UARS / Irregular breathing pattern

[sheepless]

sure, makes sense, particularly from the treatment provider's point of view, which I'm not discounting. to reiterate my own experience though, I spent more than 2 years getting my ahi down - vitally important from a health standpoint - but it wasn't until I found some relief from plm that I really started feeling better. not sure why one can't do both at once but of course I'm not a doctor.

[nevermind]

Hello mper6794,

here are some detailed screenshots of Okt 7th. Hmm, looks like the number of attachments is quite limited here...

I am currently not too worried about the CAs, I think/hope that they will go down further while I am getting used to the therapy.

I set the EPAP to 7 because I found in my first attempts earlier this year, that with values below 7 the number of flow limitations increases strongly. But I might give it a try (slowly) to see if this still is the case. The trigger values turned out to be interesting. I currently set them to what feels most "natural" to me (and that is "sensitive" for exhale and "med" for inhale). But with my currently low PS-value of 1.6 the triggers are probably not so important anyway.

Cross plotting parameters against some how-you-feel value sounds like a good idea, will do!

Concerning your last question: I don't take any medication. I am in my 40's and I have no other health issues than this one (fatigue / brain fog / concentration difficulties / ...). Blood work ok, heart ok, even got an ok MRI of my brain. This makes bad sleep the one and only apparent candidate for my issue.

[sheepless]

all those charts show plm - even the daily: while you can't infer plm from that, it does suggest something causing fragmentation. even most of the ca looks like your response to plm. other than the ca, your treatment looks pretty good. not saying it can't be better but it's adequate, as in under ahi of 5, and since plm can't be resolved by any modality of cpap, I suspect the biggest bang for your effort will be to find something to ease the plm. you may find your flow limitations (uars) decline significantly without plm as well.

[mper6794]

Hi,
_good point sheepless "I suspect the biggest bang for your effort will be to find something to ease the plm"........ theoretically this one...  " you may find your flow limitations (uars) decline significantly without plm as well"....would be possible, as  per this Dr. Barry Krakow citation "The Link between SDB and Leg Jerks The great controversy about RLS and PLMD is their relationship to SDB. Many patients with RLS and PLMD also suffer from SDB, especially upper airway resistance events. In sleep studies in some of these patients, recent research shows that the movement occurred at the end of a UARS event. Remarkably, when these patients received PAP therapy, their leg jerks decreased as air pressure normalized breathing. Of further interest, research also has shown the opposite result, in which a PLMD patient with SDB was treated with a medication to eliminate leg jerks, which then stabilized sleep and eliminated".
...in my case, I have found that leg jerks can often follow air flow reduction; I am used to counting those everyday and making crossplotting analyses of them...however, I have not experienced yet indications of UARS been improved by medications, even on the contrary, they sometimes get worse, as I intend to show later one.....

Nevermind, in terms of diagnose, your charts confirm your PLMS as main drawback, preventing you from cycling properly to deeper phase of sleep, and leading to your poor sleep quality.
 In your few 10min-windows at the beggining of the night, yet very subtle, I have spoted very few  air flow reduction-driven awakenings, therefore I think there would be still room for proper adjust of your parameters.... I would suggest you keep on scrutinizing for air flow reduction-driven awakenings.
For proper parameters adjusments I have been using  a semi-quantitative approach which may be useful for you (see attached). However, for this adjustments, I would suggest more significant "courageous" changes on your EPAPmin and PS, as I suggested above, and, also, take advantage of whatever numbers came in while on BPAP, in particular those ones you mentioned your CA's boosted; this can be very useful for ultimately narrowing of your EPAPmin and PS. For those ultimately adjusments, it would be invaluable your "normal respiratory rate" that would have coming from your lab studies.
With regard my historic experience on medications (Pregabalin 75, Conazepam 0.6, Primapexol 125, L-Tyrosine, Valerian)  for PLMS, later on I will share with you.
Good luck