Vauto, PLM, FL & Mixed 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: Vauto, PLM, FL & Mixed Apnea (/Thread-Vauto-PLM-FL-Mixed-Apnea) |
RE: [split]Vauto, PLM, FL & Mixed Apnea - mper6794 - 11-23-2019 (11-22-2019, 05:43 PM)mper6794 Wrote: Sheepless,...apologies, sheepless. There was a minor mistake on the blue phrase above, which should be, instead: _we would have to take just one more step, maybe, playing with 8.4/4.8/4.6/5.2----13.2/13.0/13.6, and adjusting your medication to see if got the absolute zero on flagged FLmax. Concerning pressures, tiny moves can be very important;no more, no less. all the best RE: [split]Vauto, PLM, FL & Mixed Apnea - mper6794 - 11-23-2019 (11-22-2019, 08:22 PM)sheepless Wrote: I can't say I understand non-waking 'fake' events. a pause in breathing is a pause in breathing....yes, results could be completely distinct if occur while sleeping, true CA, or in arousal/awakening-sleep transition, fake CA, Could not? and some may be relatively benign but they can't be good so I think they're still worth running down as long as I'm still not feeling properly rested....for sure, they are telling you your are arousal/awakening too much....and I think CA’s in general, like virus, are kind of opportunistic thing, they take advantage of weakness and insert in/follow in. In our cases, such weak points would be following up of PLMS-driven arousal/awakenings. Then, should you awake less, you would have less CA’s...then, also, fake CA's are just syntoms; cause are arousal/awakenings, things should be tackled firs of all . but I do believe plm is the problem at this point and afaik it's quite possible resolving plm will also reduce ca and pb. otoh, while there have been ups and downs, I feel generally better now than before vauto, even with the higher ahi, so I'll stay with current settings for a bit, posting dailies occasionally, especially if something different crops up. I'm glad you're willing to stay in touch, mper. RE: [split]Vauto, PLM, FL & Mixed Apnea - sheepless - 11-23-2019 vauto. 11/22/19. ps 5.0 over 8.4 - 13.4, second night. the reason I'm posting these is because I think the two 10 minute segments hint that the pb is a variation of my previously typical plm pattern. note for example, how the pattern evolves from typical to more pb-looking at 23:13 and how relatively un-csr looking the pattern is in the midst of repeated events. which further supports the idea that the events (ca, oa, h & fl) that occur during these pb episodes may be plm induced. I take (3) 0.25 mg ripinirol tablets for plm at bedtime. last night I took 2, intending to take the 3rd when I woke up sometime between 1 and 3 am. (un?)fortunately, I slept through the night! well I woke up at least a few times but never enough to mask off. I think the reason for that is because I screwed up and over-measured the amount of the cannabis concentrate that I usually take to help me sleep through the plm. 8 more or less uninterrupted hours of sleep is heaven, but the amount of concentrate needed to get there sometimes leaves me feeling even more thick headed and sluggish than usual the next day. I haven't noticed much difference in my flow rate after 1 night with a lower dose of ripinirole. RE: [split]Vauto, PLM, FL & Mixed Apnea - mper6794 - 11-23-2019 Hi, Again, I would interpret that Ropinorole did not go beyond some 4:00hs, because of the repetitive general reduction on RR, as always, reflecting concentration of fake CA's an others. Therefore, my suggestion for today would be keep the settings and try to take second dose once you wake up midnight. all the best. RE: Vauto, PLM, FL & Mixed Apnea - mper6794 - 12-07-2019 Hi, sheepless I was wondering whether could be worth a follow up in your current situation...if you are willing to, of course. May want waiting for sometime more, etc, or just give up searching for further improvement? Yet intriguing and challenging, I have the impression your situation could still be improved, by proper balancing settings, medications, and sleep hygiene. just in case, this could be waveform we would need, as before... attached.. all the best RE: Vauto, PLM, FL & Mixed Apnea - sheepless - 12-07-2019 I'm game. after about 28 nights with vauto I've had about 5 back on asv, attempting to reproduce lower flow limitations while evening out the periodic breathing that's not obviously periodic limb movement (i.e., the more sinusiodal pattern). I can't say I've been thrilled by the results so far because asv has limited ability to restrict ps and I'm leaning toward concluding the csr-like flow rate pattern is just another variation of my respiratory response to periodic limb movement anyway, implying the possibility that the machine isn't capable of resolving this pattern of plm induced disordered breathing any more than my more typical plm pattern. limiting pressure support on the asv is problematic because it requires a 5 cmw difference between min and max ps. so far I've run only asv mode. best setting for ahi has been epap 7.6, ps 0-5. the only 95% flow limitation entry so far i s 0.11 at epap 6, ps 0-5. other nights at epap 6, ps 1-6 and epap 6, ps 2.4-7.4 produced no 95% fl. not surprisingly, overall ahi is lower with asv than with vauto. interestingly, the csr-like pb is showing up in asv mode now. I'll have to confirm this is the case in asvauto mode; there used to be very little of that pattern in asvauto mode except at the very beginning of a session. now seeing it throughout. still seeing my regular plm pattern as well. I theorize that the ripinirole is affecting plm to the extent that it is showing up in more than one respiratory response pattern. again telling me I really need to get a video camera to verify this stuff. to get the most of this new asv trial I should continue it for awhile but don't really care if it's now or later. if you have a procedure and goal in mind, let's have at it. the hardest part will be giving up naps. edit: to be fair, I should also consider the possibility that seeing pb in asv now when not so much a month ago could be developing heart problems but I'd rather deal first with the more obvious and less traumatic possibility that it's a variation of my response to plm. RE: Vauto, PLM, FL & Mixed Apnea - Gideon - 12-07-2019 I'll point out that CSR and the CSR like details you posted earlier should be able to be managed with EERS RE: Vauto, PLM, FL & Mixed Apnea - sheepless - 12-07-2019 good point. thanks for your input, bonjour. hadn't thought of that. I have a sneaking suspicion it'll prove ineffective against plm induced disordered breathing, if that's what it is, but it's certainly worth a try. I did successfully reduce ca with vauto by setting trigger to very high and one of the ti settings to 0.8, but I don't remember that those had any effect on the csr-like pb (again suggesting the pb is from plm). but no point in leaping to conclusions. I'll keep EERS in mind. if I can galvanize myself into action, the first thing is to get a camera. RE: Vauto, PLM, FL & Mixed Apnea - Gideon - 12-07-2019 FYI I recently read a medical article that said CO2 manipulation (EERS) will treat People Primary Central Apnea RE: Vauto, PLM, FL & Mixed Apnea - sheepless - 12-07-2019 very good to know! |