New and Better ASV Results

[sleepinglass]

JDS interesting, thank you for the explanation, I will look at the wave forms.

My sleep physician is most definitively of the opinion that I do not need an ASV, as he is only looking for centrals, which I have sporadically and very few in number, fortunately.

On the PR S1 ASV my AHI is always well below 5, it that due to me or the ASV working in the background?

I have no idea what my AHI would be without treatment, as I have been on Xpap for sooooo long.

I wonder if I could do an EXPERIMENT to see what my AHI would be without treatment!

I am sure one night could not hurt, as fortunately I have no serious underlying medical conditions and seeing as I do not 'technically', according to my doc , need the ASV anyway, it could be extremely informative.
Even if it is just to prove him right, then I could donate my machine to someone who REALLY and TRULY needs it!

Question is, how to do it??? Can the ASV be turned off?? I would guess not. Any ideas?

[Jay Aitchsee]

Have you asked your doc if you can use your home machine during the study as you will not be looking for SDB stuff but PLMD stuff only. My doc thinks that to be a good idea.

I haven't asked yet, but I plan to. It does make sense. At the very least, I can use my own mask and pressure settings.

[Sir NoddinOff]

Regarding the PLMD issue: I've only rarely noticed bad leg movements at night, plus I've never really experienced leg movement in any of my sleep studies, however sometimes after benzo usage, I will wake up with my legs or even hips jerking around. In the past I've come to realize that it was related in my case to too much benzo usage and <surprise> even valerian root extract usage. On the other hand, NOT so much with Z-Meds like Ambien, a different class of drug. By severely restricting those GABA receptor hooking drugs like Xanax, this year I've been able to keep the legs jerks etc to near zero. I'm not sure how other pain drugs like opioids affect PLMD, having no experience with them. Same with Pramipexole, tho I understand it's helpful in Parkinson's and supposedly with RLS.

Other things that seem to help reduce PLMD for me are exercise of the lower body, eg. cycling or walking, depending on your tolerance for exercise, of course. Cycling can be especially good because it can be low impact on the knees,if one's bike is set up correctly. Also effective for me are potassium/magnesium supplements (taken in safe doses) to help suppress cramps in the large muscle groups (especially after exercise). Also I've recently added one cap of SeriPhos (a Phosphorus non-citrate supplement) at bedtime which is supposed to help calm the adrenal glands and reduce cortosol in the bloodstream. The jury is still out on the SeriPhos, but my nighttime mind/body racing seems to have been reduced as my system gets used to it.
Here's an interesting clip from WikiPedia and something I didn't know until now:
PLMD should not be confused with restless leg syndrome (RLS). RLS occurs while awake as well as when asleep, and when awake, there is a voluntary response to an uncomfortable feeling in the legs. PLMD on the other hand is involuntary, and the patient is often unaware of these movements altogether.

[JDS74]

Well, it looks as if the effects of the knee injection has worn off. My AHI has jumped to 11.8 with most of those being hypopneas. Bummer.

Maybe in the fall with arthroscopic surgery to repair the damage in my knee progress can resume
Anyway, hanging in there with still elevated Tidal Volume and night time SpO2 up from 92% to over 94% so that is good news.

[icipher]

Very happy to see you're having success with this. You numbers provided in your original post look great.

One thing i am not very knowledgeable about is Tidal Volume. you seem to be pleased that yours has risen. is there a target zone to be in?

[JDS74]

The simple answer is I don't know.
50 years ago my tidal volume was over 1,000 mL which my doctor remarked as being unusual at the time.
Since then it has dropped and has been more in line with age related declines in the general population.
But, I think, (my theory) that it should be above the norms for the general population since it started out that way.

Back when I was young and more foolish, I did an experiment to see how long I could go without breathing.
I quit at five and a half minutes because I feared I might pass out and just not breathe. Didn't feel any urgency at the time, just decided to start breathing. The world's record at the time was just over eleven minutes (without dying ).

[sleepinglass]

Great that your SPo2 levels have risen.
What do you use to measure your oxygen saturation levels and how often do you measure them?

[JDS74]

I use the original CMS50F pulse oximeter.
It is a finger sensor unit with a soft finger tip connected to a wrist device.
I'm a little sporadic in measurement although I've been measuring daily for a little over a week.
I just got curious with the increase in average tidal volume (Vt) recently and wanted to see if there was an measurable difference and there was.

The newer model is not yet compatible with SleepyHead but the early one is.

When using any home pulse-oximeter a couple of cautions should be considered.
1) the data collection rate and responsiveness will be less than and slower than a medical grade unit. That's the difference between $100 for the home unit and $400-$500 for a medical grade unit.
2) even though they are FDA approved, sometimes the sensor is a little too sensitive and creates artifacts in the data. You can see this in sudden spikes or drops in the data. Not all are artifacts though so a detailed examination of the data is required to tell the difference. The software creates a .CSV file which can be read as a text file or imported into Excel.

In my data I see sudden changes in heart rate where my sleeping heart rate jumps from roughly 60 bpm to above 100 in just a few seconds. It looks like a motion artifact but in reality is a result of a sporadic and very short-lived medical condition I get about 25 times a day (yeah, that's a bummer too since it wakes me up suddenly at the same time).

Last night I slept for six hours and had five wake ups because of this.

Even so, things are getting better.
Thanks everybody for the encouragement and support.