpret the audio recordings & my more typical plm flow rate pattern, but I know there's a school of thought about a relationship between apnea & plm. I'm certainly open to other ways of thinking about it. my sleep is so much better than even a year ago, but waking up feeling refreshed & not tired still eludes me.

returning tonight to 5.4 over 8-13.4. the foray into higher min ps was in response to the discussion about CAP & plm being reduced by more higher pressure than ordinarily required to ease other flow limitations. CAP seems to be an unlikely longshot & I have trouble with higher pressures anyway.

thanks for taking the time to comment.
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