"REM-Related" Sleep Apnea - Printable Version +- Apnea Board Forum - CPAP | Sleep Apnea (https://www.apneaboard.com/forums) +-- Forum: Public Area (https://www.apneaboard.com/forums/Forum-Public-Area) +--- Forum: Main Apnea Board Forum (https://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum) +--- Thread: "REM-Related" Sleep Apnea (/Thread-REM-Related-Sleep-Apnea) Pages:
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"REM-Related" Sleep Apnea - thecpapguy! - 04-17-2017 "REM-Related" Sleep Apnea Lately, this has seemed to be something we have talked about in the sleep center I am working, and I wrote this up. Does anyone have any further thoughts on the matter? If not, I hope you found the information helpful or insightful. Have a great day! EDIT: Quote:Article: RE: "REM-Related" Sleep Apnea - Mosquitobait - 04-17-2017 I have REM related sleep apnea (nearly all RERA). As a result, I barely qualify for a machine through insurance (in my case Medicare) because my apnea is so limited. I think they fudged my data to avoid additional paperwork. I would have qualified for a machine anyway due to low oxygen from a heart problem. Honestly, this is a case where an APAP is ideal because pressure is low most of the night, only rising during the REM or Near REM period, then dropping low again. I found Respironics 560 didn't work for me, but the Resmed S9 and Airsense handles it just fine. Not sure how a bipap would be an improvement on this issue specifically. RE: "REM-Related" Sleep Apnea - PaytonA - 04-17-2017 I think if the person has desats that are of concern and/or symptoms of sleep disturbed breathing in addition to their REM related apnea that they should definitely be treated. There are probably some other comorbidities that should necessitate treatment but I am not aware of them off the top of my head. I think you are selling the Resmed auto machines short when you make the statement that the auto machines can not react quickly enough. Of course, you could always attach sensors to their eyelids and when rapid eye movement is detected give the person a jolt of electricity to take them out of REM. That would fix it! .....Just kidding. PaytonA RE: "REM-Related" Sleep Apnea - thecpapguy! - 04-17-2017 After writing this up and posting it, I've gotten some feedback, and they are trending to exactly what you are saying! The Respironics and Fisher/Paykel auto-paps do no increase or lower pressure fast enough, while the Resmed treats much more quickly. I am trying to find some controlled clinical trials or any study data that may indicate that the Resmed algorithm is optimal in auto concerning "REM-related" events. RE: "REM-Related" Sleep Apnea - Sleeprider - 04-17-2017 (04-17-2017, 08:08 PM)thecpapguy! Wrote: After writing this up and posting it, I've gotten some feedback, and they are trending to exactly what you are saying! The Respironics and Fisher/Paykel auto-paps do no increase or lower pressure fast enough, while the Resmed treats much more quickly. I am trying to find some controlled clinical trials or any study data that may indicate that the Resmed algorithm is optimal in auto concerning "REM-related" events. I have what you're looking for, but note that Resmed sponsored partial funding for this study. http://openres.ersjournals.com/content/1/1/00031-2015 You can recognize the Resmed algorithm compared to the others very readily. The purple and blue lines are both Resmed standard and soft responses. RE: "REM-Related" Sleep Apnea - Beej - 04-17-2017 Er ... Check the spelling in 3rd paragraph, 1st sentence. RE: "REM-Related" Sleep Apnea - Cranberry Ray - 04-18-2017 thecpapguy and Sleeprider, it's discussions like this that are the reason I check the board so often. Great information and thought provoking. I now understand much better how the algorithm of different manufactures treat apneas and why it can be so important to have min pressure set close enough to the pressure required by each individual. RE: "REM-Related" Sleep Apnea - quiescence at last - 04-19-2017 I found that during some periods in the night I show a different breathing pattern than at others, and have come to believe these are while I am in REM sleep. While I am in those periods, my breathing is more erratic, but does not trigger many event counting. I have seen others that Geiger out during transition to those same periods. I am sure glad I am not suffering that, and sorry for those that do. There are some studies that found that breathing feedback loops become less sensitive or somewhat lethargic during REM sleep. So, for example, the amount of CO2 can rise a bit more before the brain whispers breathe. Breathing can become shallow and a bit more rapid (TV may drop as much as 20%, but MV usually remains nearly constant.) Hope this idea finds some application in your current work. Do you know what is the initial trigger for REM related apneas, and are they mostly OA or CA? Thanks, QAL RE: "REM-Related" Sleep Apnea - ajack - 04-19-2017 With the resmed test, you have to take into account that the machines were used in their out of the box default states. So were not tweaked for best results for the test conditions. I've got a resmart auto 3b as a spare. There is a sensitivity to events, setting that can be boosted to 5. You can also put it in auto titrate mode and double the speed of rise to events, flow restrictions, obstructive is 2 events in 3 minutes, hypopnea 3 in 3 minutes.. Although a chinese clone and a bit of a brick. I think it's a better machine than indicated in this test. As an aside I read that Resmed won a court case on resmart cloning, resmart is paying a per unit royalty, as part settlement. RE: "REM-Related" Sleep Apnea - dosco - 04-19-2017 If you're writing the article in Microsoft Word, there is a "F-K Score" checker you can use to make the composition more readable. Here's a link to instructions however Google is your friend. Regards- Dave |