UARS/FL (PLMS): Yellow/R Lights For So Many Lingering Folks_“Is Bilevel the Answer?"

[mper6794]

I have a few detailed questions to help me try and understand...

• You mentioned "unflagged RERA". If it's not flagged, how do you measure it? Do you do a detailed search of the flowrate looking for anomalies?....yes, daily counting; pretty easy to spot taking into account FR, TV, RR, leak/moves, once you get familiar with and get charts calibrated (in my case audio-recording)....maybe I could post a couple of  tens of examples later on....
  
• Ditto re PLMS arousals. You mentioned you make an overnight audio recording and other members use video. I don't think this is something that most people would do. Is there anything in the charts to indicate this?....same thing, pretty easy once you hace your charts calibrated and hear your noises while moving.....
  
• Respiratory rate varies significantly throughout the night. Which particular RR do you use - min, max, median, 95%?...the median....
  
• You mentioned trying to determine your own normal RR by placing your hands on your stomach, counting the breaths and multiplying the outcome by 0.93. I don't believe its possible to get an objective RR in this way. While you're awake the RR can vary tremendously - especially if you are conscious of it. This needs either a 3rd party observation or else get the rate from your machine.  Also, where did the 0.93 factor come from?....yes, indeed, can varies a lot, but I think it is a good proxy to start with (then, later on you can use those overnight outcomes...lowest values equivalent to triggering CA's, etc)....0.93,..these could be two papers to start with.... https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5027356/..........https://watermark.silverchair.com/040104.pdf?
  
• The graphs are still quite cluttered. Can you post just the EPAPmin, PS and RR in a single graph and leave everything else out?....I will do later on....
  
• I suspect some of the trends you've highighted in the graphs may be coincidence. You've highlighted where two lines are trending the same direction but ignored the times when they are diverging.....yes, indeed, they could converge or diverge, because are inverte relation....
  
• The scatter graphs don't fill me with confidence - there is just too much scatter to form a meaningful relationship. The R2 values are all very low - as an engineer I would want a minimum of R2 = 8. .....yes, indeed, that is the reason I have calling the approach semi-quantitative....
  

Please note I'm still trying to get my head around your basic concept - these questions are to try and eliminate the "noise" - inconsistencies and variations which don't really seem to follow the data......I appreciated very very much your points...thanks for taking your time to question this....

all the best

[mper6794]

....hi, Sheepless, DB, quite recently i have realized those my PLMS that produce arousals, that is, those ones i don't sleep through, would be of the "groaning-type".
https://www.ncbi.nlm.nih.gov/m/pubmed/28364416/

All the best

[sheepless]

my respiratory response to periodic limb movement.  in addition, I've been seeing another more sinusoidal pattern that I suspect is a variant but I'm not as sure about about it as I am the pattern below.

[mper6794]

Hi folks,

This post is just to update a preliminary suggestion on post# 93, above, on a Possible Protocol to treat UARS:

As per literature, my own case, and some few others I have been following closely, strategies to treat UARS could be, maybe in this order: 

(1) adequate sleep position, not on the backs, avoiding the so-called tongue collapse, in particular during REM (While dealing with thousands of cases, Drs. Guilleminaut, in particular his videos; Steven Park, his book Sleep Interrupted; Barry Krakow, his book Sound Sleep Sound Mind; and many others, made and have been making points on this positional drawbacks on UARS treatment);
(2) cervical collar, avoiding chin tucking, as per AB Forum’s suggestions; 
(3) BPAP, with properly balanced EPAPmin x PS;
(4) dental appliance, and
(5) surgery.

All those measures could eventually go together - when PLMS is also involved (my case; and of so many others) - with boost of ferritin; supplements and some herbs (e.g., Valerian, from which I have been getting good results. Please, you guys might want take look at these two papers: (1) A COMPREHENSIVE PHARMACOGNOSTIC REPORT ON VALERIAN: Muktika Sharma , U. K. Jain *, Ajay Patel and Nilesh Gupta; (2) DOES VALERIAN IMPROVE SLEEPINESS AND SYMPTOM SEVERITY IN PEOPLE WITH RESTLESS LEGS SYNDROME? Norma G. Cuellar, DSN; Sarah J. RatclifFe, PhD).


all the best

[mper6794]

hi, guys

Trying to go slightly further on my education ont the Chin Tucking (CT) x Tongue Collapse (TC), yesterday I sent a WhatsApp short message to my little grand daughter’s ENT/surgeon, Dr. Frd. That because I had some doubt on the independence/interelations or not of the two phenomena.

“Hi, Dr. Frd, if you don’t mind, I would like, please, ask you two quick generic questions. I sleep much worse while on my backs than on sides and stomach, and this looks the same for so many people. There has been some discussions whether this would be provoked by:

(1) gravitational tongue collapse into the throat?,
(2) or chin tucking and push of soft tissues backward (this could happen while sleep on sides)? What do you think about this in a simple way?
(3) Such two things would be distinct phenomena, which could occur at the same time?

He answered shortly: " they can occur simultaneously, however additional factor can also be involved and interact, such as hyoid bone angulation, muscle dysknesia, etc…”

It was fine for me, and, also taking into account previous very brief  personal conversation with him, I did not want to bother this very busy 68-year old doctor any further. I interpreted from his words that chin tucking and tongue collapse do exist and are distinct phenomena, not exclusive. They can occur at the same time and, at least, tongue collapse, would be aggravated while on my backs.

I might back to him when I returned for the next consult and ask for some more clarifications.

Then, I have taken a quick look at the amazing hyoid bone. Hope not having problem with this guy…..

[sheepless]

with no evidence whatsoever, my intuitive response would have been of course you can have either or both. however, it certainly seems likely that if ct is a problem, it's because it causes / worsens tc. well, I assume tc but it's probably safer to put it more generally: that it restricts the airway somehow.

[tarah]

FOR ME, sleeping on my back produces the most restful sleep. The machine takes care of the throat airway issues when I'm on my back.  My nose is my biggest impediment to restful sleep and it's the most congested when I'm on my side. Even after surgery.

[emmylouwho]

Mper6894,

Thank you so much for posting these videos. I’m almost crying because I think I’ve found what’s wrong with me. The last video could be a video of me sleeping and not sleeping too. All this time I thought I just couldn’t get comfortable for whatever reason. I don’t know what I thought PLMS looked like but it wasn’t this.