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

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

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+--- Thread: [Health] Interpreting sleep study results, EERS enhanced expiratory rebreathing space (/Thread-Health-Interpreting-sleep-study-results-EERS-enhanced-expiratory-rebreathing-space)

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RE: Interpreting sleep study results, EERS enhanced expiratory rebreathing space - JoeyWallaby - 11-23-2019

Yea it's because my mask is damaged sadly... don't know useful this data will be till I get my replacement mask Oh-jeez

RE: Interpreting sleep study results, EERS enhanced expiratory rebreathing space - JoeyWallaby - 11-23-2019

[Image: QSQgWMO.jpg]

RE: Interpreting sleep study results, EERS enhanced expiratory rebreathing space - slowriter - 11-23-2019

Have you read this page?

http://www.apneaboard.com/wiki/index.php?title=OSCAR_Chart_Organization

RE: Interpreting sleep study results, EERS enhanced expiratory rebreathing space - slowriter - 11-23-2019

On the substance, it looks pretty good during times when you don't have large leaks.

RE: Interpreting sleep study results, EERS enhanced expiratory rebreathing space - mper6794 - 11-23-2019

Hi, Joey,

While revising your charts from yesterday and several days before. Something has come up, which may have strong implications on ways to follow for your tretament:

_ there are strong suggestions your CA's occur dominantly/essentially during REM-sleep, which came as big surprise for me. It seems this would be a very rare situation, that is, REM-dependent CA's.

_I would kindly ask all other fellows involved here to go through your charts and let us know if am right concerning this association.

_anticipating I could be right, I have made a very quickly research on Google about this, and am posting those links hereinbelow.

_I have tried to acess your sleep studies, but coud not get it anymore?

_independently of this possible found, I would suggest we start everything from the beggining, following closely what systematically would come, concerning FL, RERA, and CA's, taking short and quick steps, starting up with EPAPmin, maybe as low as 6.0, and PS:0.0, rising each at time, and following closely each step.

all the best

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3724064/
https://www.ncbi.nlm.nih.gov/m/pubmed/2678403/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5430122/
https://link.springer.com/article/10.1007/s11818-016-0050-z

RE: Interpreting sleep study results, EERS enhanced expiratory rebreathing space - mper6794 - 11-24-2019

(11-23-2019, 12:58 PM)JoeyWallaby Wrote:

thanks, Joey,
charts pretty much there...apologies, but still need some more blow up; RR (10 to 20), TV (200 to 800/1000)
thanks

RE: Interpreting sleep study results, EERS enhanced expiratory rebreathing space - mper6794 - 11-24-2019

Hi, joey
For the chart on nov, 22th..
I am afraid we went on PS:4.0 and EPAP: 8.0/20, as per your chart.
It was a great blow up on expiration. It looks a great beginning.
Because I am already here, I think I could add some suggestions.
_your CA appears to be dominantly concentrate in REM stages, some misflagged as such, maybe, in the interval 9:12/9:24, for instance. In the interval 13:06/13:18, fake CA would be likely associated with arousal/awakening – sleep transition
_in the interval 8;49/8;54 would be true CA within REM
_ in the interval of larger leaks, 11;50/12;45, event would have been triggered by instabilities of the leakings themselves; I am very familiar with this;

Hope others could shed lights as well.

Kept thinking/brain storming with myself, on the REM dependent-CA's, like this: What you think?
_ CA essentially associated with REM phases
_you leak a lot on REM stages, and maybe coincides with time you take off mask recurrently..
_acting out leads on leakings, or just intensification of RR?
_would you be acting out, quasi-awakening, holding breaths (fake CA) and back to sleep?
_remember, except for atony, REM is pretty much awake. REM is unstable as per its own
nature.
_CA in REM could eventually disappear with time faster and easier than in NREM's, once
RRV (respiratory rate variability) become smoother with the BPAP; If not, other alternatives should be studied, including using the EERRS.
_sleep studies indicated any possibility of RDB?
_REM-dependent should be given same concern as the NREM’s?
_would they respond the same way? To PS?, because much higher RRV?
_Another sleep study and talking to your doctor? Some approach for REM-dependent CA may involve some medication?
_Respiratory Effort within REM leads to OA/H (or quasi < 10s) and recoveries, which lead to leaks; leaks lead to more instability and RRV (and eventually fake CA’s).
What to tackle first: slow down respiratory effort, RRV, by getting your fine tuned parameters!

Then, my suggestion:
Start all over again, from the bottom on pressures, and move in short, yet fast, steps. For next nigh: PS:0.0 zero, EPAPmin:6.0

What is the general plan and first goals?
1- Moving EPAPmin and PS upward, from 6.0/0.0, one each time, some breaks maybe, careful observations and annotations/cross plotting of all parameters (see an recent case hereinbelow);
2- First goal: get FL flagged max : zero. This would the main metric initially, while take close observation of true CA’s and HYF. Once we get would mean you also have your fine-tuned parameters, as well as improved waveforms with respect H or quasi, no flat top, an so on.
3- Expectations: we end up having your fine-tuned EPAPmin within some 15/20 days.

Are you on any medication?

let us try...all the best

RE: Interpreting sleep study results, EERS enhanced expiratory rebreathing space - mper6794 - 11-24-2019

thanks, Joey,
charts pretty much there...apologies, but still need some more blow up; RR (10 to 20), TV (200 to 800/1000)...but need data on the left
thanks

RE: Interpreting sleep study results, EERS enhanced expiratory rebreathing space - mper6794 - 11-24-2019

....and, please, also, charts, whatever Full night or windows, should have also the same waveforms.
.... I would prefer Full night + some 5 ten-minute windows, to start with.
....with overlays of flagged events.

Many thanks

RE: Interpreting sleep study results, EERS enhanced expiratory rebreathing space - slowriter - 11-24-2019

(11-24-2019, 06:13 AM)mper6794 Wrote: Then, my suggestion:
Start all over again, from the bottom on pressures, and move in short, yet fast, steps. For next nigh: PS:0.0 zero, EPAPmin:6.0

What is the general plan and first goals?
1- Moving EPAPmin and PS upward, from 6.0/0.0, one each time, some breaks maybe, careful observations and annotations/cross plotting of all parameters (see an recent case hereinbelow);
2- First goal: get FL flagged max : zero. This would the main metric initially, while take close observation of true CA’s and HYF. Once we get would mean you also have your fine-tuned parameters, as well as improved waveforms with respect H or quasi, no flat top, an so on.
3- Expectations: we end up having your fine-tuned EPAPmin within some 15/20 days.

Much of this thread is about using EERS to reduce CAs. But I don't see you addressing that at all.

It seems to me if he has continued CAs even with controlled leaks, then perhaps he needs more deadspace on the EERS.

Also, per my post on a another thread, it seems EERS is highly leak-sensitive.

I would personally find a way to fix the leaks, then confirm the correct EERS volume to get low or no CAs, then worry about the rest.