Need help reading my charts

[Rich66]

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[Rich66]

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SarcasticDave, I was thinking of trying your suggestion on reducing the max epap and adding back to the ps max.  It's worth a try.

[SarcasticDave94]

There's lots of Hypopnoea at 58, 1 Central, it looks like page 7 someone writes 214 PLM, and there's a OSA and PLM diagnostic code on page 3, and some concern about oxygen percentage being below normal range.

[kappa]

As a fellow sufferer of PLMS I think you need to move the focus on to the leg movements rather than trying to force your breathing in to some sort of conformant pattern. Picture a servo and damper mechanism to get the saddle on a bucking horse all stable. Sure the staddle is some sort of rideable but the poor horse (i.e. you) is even more distressed by this additional push and pull of the servo.

Curious that your report has no graphs of the PLMs, but the tech indicated that they were intermittent, so with a overall PLMI of 58/hour that means when you did have PLM the rate was even higher (probably every 30s or so as we see in the graph, so 120/hour).

I have an 9-axis accelerometer I wear on my leg and use the rotation axes as a very sensitive and discriminitory metric to work out what measures are working for me. Currently that's Clonazepam as prescribed by my Neurologist, but my Pulmonologist hates using that (addictive, blah blah blah) that so I'm going to see if he has a better suggestion that actually works...

Do you have RLS? That's often (but not always) associated with PLMD. You might want to see a neurologist and see what they suggest if your regular and pulmonologist/sleep doc can't/won't help here. As something that is easy to do with OTC meds, try increasing your stored iron (Ferretin) levels if they are at the lower end of the range - "normal" is 20-400 (or some similar absurdly wide range). You want to try and get that over 100 if you can (which may be hard with OTC meds). Suggestions on RLS forums (rlsuk is great) are for a double dose of an iron chelate type supplement ("gentle iron") every other day.

[Rich66]

Thank you everyone for the help.  I feel like someone who got on the wrong bus somewhere.  I can see I need to redirect my attack on the situation.  I've been a thin person my whole life due to hard physical work and play.   My adult weight was usually about 175 lbs, but for the last 13 years, since basically retiring, all I've done is eat well, and now weigh 204.  So I'm thinking some weight loss is in order also.  I feel that my Pulmonologist/sleep doctor has glazed over any PLMD issues -- and apparently I'm going to have to push the issue.  Every time I see the sleep doc, for about 2.75 years now, I take the SD card from the machine and they download the information -- but the doc never really talks about it.  I remember she came in once and said "No apneas".     And that was the extent of that conversation.  It's more about am I comfortable with it and compliant with it.  Then when the insomnia came into the picture, the discussion is more about sleep schedule and getting me more drugs to eat.  That was before I learned about this site and that I can download the SD card also (and that was before I learned the doctors and the DME's are really quite useless when it comes to actual help).

I have not been diagnosed with RLS, and I'll start reading up on it, I would say I do not have it -- but I've been wrong about this stuff before.  Thanks for the info kappa -- I've bookmarked the site and will be trying to learn what I can about all this.
Also, it looks like I'll be getting an oximeter-- thanks Dave and Sheepless.

[sheepless]

I agree with kappa. your ahi is great. no harm in trying but I strongly suspect increasing pressure won't be beneficial. in fact, as I mentioned earlier, it may be better to bring your settings closer to fixed pressure. otherwise, best to do everything you can to try to control the movements.

my latest sleep doc, who's a neurologist and whom I ditched for his expensive lack of attention and lousy service , said nothing about the plm reported on my sleep study. when I complained about better ahi not producing better sleep and mentioned rls at 3 separate appointments he still failed to mention plm. only after I asked 4 times for my complete report (first 3 times they sent the one page summary) did I see the plm notation. after giving up on the sleep/neurologist I asked my family doc for help. I've been taking ropinirole which I would say it's maybe 75% effective (to make up a number) in reducing my plm. I also have rls, the distinction, at least in my mind, is rls while awake and plm while asleep. plm invariably follows rls but I can have plm without rls too.

with virtually all hypopnea, there's at least a chance they're triggered by plm and you don't have apnea at all. of course that remains to be seen.

good luck!

[SarcasticDave94]

Something to keep in mind is your diagnosis of Pulmonary Sarcoidosis. Might that be why you're on an ASV? Because I'm sure you didn't just get handed the ASV for more or less no reason. I'm just making sure this aspect is kept in the mix.

[sheepless]

excellent point Dave. I didn't say anything because I know absolutely nothing about it but it may be a wildcard Rich might take up with his providers.

[Rich66]

It was my prostate cancer doctor that asked me if anyone had mentioned anything about my lungs (I said no) -- then they referred me to a Pulmonologist.  Then my general doctor had me do a home sleep study because I told him I had been waking up gasping for air.  When I had a lung test with the Pulmonologist he told me about the Sarcoidosis, and I told him about the home sleep study -- his comment was "I hate when they do that".  He signed me up to take one of their lab sleep studies.   I tried 3 different machines (starting with CPAP and stepping up each try) and couldn't use them, then the ASV was tried and it was workable.  The doctors diagnosis was "my brain does not send the signal to my lungs to breathe".  And with almost half the oxygen receptors in my lungs being clogged, I can't help but think that it would affect the epap or ipap pressures that are needed.  I also don't know if it could be a cause of the PLMD.  But it sounds like that is the direction I need to be looking at.  And I've already ordered the pulse oximeter from Amazon -- it sounds like I'm the perfect candidate that should be using one.

[SarcasticDave94]

OK yep I copy it. I'm quite certain the brain not sending breath signals means Central Apnea. That's the reason for ASV.

So I'm curious. Which pulse oximeter are you getting? That reminds me, mine is lying around somewhere in a box after I moved recently.