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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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TASmart
 
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Re: sleep vs wake breathing and effect of hypops ? question

Postby TASmart on Sat Nov 11, 2017 9:17 pm

Because when the body senses difficulty in breathing the brain changes to a lighter or non-sleep state. Also, memory consolidation occurs mainly in the deeper sleep states. Since most rejuvenation of the brain occurs during stage 3/4 and REM sleep. being constantly roused from those deeper states to lesser states prevents the brain from fully rejuvenating and consolidating memory.

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Re: sleep vs wake breathing and effect of hypops ? question

Postby zoocrewphoto on Sat Nov 11, 2017 10:10 pm

xxyzx wrote:
TASmart wrote:Because when the body senses difficulty in breathing the brain changes to a lighter or non-sleep state. Also, memory consolidation occurs mainly in the deeper sleep states. Since most rejuvenation of the brain occurs during stage 3/4 and REM sleep. being constantly roused from those deeper states to lesser states prevents the brain from fully rejuvenating and consolidating memory.

=======

does it really sense any difficulty on short hypops ?
how is that worse than congestion when
body breathes normally
just increases RR or Vt to get the right spo2 levels



Have you ever had a child? Did you sleep lightly when you were afraid they were sick? Have a spouse who was ill, and you slept lightly to keep an eye on them? Ever have a scare in the middle of the night, and you have trouble getting back to sleep? Ever know that you are going to have a bad night of sleep, so you you stay up later, avoiding that sleep?

The brain KNOWS that there is a problem breathing. Even if it doesn't sense each event instantly, it is aware of the history and the NEED to sleep lightly to prevent such events from happening. It is a matter of self preservation. If deep sleep is dangerous, the brain will try to prevent it.

As a child, I was a deep sleeper. I could sleep though thunder storms. I never heard the tree that fell during a storm. I could sleep through alarm clocks. As an adult with sleep apnea, I became a light sleeper. My brain preventing me from long events. Now, I can't even sleep through a mild hiss from my mask. I maintain an almost zero leak line because any hiss wakes me up, and I must fix it.



You may think we can't do this in our sleep, but the brain is very smart and still thinking as we sleep. The night after my sleep study (split night with AWESOME titration), I had a dream that I had to wait 6 months to get a cpap machine, and I was angry. I wanted it now. My brain, while asleep, KNEW that the cpap machine in titration was WHY I had a great night of sleep. And it wanted it AGAIN.

Many people, when they start cpap therapy, find that they sleep deeper after successful therapy, and some of them need to make adjustments because they need more pressure when actually sleeping deeply. They also tend to feel worse than pre-cpap if they skip a night. Why? Because they stopped being hyper vigilant while sleeping. Their defense mechanisms that they built up over the years had relaxed, trusting the machine to take care of the problem.

Without a cpap machine, I was averaging at least one event per minute, ALL night long. Probably closer to two, if we had done a full night diagnosis. That's a lot of stress, all night long. No restful sleep.

Take a look at my graphs from my sleep study. You can see that I never dropped into deep sleep or REM without cpap. Then, with cpap, I have pretty decent sleep cycles. Also, take a look at my oxygen saturation. My events during the titration were 127 hypopneas and 71 apneas (0 centrals). Almost double the hypopneas yet my oxygen desats are fairly consistent.

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Re: sleep vs wake breathing and effect of hypops ? question

Postby TASmart on Sat Nov 11, 2017 10:14 pm

xxyzx wrote:
TASmart wrote:Because when the body senses difficulty in breathing the brain changes to a lighter or non-sleep state. Also, memory consolidation occurs mainly in the deeper sleep states. Since most rejuvenation of the brain occurs during stage 3/4 and REM sleep. being constantly roused from those deeper states to lesser states prevents the brain from fully rejuvenating and consolidating memory.

=======

does it really sense any difficulty on short hypops ?
how is that worse than congestion when
body breathes normally
just increases RR or Vt to get the right spo2 levels


You are making an assumption that sleep stages and transitions and arousals are totally driven by blood CO2 ( which is really what the body uses for normal breathing, not O2 levels). But there are other factors that cause sleep arousals, and having restricted breathing is one of them.

