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

[WillSleep]

the plots of your self titration are so busy it's hard (for me) to get a handle on what's going on and what it means, at least quickly.  in time, adding slides that isolate one or a few plots to make it easier to interpret would certainly help me.

 
Hi Mper, 
 
This was my thought as well.
 
You are working hard to do a great service to Sheepless and the community.  The examples you posted above are pretty advanced, include a lot of history and number of learnings you gathered along the way.  I think it will be easier for others to come up to speed with simpler versions.  
 
A few ideas that might help simplify, just starters:

• I would probably remove mention of multiple machines.
  
• I would remove mentions of multiple meds and med transitions and just a one med starting halfway through as a example for the impact of Meds and how to track them.  
  
• For analytics and tuning purposes to me it seems like IPAP Max does not add much beyond IPAP 95% so I would remove IPAP Max. Like-wize I would remove PMax.
  
• People might look for AHI as a starting point to understand the slide so I would make AHI more visible on the chart and in the Legend.  
  
• The scatter gram shows that at a certain level Sleep Effeciency and HYF are not statistically different decision drivers in this analysis.  So I would either pick one or combine them into and display them as one index.  
  
• Rather than the SE x HYF scatter gram I would display a scatter gram or two that show the most important outcomes the process is trying to produce.  Like if the or one of the most important conclusions is (RR/2 x PS) or (PS x HYF)  or (EPAPmin-PS X HYF/2) or (EPAPmin-PS X HYF/2) or ((EPAPmin-PS x 2)) X (PLMS/hr+RERA)) or  
   (PS X (HYF - (PLMS/hr+RERA)/2)) then I would display that scatter gram or two.   

 
Thank you for the time you are putting into this work.
 
WillSleep

[mper6794]

_thanks, Will.
This historic was not intended to mean too much for the semi-quantitative approach. It was more focused on discussions with sheepless, the only case i know PLMS is astonishing drawback here.
I have taken advantage of the historic just to show some milestones on my 7-month journey. The historic itself is not important.
Anyway, i Will try something better... thanks

[WillSleep]

Mper,

I think the contribution your making is awesome. 

Was just suggesting a simpler view to ease the communication work.


WillSleep

[slowriter]

Mper,

I think the contribution your making is awesome. 

Was just suggesting a simpler view to ease the communication work.

WillSleep

This.

The problem, mpers, is that your method is still really only clear to you.

For people to understand it, they also need to understand how it relates to standard titration protocols that are the basis of recommendations people here make.

If you simply said "this is what I do; it's helpful for me," that would be entirely different issue.

But, and this is the problem: you're promoting it here, and using it as a basis to make recommendations, without having explained it so people can understand. 

This is the basis of some recent conflict, and if you don't clear it up, the conflict will continue, I predict.

And more information and data is not helpful; you need less ;-)

[mper6794]

Thanks, slowriter
...i got your point. Will try better...
...i Will keep on trying applying It, yet only in one ir two cases i am already involved.
Then, the Idea would to be keep myself restrict to this thread.

Many Thanks

[mper6794]

sheepless pid='319962' dateline='1574105444']I'm happy to be a test case, partly curious, partly thinking apap and asv haven't done it for me yet and I feel no worse and maybe a little better on vauto (to my surprise actually)......

 
Hi, sheepless,
_hope you are doing fine, since we finished your case, at posts #143--#144. I think, it took us some 16 days to ultimately have your tailored EPAPmin and P.S, around 8.2/8.4....5.2/5.4 (attached). As I said there, on your thread, I think you could keep tweaking within these ranges aiming at getting absolute zero (i.e., FLmax = 0.0).
_As we both agree your main drawback, on your UARS-PLMS case, is the PLMS itself. Hope medications adjustments as we discussed (links herein) would keep you improving your HYF index.
_ I don’t know whether you keep thinking you anytime had problems with CA's, which led you to ASV. If so, as we plenty discussed on your thread, we are in complete disagreement. You would be just a case of UARS-PLMS, in which PLMS was astonishing, maybe exacerbated by 36 months struggling to tackle everything.
_ I do recognize and have profound respect and consideration on all efforts our dear fellows spent on your case. Should we have moved forward at all, it could be, in great extent, accounted to previous efforts, insights, and eventually misleading directions. It is part of the game.
 
http://www.apneaboard.com/forums/Thread-...ea?page=14
http://www.apneaboard.com/forums/Thread-...ea?page=15

[mper6794]

[attachment=17509]Hi, dear fellows

_from time to time, i have decided to use this my single thread to illustrate some aspects of my own therapy on UARS-PLMS case, pretty much worked out these days, after 7 months of daily analyses of OSCAR outcomes.
_ most of the time these illustrations could have to do with cases running out there contemporaneously;
_ this post aiming at illustrating fake REM/Leak-dependent CA’s, which eventually could lead to misleading directions.
_ As I know my case very well, I am pretty sure all these CA’s (attached) are within REM stages and are fake, caused by leaks, which, in turn, are caused by too much relaxation, chin retraction and loosing mask stripes.
_ sometimes REM-dependent CA’s can be also caused by the REM respiratory instability itself, and arousal/awakening-sleep transition within REM;
_ on both case solution could come from (1) not sleep on your backs, avoiding tongue collapse, (2) using the cervical collar, (3) avoiding ing sedating medications (detonate leaks in my case) ;and (3) better pressures adjustments.
 
All the best

[mper6794]

 
Hi, sheepless,

...almost forgot: as an " undisciplined nice fellow", you could eventually improve your sleep hygiene. This was essential in my case; never thought would be so important: you start crediting sleep drive at the very minute you wake up in the morning, at every minute you don't nap more 25 minutes, and so on...

All the best

[mper6794]

Hi,
I am afraid I may have prolific sleep nights on kind of weird situations.

This post is to illustrate my main night wake up at 3:05:24, coming from my REM 3 period (some 50 minutes). It follows nightmares and brings some asphyxiation during the latest quasi-Hypopnea just before it. Woke up with strange heart sensation.

Still wondering what would have happened; two possibility for a while:  (1) I was sleeping on my back (unfortunately I did not just play attention to), which is very rare, with consequent ultimate tongue collapse; (2) two longer REM periods of this night (reaching amazingly 52%); this a very unusual. It  happened, I think, on account of a huge sleep drive at 23;30 yesterday, because a very poor night before, and disciplined sleep hygiene.
 
All the best

[mper6794]

Hi, folks

No sure if all UARS people in this Forum have ever seen this Dr. Barry Krakow’s video, which I struck some five months ago. Dr. Barry, himself a UARS sufferer, is magnificently illustrating this serious sleep impairment and comorbid issues. And this amazing point: why UARS keep on going so oblivious around the world?


All the best

https://www.youtube.com/watch?v=izgtCxsL...ex=13&t=0s