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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
OleJunk
 
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Total Time in Apnea (TTIA)

Postby OleJunk on Thu Apr 20, 2017 11:42 am

Hi Guys 8) first post!

A request and then a big assumption: Everyone! Please list what you've done to reduce your Total Time in Apnea (TTIA)?

I am willing to bet:
The real reason Apnea is bad is not mainly because it interrupts sleep. It is bad because of starving the brain and body of oxygen.

If that's wrong I'll go back to trying to reduce AHI.

To me, the AHI isn't that useful by its self - it doesn't tell you how severe the interruptions were except if it's a CA, OH, H. :?
For example:
Sleep period: 7hrs
Total no. of events (OH): 2
AHI: 2/7 = 0.23%
Event 1 duration: 00:14
Event 2 duration: 35:07

In the above example, the person would not have survived the night but would have an AHI of 0.23% :?:

So to start I'd like to state some of my thoughts about ways to reduce TTIA.

1.Exercise (Not sure which is the best but swimming seems quite good) Also yoga if I can work up to it!

2.Breathing Exercises (looking into work by the iceman Wim Hof or pranic breathing techniques like Tummo)

3.Make the CPAP machine work as best it can (get decent masks, change filters regularly etc...)

I hope you enjoy the long post! Thanks

Also, it might be controversial but how do people feel about posting something like body mass index (BMI) or weight and body fat %?
It might be helpful to people to know how similar they are for their advice.

For example, I'm odd in that with a BMI of 22, weight of 85Kg and body fat ~~10%. Still have an untreated apnea of 35.2 / hour.
Some advice may be appropriate to me but not to other people...

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LSAT
 
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Re: Total Time in Apnea (TTIA)

Postby LSAT on Thu Apr 20, 2017 12:01 pm

OleJunk wrote:Hi Guys 8) first post!

A request and then a big assumption: Everyone! Please list what you've done to reduce your Total Time in Apnea (TTIA)?

I am willing to bet:
The real reason Apnea is bad is not mainly because it interrupts sleep. It is bad because of starving the brain and body of oxygen.

If that's wrong I'll go back to trying to reduce AHI.

To me, the AHI isn't that useful by its self - it doesn't tell you how severe the interruptions were except if it's a CA, OH, H. :?
For example:
Sleep period: 7hrs
Total no. of events (OH): 2
AHI: 2/7 = 0.23%
Event 1 duration: 00:14
Event 2 duration: 35:07

In the above example, the person would not have survived the night but would have an AHI of 0.23% :?:

So to start I'd like to state some of my thoughts about ways to reduce TTIA.

1.Exercise (Not sure which is the best but swimming seems quite good) Also yoga if I can work up to it!

2.Breathing Exercises (looking into work by the iceman Wim Hof or pranic breathing techniques like Tummo)

3.Make the CPAP machine work as best it can (get decent masks, change filters regularly etc...)

I hope you enjoy the long post! Thanks

Also, it might be controversial but how do people feel about posting something like body mass index (BMI) or weight and body fat %?
It might be helpful to people to know how similar they are for their advice.

For example, I'm odd in that with a BMI of 22, weight of 85Kg and body fat ~~10%. Still have an untreated apnea of 35.2 / hour.
Some advice may be appropriate to me but not to other people...


I don't recall ever seeing anyone that had an apnea (stopped breathing) for 35 minutes. :roll: :roll:
My average night is AHI 1.5-2.5.....If I have 15 events at an average of 15 seconds each, that's TTIA of 4 minutes in a night when I slept 7 hours. You don't know what you are talking about :!:

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Last edited by LSAT on Thu Apr 20, 2017 1:07 pm, edited 1 time in total.


[color=#0000BF]S9 Autoset
Back up mask is another Quattro FF and an F20
Buckwheat Hull Pillow (CPAPfit) from http://www.pur-sleep.com/

xxyzx thinks he knows everything....that's why he attempts to answer every post......beware his answers.

