Kiwii's Search for Restful Sleep

[kiwii]

My IMGUR home page (free account) URL looks like https://beerdujour.imgur.com/all/

When I look at my account using the same URL pattern, I do see some options for resizing - although it looks like it will be resized as it is being uploaded. Which is the correct size to use?:

thumbnail - 150x112
thumbnail - 320x240
message boards - 640x480

eta: Oh heavens... I'm an idiot. Ok, so I see how to get the screen you showed earlier. Thanks!

[kiwii]

Oops. I misremembered the original recommendation...

Sleeprider said: Based on what I'm seeing here, I recommend you move EPAP min to 6.0, IPAP max to 12 and PS to 3.0. So PS 3.0 over 12/6.

May I please have your opinion of the most recent data? Thank you.

[Sleeprider]

Regardless of what I said before, I think you need more pressure at the top. So with EPR at 3, I think a maximum pressure of 13, 14 or 15 is not out of order. In all of your posts above, the problem is entirely obstructive, however the price of higher pressure is potentially higher aerophagia. In your case, it remains a balancing act of treating OA with higher EPAP pressure, while trying to avoid blowing up like a balloon.

[kiwii]

Thank you.

Would it be reasonable to raise it to 6-13 tonight? or is it too soon? (I've been at 5-12 for 3 nights)

At the current setting, I am not having aerophagia. Bring it on.

[Sleeprider]

I think that's fine. Your event rate is still over 5 and it's obstructive. Go for it.

[kiwii]

Much appreciated!!

[kiwii]

I was doing well for awhile.

I'm not doing well now. I had a question about a peculiar breathing pattern that I've woken up to a few times in the past 20 years, plus once when I was on IV morphine in the hospital. Basically, I wake up to the realization that inhalation is not occurring automatically. It feels as though my lower rib cage has sunken in on itself. I have to consciously make an effort to inhale. Once I get it past a certain point, inhalation kicks in and it is fine. Usually it is easiest to just turn onto my side.

This breathing came to mind in response to one of the intake questions asked by Dr #2 in mid-October. I thought his body language conveyed that he didn't believe me, and I didn't give it much thought because it's not like it was happening on a regular basis. He was also dismissive of my testing ODI of 63.1%, saying that the monitor must have fallen off during the night (it didn't; it was taped on and still in place when I woke up).

The peculiar breathing happened again on Nov 9th.

I've just read a wikipedia article on Central Sleep Apnea which says, in part:

There is no effort made to breathe during the pause in breathing: there are no chest movements and no muscular struggling, although when awakening occurs in the middle of a pause, the inability to immediately operate the breathing muscles often results in cognitive struggle accompanied by a feeling of panic exacerbated by the feeling associated with excessive blood CO2 levels.

I do not experience panic but, other than that, this pretty well describes what I have experienced - especially the inability to immediately operate the breathing muscles. Even when I am consciously TRYING TO INHALE, it takes TIME and EFFORT to get it going.

And now for a rant: I am told that I "could DIE!" simply by changing my own pressures, but no one seems to be listening when I say that I wake up because I am not inhaling. I feel like I am in some bizarro alternate reality. I have a referral to a pulmonologist from my PCP, and received a copy that shows the referral is to have him take over management of asthma. No wonder the appointment is for late January.

I will try to finish later. The level of despair and frustration that I am feeling is really getting to me.

[Sleeprider]

Kiwii, have you ever tried a trigger setting other than medium?

[kiwii]

No. I've been trying to understand Ti Min & Max too. My breathing is slow, about 7 bpm. I'm on default settings, and the Ti Min is 0.3 which appears (to me) to be for people with faster breathing. But, no, those settings (trigger, cycle, Ti Max & Ti Min) are all default.

[PoolQ]

you sound so much like me. TImin for me is not important, I breathe slowly. TI max on the other hand is very important and at default felt like each breathe was being cut off. I cannot sleep like that. I increased TI max to 4 seconds. This got me most of the way there.

Trigger is how sensitive is the machine to you starting to inhale, I set it a couple notches more sensitive

Cycle is how sensitive is the machine to my stopping my inhale. I made mine one notch less sensitive

Again this was for my slow breathing.

All 4 of these settings are not therapy settings but they are comfort settings so you and the machine do not fight each other