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wildly jagged flow rate curves -- do you see this in your data?
#31
RE: wildly jagged flow rate curves -- do you see this in your data?
great info on the value of cervical collar! thanks!

QAL
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#32
RE: wildly jagged flow rate curves -- do you see this in your data?
Best description about my sync issue would be at times the machine has gone to inhale when my lungs are still on extended exhale, then PAP and I are 180° out of phase where it's on inhale I'm not, and I go to inhale and it's ready for me to exhale, then a timing trainwreck where it keeps trying to get me to inhale but it stacks/packs the air in. Hence the lack of timing controls destroys the chance for PAP to work with me. Throw in disrupting sleep with the frequent sync fumbles and it's just going off the cliff from there.

In reference to your question.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#33
RE: wildly jagged flow rate curves -- do you see this in your data?
Yeah what you are describing isn't quite what I'm seeing. I've got six years of no pressure support of any kind -- EPR turned off -- and I've got hundreds of instances of me heading off on the don't-know-if-I'm-coming-or-going spells. So the PS/EPR doesn't drive it -- I'm driving it under my own power, but PS can damp it down as long as the trigger isn't too sensitive.

The physicist husband's comment is that the airway shape is wicked complicated, with all sorts of opportunities for resonance. And then any change of position can make the natural frequency of the system change completely. What's also really interesting to me is that this didn't start at the beginning -- my weight loss was in excess of 100 lbs before I saw it the first time 5-1/2 years ago.

I think that the biggest difference is simply that the machine is working so much harder for you, that when anything goes wrong the whole thing goes to hell. Besides the Tacoma Narrows example the other classic example of resonance is an early-70s car which had a resonance frequency of 53 mph. It was perfectly smooth at 51 & 55, a little choppy at 52 & 54, but go exactly 53 mph and the car would shake itself apart. The engineers fixed it by welding a small steel plate on the undercarriage, and it shifted the natural resonance frequency enough that it was not near any speed that the car was going to go. I think that me in the cervical collar is like welding the plate on. But when you start battling against the ASV it's more like driving 53 mph over potholes and the car just shakes itself apart...
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#34
RE: wildly jagged flow rate curves -- do you see this in your data?
For me, yes that about sums it up. I need the adjustable plate welded on that ResMed's ASV forgot.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#35
RE: wildly jagged flow rate curves -- do you see this in your data?
congrats on getting the patch, and knowing where to apply it.
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#36
RE: wildly jagged flow rate curves -- do you see this in your data?
cathyf,
Thanks for giving me a head’s up about your thread. I’m downloading and skimming some of the resources mentioned. Have you been to an Eye/Nose/Throat (ENT) doctor? My sleep doctor is sending a referral for me, so that we get to see what goes on inside while I’m sleep breathing.

I’ve got the cardio ballistic artifacts that showed up similarly near to the end of one of your long strips - but I don’t have it dip below the zero line the way your earlier examples show. Increased pressure and EPR (and now bilevel PS) has a good effect on that wave form smoothing for me.

-SleepyCPAP
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#37
RE: wildly jagged flow rate curves -- do you see this in your data?
(10-28-2021, 11:06 PM)cathyf Wrote: Yeah what you are describing isn't quite what I'm seeing. I've got six years of no pressure support of any kind -- EPR turned off -- and I've got hundreds of instances of me heading off on the don't-know-if-I'm-coming-or-going spells. So the PS/EPR doesn't drive it -- I'm driving it under my own power, but PS can damp it down as long as the trigger isn't too sensitive.

PS/EPR doesn't drive/cause this but it clearly improves it by reducing how often it occurs. Everyone with this sort of breathing that I am aware of has found improvement with higher PS/EPR. PS/EPR only has one effect that can possibly explain that, increased ventilatory assistance reducing respiratory effort required. I don't believe it has anything to do with different blockages, vibrations or things like that as increasing PS/EPR doesn't really help those issues. 

You have obvious flow limitations/restricted breathing which causes excess respiratory effort to be required. It seems fairly likely that this is related to respiratory effort and probably some sort of predisposition towards this breathing (no idea what that predisposition would be though).
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#38
RE: wildly jagged flow rate curves -- do you see this in your data?
So now I'm back to confusion -- I had it happen last night on my vauto, PS=4, medium trigger.

It was definitely short. Movement, followed by 11-12 minutes of wild jaggy, followed by another period of movement, a short cluster of positional apnea, movement, a short central, then it's all over.

Here's a zoom -- you have to scroll sideways...
    https://www.dropbox.com/s/s78vxzx3cfr7xj...m.pdf?dl=0

Here's just the 20-minutes surrounding the action:
    https://www.dropbox.com/s/6zyzc2l7va7pin...s.pdf?dl=0

Here's the whole night to see it in context:
    https://www.dropbox.com/s/r9pkm17mexn7gd...5.pdf?dl=0

I think I need to set up a camera so that I can figure out if there is some position that I can identify that's associated with this.

Anybody have any thoughts?
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#39
RE: wildly jagged flow rate curves -- do you see this in your data?
(11-06-2021, 09:31 PM)cathyf Wrote: I think I need to set up a camera so that I can figure out if there is some position that I can identify that's associated with this.

Anybody have any thoughts?

I agree with you and assume you were wearing the cervical collar which has cut your FL dramatically. There's more, as we know, to positional fL and apnea than flexion, chin tucking, which is so commonly our problem.

To me it looks like you need to check angular rotation about your longest bodily axis, and then if necessary, the elevation angle of your upper body from the flat-supine position--rule those out next. 

My recollection is that you have mentioned some sensitivity to head positioning that approaches the  " sniff  " position.  That might relate to other positional effects.
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.  (Disclaimer use permitted by sheepless)

 
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#40
RE: wildly jagged flow rate curves -- do you see this in your data?
Actually, no cervical collar. I've been struggling with it -- if I get it too loose, I get as much positional apnea as without it. But too tight and I feel strangled. I woke up two nights before having a severe panic attack so I've been taking a break.

I've been trying to wean off the collar for a couple of months, because I have seen that with the vauto the bursts of positional apnea are pretty short.
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