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Goofproof
 
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Re: Total Time in Apnea (TTIA)

Postby Goofproof on Thu Apr 20, 2017 1:01 pm

I do one thing, I use my XPAP, everytime I sleep, I monitor my data and adjust the XPAP to give me the best numbers it can. Everything else takes care of it'self! Jim

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OleJunk
 
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Re: Total Time in Apnea (TTIA)

Postby OleJunk on Thu Apr 20, 2017 1:27 pm

I don't recall ever seeing anyone that had an apnea (stopped breathing) for 35 minutes. :roll: :roll:
My average night is AHI 1.5-2.5.....If I have 15 events at an average of 15 seconds each, that's TTIA of 4 minutes in a night when I slept 7 hours. You don't know what you are talking about :!:


Perhaps I don't :)

I'm sure you wouldn't! - they'd be dead :wink:

You're right though - in your example the maximum individual length of time a person could be in apnea is 100s or 00:01:40

still quite a bit of brain starvation during sleep but not quite as wacky as my wacky example was

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palerider
 
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Re: Total Time in Apnea (TTIA)

Postby palerider on Thu Apr 20, 2017 1:57 pm

OleJunk wrote:I am willing to bet:
The real reason Apnea is bad is not mainly because it interrupts sleep. It is bad because of starving the brain and body of oxygen.

no, it's both.

OleJunk wrote:If that's wrong I'll go back to trying to reduce AHI.

which will also reduce your TTIA.

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OleJunk
 
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Re: Total Time in Apnea (TTIA)

Postby OleJunk on Thu Apr 20, 2017 2:16 pm

palerider wrote:
OleJunk wrote:I am willing to bet:
The real reason Apnea is bad is not mainly because it interrupts sleep. It is bad because of starving the brain and body of oxygen.

no, it's both.

OleJunk wrote:If that's wrong I'll go back to trying to reduce AHI.

which will also reduce your TTIA.



Ok! I guess with a normal distribution then it's likely there won't be extended lengths of interruption - I feel damage directly related to respiratory deficiency will go up with time (sleep interruption wouldn't).

AHI isn't related to TTIA except that you have a minimum period in adults of 10s before an AHI event is considered.
That means that assuming most of your events are close to 10s in duration your TTIA will go up in relation to the AHI.
If they aren't however, then AHI doesn't tell you much - it doesn't give you any shape to your data.

I feel TTIA is the most important measure I can find since first opening my data with SleepyHead a few days ago. Ideally it'd tell me the standard deviation of the measurements but perhaps thats asking too much :)

Going to buy an oximeter to run in parallel for a bit - these machines don't go far enough to be sure you're safe if my understanding holds water

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palerider
 
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Re: Total Time in Apnea (TTIA)

Postby palerider on Thu Apr 20, 2017 2:28 pm

OleJunk wrote: these machines don't go far enough to be sure you're safe if my understanding holds water

you're new, you'll learn.

some people have minimal desaturation, but still suffer greatly the effects of apnea, because not being able to sleep is debilitating.

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Bill44133
 
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Re: Total Time in Apnea (TTIA)

Postby Bill44133 on Thu Apr 20, 2017 2:34 pm

Welcome to forum...

Take 15 minutes and review this youtube video it will help you understand what is going on.
https://www.youtube.com/watch?v=-gie2dhqP2c

This video put the whole thing in perspective for me.

It should be required viewing for any one who is new. You can show it to your family and friends so they will understand and can be supportive of you.


I wish you well... :)

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Wbferrara
 
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Re: Total Time in Apnea (TTIA)

Postby Wbferrara on Thu Apr 20, 2017 3:09 pm

Another consideration is that an apneic episode represents a stress to the body, and the repetitive release of stress related hormones can have cumulative effects to the heart, raise blood pressure, affect glucose tolerance and insulin resistance etc. The insurance companies realize that preventing these chronic complications is to their advantage. I doubt there has ever been a claim for someone who died because of nocturnal asphyxia.

