Semi OT - Insp.-Exp. Ratio

[JDS74]

Since my ratio is inverse of normal, I.e., my expiration time is shorter than inspiration time, I did a search to see what that might mean. Mine is about 2:1 instead of the "normal" 1:2. Curious.

Found this site:
http://rtboardreview.com/public/tables_ ... meters.htm

What was especially interesting to me was:

In normal individuals, the I:E ratio ranges from 1:2 to 1:3 (expiration being about two to three times longer than inspiration). In patients with expiratory airflow obstruction (e.g., COPD patients), the expiratory time is typically prolonged. This results in lower I:E ratios, such as 1:4 or 1:5. A prolonged expiratory time and low I:E ratio is a cardinal sign of expiratory airflow obstruction.

The information discussed is related to ventilation and not CPAP stuff, but it is interesting all the same.

[RubySnooze]

JDS74, thanks for posting this.

I'm not so sure it's OT. OSAHell recently wrote that his ratio was reversed, too, but after switching from APAP to ASV, his expiration time became longer than his inspiration time. I'm currently on APAP (doesn't appear to be working very well) and mine is reversed, too.

Are your apneas/hypopneas currently well controlled?

Possibly you are onto something.

[JDS74]

Hypopneas not so much. Obstructives almost always zero, centrals mostly below 2.

My numbers are worse than when I was using a PR Auto BiPap but I do feel better during the day. i I have an undiagnosed condition that wakes me up at 45-60 minute intervals. Been lots of places looking for a solution. I suspect that's the source of the hypopneas.

My various docs and I are playing lab rat (that's me playing the part of the rat) and trying different meds to see if we can find some help. No joy so far so I keep on with keeping on.

[M'ohms]

JDS,

I'm reading your posts with great interest. As you know, I am in the same boat as you, including the frequent awakenings. Pursuing the low SpO2 thing, I went to my cardiologist who dx'd me with exercise-induced hypertension and exercise-induced arrhythmia. My heart, it turns out, is fine, so the mystery deepens... I'm almost afraid to become a lab rat. Who knows what else they'll tell me. You are braver than me.

Keep us informed with your progress--we care about you!

[JDS74]

M'ohms,

I've been hunting this particular one for 11 years now.
The search found prostate cancer, hypothyroidism, severe complex sleep apnea, and, ta da!, the real winner, acromegaly.
But the original problem still exists. I've found solutions for all of these incidentally found conditions.

Its not so brave to keep trying to find the underlying condition that totally fragments my sleep. Lack of real restorative sleep is a really bad thing.

My doctors and I no longer have the traditional doctor-patient relationship. It is much more like colleagues researching an interesting condition. When a new med is proposed, its finally up to me as to how much and how long. Then I report back on the results of the experiment. Some have gotten to the end of their expertise, others struggle on with me.
I love them all.

[M'ohms]

Fascinating--especially the acromegaly! You have the ideal relationship with your doctors. I wish I could say that. The newest road that my cardiologist wants me to take is a tilt table test to find out why I am chronically dizzy. Since my heart checks out, I don't think I need to do this test (it looks for circulatory reasons for the dizziness). So I'm still up in the air, so to speak.

This morning, I decided to check my SH reports with an eye towards the I:E ratio. Seems like this is another area we have in common. My inspiration time is about twice my expiration time also. Thanks for looking at this. I don't see my doctor until October, but will look into this as well.

Keep in touch!

[JDS74]

What is the nature of your dizziness? All the time? Does the room seem to be spinning?
Inner ear issues can cause this. Have your doctors evaluated this as an inner ear problem?

Or is it like just before fainting? Sudden drops in blood pressure or even moderate drops can cause the sensation of being dizzy.

What does your doctor say about the condition the test will discover, if present?

When I was up at Mayo's, the doctor ordered this test which was negative for me.
This is what Mayo Clinic says about this test:
Mayo Tilt Table Test

[M'ohms]

Thanks for the link. My dizziness (room spinning, so actually vertigo) comes on with no rhyme or reason, almost daily. In the office, the cardiologist checked my BP while standing, sitting, laying down and suddenly standing. There was no change in BP, which I feel would be the result with the tilt table test. I do have a "clicking" in my head for the last several weeks that wakes me up at night, which seems like fluid in my eusthacian tube. This seems like the likely suspect for my dizziness. After my exercise-induced stuff is settled with the cardiologist, I am supposed to return to my primary, so I will pursue this at that time.

[JDS74]

That really sounds like an inner ear problem. Have you seen and ENT doctor to get that checked?

The description of the maneuvers in the cardiologists office pretty much cover what the tilt table would do and if the results were negative, time to move one. Clicking could be an obstruction in the Eustachian tube clearing and then re-obstructing. Does this happen when you mask up and pressure is added to your system? Some people experience that clicking sound on airplanes as they ascend or descend and the air pressure changes. In some cases, they feel pain as a result that can be alleviated by yawning or nose blowing.

[M'ohms]

At night, every sound is amplified so I am more aware of the clicking then. Turning on my machine has no effect on the clicking; rather I tend to notice it beginning around 2:00 in the morning. At first, I thought that my humidity was too high, so I turned the humidifier down. Within a half hour, the sound returned, so I turned the humidifier back to the original setting. It took me several nights to realize that the humidity wasn't causing the clicking. I don't have any pressure pain associated with it.

I have also noticed the clicking during the daytime on several occasions. I spoke with my nurse advocate this afternoon, and she suggested taking an OTC allergy pill daily for several days. If it is fluid in the eusthacian tube, the pill should dry it up and the dizziness go away. I will give this a try before going to my ENT. I've seen enough doctors this month!

[JDS74]

Does she mean a decongestant? They have a tendency to dry things up and may help. Fluid in the inner ear can sometimes cause these kinds of symptoms.

[M'ohms]

Yes, she suggested Claritin or Zyrtec.

[OSAHell]

Hi JDS74,

Thanks for sharing, sadly the link doesn't seem to work anymore (I get a 404 Not Found error since I first try it a couple fo days ago)...

I also had reverse ratio ( about 2:1) but on APAP, on CPAP (fixed pressure) it was close to 1:1 and on ASV it's really close to 1:2. I've tried to look into it when I noticed it in Sleepyhead but had hard time finding infos on that at the time. And since I started feeling better after a couple of weeks on ASV, I put my focus on others more obvious problems.

[JDS74]

Hi JDS74,

Thanks for sharing, sadly the link doesn't seem to work anymore (I get a 404 Not Found error since I first try it a couple fo days ago)...

I also had reverse ratio ( about 2:1) but on APAP, on CPAP (fixed pressure) it was close to 1:1 and on ASV it's really close to 1:2. I've tried to look into it when I noticed it in Sleepyhead but had hard time finding infos on that at the time. And since I started feeling better after a couple of weeks on ASV, I put my focus on others more obvious problems.

What link are you referring to? Is it the time parameter link?
All the links to RTBoardreview pages seem to be missing. Perhaps the site is off line just now.

[OSAHell]

Yes, it was the "time parameter" link in your first post. When I go to http://rtboardreview.com/public/ it's look like there is no more "tables_lists" folder anymore... Maybe they moved it to the private (or paid) section of there site.