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Re: sleep vs wake breathing and effect of hypops ? question

Postby Pugsy on Sun Nov 12, 2017 10:56 am

xxyzx wrote:didnt AASM just add desats to the definition of hypop to account for that being necessary to be included in AHI


No they didn't "just add" the desats to the definition of hyponea....it's been there for at least as long as I have been on cpap.

xxyzx wrote:hypops alone are not a problem unless they cause desats


Again you spout this and it simply isn't true. There are other issues besides desats that impact sleep quality and how we feel or don't feel.
Just because you think that desats is the end all judge and jury for something being important or not doesn't make it so.

I would ask you to cite your references besides "some doctors" or 3rd party hearsay but I know that won't happen so I won't bother.
I may have to RISE but I refuse to SHINE.

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Re: sleep vs wake breathing and effect of hypops ? question

Postby Pugsy on Sun Nov 12, 2017 10:57 am

xxyzx wrote:no answers that would contradict what i am saying here


Doesn't mean that you are right. Just means someone didn't want to waste their time trying to understand the gibberish you wrote and respond because it wasn't worth the effort.
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Re: sleep vs wake breathing and effect of hypops ? question

Postby cliffspab on Sun Nov 12, 2017 10:58 am

Not sure if anyone told you yet, but Redmed misreports all hypopneas as 10 seconds on Sleepyhead. It's a bug, and they're probably longer.

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Re: sleep vs wake breathing and effect of hypops ? question

Postby jsielke on Sun Nov 12, 2017 11:34 am

Pugsy wrote:
xxyzx wrote:didnt AASM just add desats to the definition of hypop to account for that being necessary to be included in AHI


No they didn't "just add" the desats to the definition of hyponea....it's been there for at least as long as I have been on cpap.

xxyzx wrote:hypops alone are not a problem unless they cause desats


Again you spout this and it simply isn't true. There are other issues besides desats that impact sleep quality and how we feel or don't feel.
Just because you think that desats is the end all judge and jury for something being important or not doesn't make it so.

I would ask you to cite your references besides "some doctors" or 3rd party hearsay but I know that won't happen so I won't bother.


Another case for banning this idiot. Someone who doesn't know any better take him seriously. I know "moderation" brings screams of "abridging individual rights, etc , but really, this clown has gone from being the village idiot, to a serious threat.

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Re: sleep vs wake breathing and effect of hypops ? question

Postby Lucyhere on Sun Nov 12, 2017 1:04 pm

.
[quote="xxyzx"]the only idiot is you[quote]


Sure, so many members are wrong; only you are 'right'!

You must have mirrors all around your house. Keep looking in them. :roll:
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Re: sleep vs wake breathing and effect of hypops ? question

Postby Jay Aitchsee on Sun Nov 12, 2017 3:19 pm

xxyzx wrote:The brain only knows there is a problem breathing when there actually IS a problem breathing

over a wide range the body automatically adjusts for congestion or other blockage by increasing RR and then Vt

mere hypops without desats would not disturb sleep
and yes all those other things the brain can be aware of and will disturb sleep or wake you up

didnt AASM just add desats to the definition of hypop to account for that being necessary to be included in AHI
hypops alone are not a problem unless they cause desats


As pointed out in one of your other threads, the AASM doesn't require a desat to score an hypopnea. A 30% reduction accompanied by an arousal will also qualify, "There is a ≥3% oxygen desaturation from pre-event baseline and/or the event is associated with an arousal", emphasis added.
And isn't an hypopnea with an arousal a special case of RERA, of which you are fond of mentioning in your discussions of the importance of RDI?
I would think an arousal, with or without a desat, might qualify as a sleep disturbance. Certainly it represents a change is sleep stage.

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Re: sleep vs wake breathing and effect of hypops ? question

Postby TASmart on Sun Nov 12, 2017 7:12 pm

No I did not ost that desaturations are required. In fact, I posted the latest iteration which said that it was either or.

