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Positional OA's - Chin Tucking Faux Pas?
#1
Angry 
Positional OA's - Chin Tucking Faux Pas?
I had a very unusual night last night. Kind of a one-off faux pas of chin tucking I presume. I'm not overly concerned since my AHI's on a running 2-week average are around 2.5. I don't know why, but I had kind of a restless night last night. Ironically I felt pretty well rested good throughout the day, so I think this is a one-off incident that isn't anything to be concerned about. One bad night does not make for a trend.

I've never seen this type of sleep report (for me) since I have been on PAP. Yes, smaller clusters, but not quite like last night. I am guilty of chin tucking, so all I can think is that this is perhaps a typical graph of clustered OA's, although they were identified as UA's and H's on my ASV machine.

Normally I can successfully combat the chin tucking by just smashing blankets under my chin. That seems to work pretty well for me to keep my gaping pie-hole closed along with combating the chin tucking. I'm guessing I was just sorely unsuccessful last night. (Soft cervical collar is a no-go for me.)

Any ideas, or am I reading and analyzing this one correctly? I'll keep tabs on all this over the next few days.
Session 1 looked great then #2-4 were  Shock-2

Bigwink

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RayBee

~ Self-Treatment - via ApneaBoard experts.
~ Self-Pay - no help from Kaiser other than getting my script, then a pat on the butt and out the door.
~ Self-Educated - via ApneaBoard experts, its many users, and posted reference material.
~ Complex Apnea - All Night AHI=34.2/h, Supine AHI=45.5/h
~ Using a 2021 16" MacBook Pro M1 Max, 32 GB, 1 TB, macOS Monterey V12.6.2.
~ Pay no attention to the dog behind the cup, he ain't a docta, and does not give medical advise.
~ Woof, woof.

I-love-Apnea-Board
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#2
RE: Positional OA's - Chin Tucking Faux Pas?
Close up chart posted...

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RayBee

~ Self-Treatment - via ApneaBoard experts.
~ Self-Pay - no help from Kaiser other than getting my script, then a pat on the butt and out the door.
~ Self-Educated - via ApneaBoard experts, its many users, and posted reference material.
~ Complex Apnea - All Night AHI=34.2/h, Supine AHI=45.5/h
~ Using a 2021 16" MacBook Pro M1 Max, 32 GB, 1 TB, macOS Monterey V12.6.2.
~ Pay no attention to the dog behind the cup, he ain't a docta, and does not give medical advise.
~ Woof, woof.

I-love-Apnea-Board
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#3
RE: Positional OA's - Chin Tucking Faux Pas?
Damn fine job of posting up your charts. I'm gonna have to learn how to do it one of these days.  Unsure
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#4
RE: Positional OA's - Chin Tucking Faux Pas?
It may be sleep wake junk. Did you wake up a lot during the night or were you just dozing off instead of sleeping?
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#5
RE: Positional OA's - Chin Tucking Faux Pas?
(08-17-2019, 09:49 PM)alexp Wrote: It may be sleep wake junk. Did you wake up a lot during the night or were you just dozing off instead of sleeping?

Great question.

I usually seem to find my SWJ around the 5 to 10 minute area post head-on-pillow and prior to waking. As I recall, these times shown, I was asleep. But apparently not too well.  Oh-jeez
RayBee

~ Self-Treatment - via ApneaBoard experts.
~ Self-Pay - no help from Kaiser other than getting my script, then a pat on the butt and out the door.
~ Self-Educated - via ApneaBoard experts, its many users, and posted reference material.
~ Complex Apnea - All Night AHI=34.2/h, Supine AHI=45.5/h
~ Using a 2021 16" MacBook Pro M1 Max, 32 GB, 1 TB, macOS Monterey V12.6.2.
~ Pay no attention to the dog behind the cup, he ain't a docta, and does not give medical advise.
~ Woof, woof.

I-love-Apnea-Board
Post Reply Post Reply
#6
RE: Positional OA's - Chin Tucking Faux Pas?
It looks tome for some reason your max ipap of 20 was not enough to encourage you to breath, not chin tuck specifically but particularly resistant Central Apnoea.


Any meds changed ?
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#7
RE: Positional OA's - Chin Tucking Faux Pas?
(08-18-2019, 01:49 AM)jaswilliams Wrote: It looks tome for some reason your max ipap of 20 was not enough to encourage you to breath, not chin tuck specifically but particularly resistant Central Apnoea.


Any meds changed ?

No med changes.

I was really interested in seeing what last night's numbers would bring. Back to the same old boring (we like boring) numbers and chart. After discounting the SWJ, my AHI was 2.06. That kind of reinforces the idea that it was a somewhat unique oddity.
I don't think I can blame it on an alien Crazy  abductions either.  Dielaughing  Although some of my friends might disagree.  Oh-jeez
RayBee

~ Self-Treatment - via ApneaBoard experts.
~ Self-Pay - no help from Kaiser other than getting my script, then a pat on the butt and out the door.
~ Self-Educated - via ApneaBoard experts, its many users, and posted reference material.
~ Complex Apnea - All Night AHI=34.2/h, Supine AHI=45.5/h
~ Using a 2021 16" MacBook Pro M1 Max, 32 GB, 1 TB, macOS Monterey V12.6.2.
~ Pay no attention to the dog behind the cup, he ain't a docta, and does not give medical advise.
~ Woof, woof.

I-love-Apnea-Board
Post Reply Post Reply
#8
RE: Positional OA's - Chin Tucking Faux Pas?
the chart in post 2 is very similar to the chart in another of your threads, title beginning "odd ua events..."

there was a difference of opinion there too with respect to whether these are obstructive or central. I wonder if thought central because ps is swinging a lot as if trying to initiate a breath. however, epap also rises (can't tell if this is true in the chart above but it is true in the chart in the other thread), suggesting obstructive. plus, respiratory effort is visible and there are recovery breaths that I've read here are associated with obstructive events. the ps could be swinging in response to limited flow after the inhale spike. take this with a grain of salt however, after 2.5 years, I still don't know how to distinguish oa from ca.

regardless, the flow looks a lot like my flow when I'm having periodic limb movements. I don't have as many events as you during these flows but that might be a separate issue. too many threads, I don't remember if you said whether you had any indication of plm in your sleep study or reports of such from others.

I find a plm jerk causes me to inhale sharply, often accompanied by a moan or groan that looks in the flow like a snore, followed by a surprisingly regular number of lesser breaths, and ps rises rapidly in response to either my sharp inhale or the relatively flow limited breaths between the sharp inhales. I think this is a misapplication of ps, having little to no hope of blasting through what I assume are reduced flow breaths in response to the 'violence' of the plm jerk (which I suspect are more forceful limitations than those occurring absent plm), resulting in increasing leaks and aerophagia.

IDK if plm is an issue for you but something to keep in mind. meanwhile, your events do look positional. some kind of chin/jaw support would help that. plus I'd incrementally nudge min epap to start and I'd also reduce my max ps if you are seeing leaks and aerophagia as a result of those swings.

otoh, if they really are central, some say to open up the max ps to give the machine the freedom it needs to trigger a breath.

trial and error is the name of this game. trying one thing at a time might help identify the problem.
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