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LoBattery
 
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Re: Total Time in Apnea (TTIA)

Postby LoBattery on Fri Apr 21, 2017 9:10 am

I don't think the question was really answered. I don't see why total time isn't as good a marker as AHI for the kind of sleep you had that night. While it doesn't tell you how to correct the issue, it is a pretty good marker and I don't see why it isn't talked about more.
Seeing and believing are often both wrong. FOW

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LSAT
 
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Re: Total Time in Apnea (TTIA)

Postby LSAT on Fri Apr 21, 2017 10:03 am

LoBattery wrote:I don't think the question was really answered. I don't see why total time isn't as good a marker as AHI for the kind of sleep you had that night. While it doesn't tell you how to correct the issue, it is a pretty good marker and I don't see why it isn't talked about more.


I think it's a meaningless figure....I would guess that in 99% of Obstructive SA users , the TTIA will be less than 5 minutes in a 7-8 hour night which is about 1% of the time. (You should not include CA's ).

_________________
Mask: Mirage Quattro™ Full Face CPAP Mask with Headgear
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: S9 Autoset...APAP Settings 11-15


[color=#0000BF]S9 Autoset
Back up mask is another Quattro FF and an F20
Buckwheat Hull Pillow (CPAPfit) from http://www.pur-sleep.com/

xxyzx thinks he knows everything....that's why he attempts to answer every post......beware his answers.

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LoBattery
 
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Re: Total Time in Apnea (TTIA)

Postby LoBattery on Fri Apr 21, 2017 10:36 am

TTIA seems to track AHI almost identically, but I never hear what peoples total time is. If there are good events than AHI is just as meaningless.
Seeing and believing are often both wrong. FOW

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Goofproof
 
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Re: Total Time in Apnea (TTIA)

Postby Goofproof on Fri Apr 21, 2017 11:59 am

Your body contains blood with O2 in it, carried by your red blood cells, as long as the pump is running your body can use that for support. The new CPR is done without the breaths, and relies of moving that blood for life support. Jim

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LoBattery
 
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Re: Total Time in Apnea (TTIA)

Postby LoBattery on Sun Apr 23, 2017 8:56 am

The OP gave an extreme example, but a week ago I woke up after 4 hours. My AHI was something like 0.7. When I got up in the morning it was 8.8. A lot happened in that 4 hours. Just how did AHI get to be prom queen? I would have thought having the highest number of events in any 60 minute period would have been more useful.
Seeing and believing are often both wrong. FOW

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robysue
 
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Re: Total Time in Apnea (TTIA)

Postby robysue on Sun Apr 23, 2017 12:37 pm

I stumbled on this article today and it has some relevance to this thread: Length of Individual Apnea Events Is Increased by Supine Position and Modulated by Severity of Obstructive Sleep Apnea published in a peer reviewed journal. (I have access to the full article on line, and I don't think I have a subscription to the site. If the link doesn't work for you, and you are really interested in reading it, pm me.)

Table 2 of the paper is kind of interesting for putting the OP's extreme (made up) example into perspective. The study involved over 500 patients and they gathered data on over 56,000 individual hypopnea events and over 36,000 individual obstructive apnea events. The longest hypopnea recorded in the study was 127.7 seconds, or a bit more than 2 minutes in length. The longest apnea was 92.5 seconds, or a bit more than 1.5 minutes in length. So the idea that someone could have a hypopnea (let alone an apnea) that lasted 35 minutes is preposterous.

Nonetheless, the OP's idea that the significance of the length of events has not been looked at very much does seem to have some validity. The authors of the above article state in the abstract:
In severe OSA, the obstruction events are longer in supine compared to nonsupine positions. Corresponding scientific information on mild and moderate OSA is lacking. We studied whether individual obstruction and desaturation event severity is increased in supine position in all OSA severity categories and whether the severity of individual events is linked to OSA severity categories.


The paper looks a a wide number of parameters, including the severity and duration of O2 desats associated with prolonged apnea events.

The authors of the paper conclude that regardless of the severity of the apnea, events that occur when sleeping on the back tend to be longer and tend to be associated with more severe O2 desaturations. Hence, it could be that what the OP can proactively do to minimize "total time in apnea" is to minimize supine sleep along with minimizing his treated AHI.

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