[Health] Interpreting sleep study results, EERS enhanced expiratory rebreathing space

[Sleeprider]

My preferred settings would be trigger high, cycle medium, Ti Min 0.8 Ti Max 2.0.

[JoeyWallaby]

My preferred settings would be trigger high, cycle medium, Ti Min 0.8 Ti Max 2.0.

I could try that. The Ti Max 2.0 would feel weird when I'm awake but my median insp time is 1.4 on most nights so it would be okay once asleep.

What is the difference with cycle medium vs high? Is it less harsh/sharp on exhalation?


This is the chin strap I'm wearing by the way. Not the terrible neoprene ones.


Last night was EPAP Min 8.0, PS 5.0, Ti Min 0.1, Ti Max 4.0, Trigger High, Cycle High. Standard length EERS, cervical collar, chin strap and mouth taped. I woke up and took off mask and stuff last night because I forgot to insulate EERS so condensation happened. I’ve insulated it now. 

Time didn’t set properly on night vision camera, so I can’t put in timestamps. From looking at the recording, compared to last night, I spent more time on my side, moved less and the movements that did occur, weren’t as large. After I took CPAP mask and other equipment off, I dropped my mouth open and started to grind my teeth. I also tucked my chin once.

I could probably put PS up a little and EPAP Min down a little. I could breathe out okay against EPAP Min 8.0 but PS 5.0 didn’t feel that substantial.

Overview

Events






Waveforms

[mper6794]

Hi, Joey

_looks a interesting short chunk of 3 hrs, maybe not representative. Respiratory outcomes, except for MV of 9.0, maybe higher then your normal, looks ok.
_so, you have taken measures:

[mper6794]

...too early, sorry....keep on going

[JoeyWallaby]

In this video lankylefty says too high of an Epap Min will cause CAs at 6:00 and 8:00
And he really doesn’t like bilevel auto for some reason 19:40

[mper6794]

Hi, Joey,

- looks an interesting short chunk of 3 hrs, maybe not representative. Respiratory outcomes, except for MV of 9.0, maybe higher than your normal, looks ok.

_so, you took (or ended up with) pretty much protocol measures to treat the UARS: (1) better positioning; (2) collar; (3) chin strap, as well as (4) EPAPmin x PS, which appear close to your fine-tuned values, once you got FLmax approaching to zero.

_ number of arousals within REM periods looks pretty much bearable, maybe. In future, it will depend on the rest of the night, in particular, later hours, when situation in general get more complex to stabilize;

_ I would not ask HYF, because interruption.

_However, for now, maybe this challenging question would be more important for all of us involved in your case: Would you have got this nice chunk because of (1) to (4), that is, tried to beat the causes; or because you would have beat anticipated non-existent CA (non-existent symptoms, because 1 to 4) with the EERS? Yes, I would not expect any significant CA, because you arousal/awakening much less, therefore there would be no reason for CA’s to be there.

_And, also, those events at 9:10, maybe 10:17, 10:26, and 10:27 still would be fake, following arousal/awakenings.

All the best

[slowriter]

My preferred settings would be trigger high, cycle medium, Ti Min 0.8 Ti Max 2.0.

Upon what did you make those Ti recommendations?

[Sleeprider]

The basis is anecdotal that with CA events a higher sensitivity on trigger and longer Ti Min simply reduces event rates, sometimes significantly. http://www.apneaboard.com/forums/Thread-...AHI?page=7

With CA events and UARS, it is counter productive to cycle to EPAP prematurely. Think about it, it's a pretty easy piece of logic. Thus Cycle is medium and Ti Min is extended from the default 0.3.

[JoeyWallaby]

Should I try something to stop me from rolling onto my back? If I lay down on my side with everything relaxed, I can breath pretty well. Lying on my back? Not really.

Actually... when I wake up (during the night or in the morning), I'm almost always on my back. While, when I go to sleep, I'm always on my side. Meaningful or just a coincidence?

[mper6794]

Should I try something to stop me from rolling onto my back?...no doubt!.... If I lay down on my side with everything relaxed, I can breath pretty well. Lying on my back? Not really.....that is the rule for UARS's!

Actually... when I wake up (during the night or in the morning), I'm almost always on my back. While, when I go to sleep, I'm always on my side. Meaningful or just a coincidence?....no coincidence, your brain is telling you go on your sides; best way to get air soon. I used to be an stomach sleeper for years, without knowing why, until some 6 months ago when I started my true therapy.
Please, you want go deeper, take a look at Dr. Steven Park's book: Sleep Interrupted, as well on his free internet articles on UARS.

all the bes.