.

[SleepingUgly]

Uggy- WHAT?!?! I thought those pain pill posts you made to me were special. I thought we had a thing going on here. Little did I know that I was just your plaything while you were trooped up on pain killers.

Those were the days... Gatorade slushies, crushed narcotics, and hope. Now all I've got is CPAP blues.

[Jaylee]

Uggy you need to be a Special Snowflake like me. If you were a Special Snowflake, you would not have any CPap problems. You would sleep soundly and Cloudy would flirt with you.

[SleepingUgly]

Uggy you need to be a Special Snowflake like me. If you were a Special Snowflake, you would not have any CPap problems. You would sleep soundly and Cloudy would flirt with you.

Look, if I could get MUFFY to flirt with ME, I can get Cloudy to flirt with me. (Flirt, Cloudy, flirt)

[NotMuffy]

How about a Function Asterisk (f*)?

or f***?

No thanks, I'm good for a couple weeks.

Muffy, are you flirting with me??!

WHAT???!!

NO WAY!!!

When you said "(How about a) f***"?" I thought you meant a "f***", not a "f***".

Besides, muffins don't f***, anyway.

[NotMuffy]

BTW, do you realize that in terms of Replies, out of about 53,600 Topics, this is the 25th Most Popular of all time?

Should it be referred to as "The Dot" or just "."?

[NotMuffy]

As it was suggested in ".", the approach to Flow Limitation may not be as clear-cut as we like.

Perhaps we should submit the following questions to the already completed presentation by Dr. Park:

• Should there be a "Zero Tolerance" to FLs?
• Is "Expiratory Intolerance" (as evidenced by its sudden disappearance) a simple lack of understanding of waveforms?
• Is ASV an acceptable mode to treat FLs, or another misunderstanding of the mechanics of flows?

[ozij]

Do "NotMuffins" have new grandchildren?

Because I remember one of the Not Muffin famiy's progenitors (or is it predecessors?) who had a very new very sweet baby grandchild in his signature line a while.

Looks like time for congratulations!

O.

[OutaSync]

A new baby?!!!! Who is it, NotMuffy?

[Rebecca R]

As it was suggested in ".", the approach to Flow Limitation may not be as clear-cut as we like.

Perhaps we should submit the following questions to the already completed presentation by Dr. Park:

• Should there be a "Zero Tolerance" to FLs?
• Is "Expiratory Intolerance" (as evidenced by its sudden disappearance) a simple lack of understanding of waveforms?
• Is ASV an acceptable mode to treat FLs, or another misunderstanding of the mechanics of flows?

NM I don't want to lose the opportunity to learn from this thread. Please forgive me if my questions were already discussed and I missed them.

• Am I correct in assuming that if the software filter is set incorrectly pre-sleep study, that FLs cannot be viewed post-sleep study?
• In your opinion can the FLs on a sleep study be compared to the FLs on the S9 or are they apples and oranges?
• How much of a FL is significant enough to worry about?
• What is Expiratory Intolerance?
• Is there a way to try to treat FLs on our own without ASV? Dial wingin'?

Thanks,


r

[SleepingUgly]

Great questions that I'm also interested in, Rebecca! They dovetail with some of the questions I was asking about FLs here:

viewtopic/p565423/Ask-Dr-Park-Top-10-Qu ... ml#p565394

[NotMuffy]

Looks like time for congratulations!

Thanks very much, o.!

[NotMuffy]

A new baby?!!!! Who is it, NotMuffy?

MiniMuffy, of course!

[SleepingUgly]

Awwww, sweet!

[NotMuffy]

Am I correct in assuming that if the software filter is set incorrectly pre-sleep study, that FLs cannot be viewed post-sleep study?

No. As long as the hardware filters are set correctly, software filter-wingin' can occur any time, as much as you want, either during collection or analysis.

In your opinion can the FLs on a sleep study be compared to the FLs on the S9 or are they apples and oranges?

The company line for FLs would be that they would have to qualify as a RERA, and that can't technically be done with the S9 (although it can frequently be inferred).

How much of a FL is significant enough to worry about?

One that would cause an arousal.

That said, plenty of folks consider "primary" snoring nearly as much of a health risk as OSA:

A study published in the March (2008) issue of the journal Sleep found that loud snorers had a 40 percent greater risk than nonsnorers of suffering from high blood pressure, 34 percent greater odds of having a heart attack and a 67 percent greater chance of having a stroke.

What is Expiratory Intolerance?

A theory proposed by Barry Krakow (soundly disproved by SAG) that "bumps" on the expiratory limb of a waveform were diagnostic of unstable airway and clinically relevant.

Is there a way to try to treat FLs on our own without ASV? Dial wingin'?

I know of no objective data that shows that ASV can successfully treat FLs.

I would also argue that it would not offer any advantage over conventional therapy. You'd have to generate a fairly significant FL for the ASV to decide to attack it. Why wait for the event to begin and hope you could attack it in time?

Most important, have to figure out if the FLs were fixed or flow- or pressure-responsive (I mean, if the FLs were due to narrow nasal passages, it might be quite difficult to put a dent in them). In the classic Mountainwoman Thread (copied from TAS):

viewtopic.php?f=1&t=26896&p=242587&hili ... an#p242587

The GK420E's bad habit of "pressure runaways" was usually due to an attack of fixed flow limitations by their IFL1 option.

[SleepingUgly]

Can I jump into this FL discussion?

The company line for FLs would be that they would have to qualify as a RERA, and that can't technically be done with the S9 (although it can frequently be inferred).

When you say the company line for FLs would be that they would have to qualify as a RERA, do you mean to be scored toward RDI?

IS a RERA a FL with associated arousal?

Is there a way to try to treat FLs on our own without ASV? Dial wingin'?

I know of no objective data that shows that ASV can successfully treat FLs.

I would also argue that it would not offer any advantage over conventional therapy. You'd have to generate a fairly significant FL for the ASV to decide to attack it. Why wait for the event to begin and hope you could attack it in time?

This relates to what I posted on the current Dr. Park thread:

Can someone who listened to the teleseminar explain this slide:

Can CPAP convert OSA to UARS?
– CPAP controls apneas, hypopneas, snoring
– But NOT RERAs, IFL
– Spontaneous arousals?
– Can have OSA and UARS
– Most common reason for persistent fatigue despite optimal CPAP use

Did he say that CPAP can convert OSA to UARS? And why is he saying that CPAP does not control RERAs or FLs? In theory if you crank the pressure up enough, you should be able to eliminate FLs, no?

Can you speak to any of this?

Most important, have to figure out if the FLs were fixed or flow- or pressure-responsive (I mean, if the FLs were due to narrow nasal passages, it might be quite difficult to put a dent in them).

How do we figure that out?