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Re: sleep vs wake breathing and effect of hypops ? question

Postby TedVPAP on Sun Nov 12, 2017 11:27 pm

xxyzx wrote:
TASmart wrote:Because when the body senses difficulty in breathing the brain changes to a lighter or non-sleep state. Also, memory consolidation occurs mainly in the deeper sleep states. Since most rejuvenation of the brain occurs during stage 3/4 and REM sleep. being constantly roused from those deeper states to lesser states prevents the brain from fully rejuvenating and consolidating memory.

=======

does it really sense any difficulty on short hypops ?
how is that worse than congestion when
body breathes normally
just increases RR or Vt to get the right spo2 levels


Based on this logic, a person with a cold will sleep just as well - which of course we know is not true.

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Re: sleep vs wake breathing and effect of hypops ? question

Postby zoocrewphoto on Mon Nov 13, 2017 1:57 am

xxyzx wrote:you need to cite your sources for that illogical belief that non desat hypops are causing disturbances



Why would anybody need to cite their sources when you never do? You won't prove a source when we ask you. You have never given us ANY reason to believe you are credible. You are just another anonymous person on the internet. You can claim all you want about how smart you or, or your job, or your education, but without a real name or proof, nobody has any reason to believe that any of it is true.

You won't even post data from your machine. We don't even know if you actually have a machine, or if this is all talk.

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Who would have thought it would be this challenging to sleep and breathe at the same time?

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Re: sleep vs wake breathing and effect of hypops ? question

Postby Guest on Mon Nov 13, 2017 3:28 am

xxyzx wrote:
cliffspab wrote:Not sure if anyone told you yet, but Redmed misreports all hypopneas as 10 seconds on Sleepyhead. It's a bug, and they're probably longer.

=======

False

i have seen resmed hypops that were listed as longer
last report had one at 18 seconds but most were ten

the problem is that the 10 second ones do not seem to be hypops at all
as there is no confirmation on any of the graphs to indicate that happened


That is really interesting. Where does this 18 second long hypopnea come from? ResScan or SH?

My understanding so far, which is purely based on the AirSense 10 series, is: ResMed does not give a length at all for hypopneas or RERAs - it is just a flag without any time attached to it. As the S9 seems to report for hypopneas the length over 10 seconds, SH adds automatically 10 seconds for every hypopnea.
If you look at the very same data in ResScan there is no length for hypopneas and RERAs.

If you really had a hypopnea (I am NOT disputing the fact - I mean: if SH didn't got that wrong) with a value of "8" attached to it, it would be really interesting to see what ResScan makes out of it.

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Re: sleep vs wake breathing and effect of hypops ? question

Postby Jay Aitchsee on Mon Nov 13, 2017 7:50 am

Guest wrote:My understanding so far, which is purely based on the AirSense 10 series, is: ResMed does not give a length at all for hypopneas or RERAs - it is just a flag without any time attached to it. As the S9 seems to report for hypopneas the length over 10 seconds, SH adds automatically 10 seconds for every hypopnea.If you look at the very same data in ResScan there is no length for hypopneas and RERAs.


Interesting observation, Guest. I believe you are correct that ResMed and ResScan do not display duration of Hypopneas, at least not for my S9 and previous S8. SleepyHead does appear to measure and report the duration. If you hover the cursor over an event in SleepyHead, it will display the duration of the event by color shading. I don't have many hypopneas, but for those that I have the color shading seems to match the decline in flow and equals the duration as reported by SleepyHead.
SleepyHead indeed has the ability to measure these events as evidenced its ability to flag and report user defined criteria (see SH preferences), but I can't absolutely attest to its accuracy, only that it looks accurate.

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Re: sleep vs wake breathing and effect of hypops ? question

Postby Guest on Mon Nov 13, 2017 8:24 am

yes, that is true.

My point was: it does not matter, what SH makes out of it or shows - the devices (at least AirSense 10) themself simply do not report a length. At least to my current understanding.

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