Strong correlation between movements, flow rate dislocations and appearance of apneas?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Rubicon
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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by Rubicon » Wed Jan 31, 2024 4:04 am

They've scurried under the refrigerator.

Give 'em a couple more days.

That, or they realized
it's a stupid idea.
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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by Albatros » Wed Jan 31, 2024 4:24 am

Yes it is true.
Sleep apneas thanks to CPAP therapy are no longer the cause of my sleep problems.
PLM's are the cause.

My only point with my Post was to notice the link between movement and apnea. It seems that the process is as follows: the movements (turning right left/left tight, I assume) lead to strong disturbances of the Flow rate, which degenerate into apneas.

Therefore, even if it looks obvious, a good practice might be to learn getting body positions which limit the movements ?

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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by ozij » Wed Jan 31, 2024 5:07 am

Albatros wrote:
Wed Jan 31, 2024 4:24 am
Yes it is true.
Sleep apneas thanks to CPAP therapy are no longer the cause of my sleep problems.
PLM's are the cause.

My only point with my Post was to notice the link between movement and apnea. It seems that the process is as follows: the movements (turning right left/left tight, I assume) lead to strong disturbances of the Flow rate, which degenerate into apneas.

Therefore, even if it looks obvious, a good practice might be to learn getting body positions which limit the movements ?
Your sleep is disrupted by the movements, which also disrupt your breathing. I doubt you can have any volitional control of those movements - maybe a weighted blanket? I don't know.

The machine's registers "apnea" or "flow limitation" whenever your breathing is not the regular breathing of sleep. Tracking your "non-sleep" breathing is a waste of time.
Basically, you have two problems when you sleep:
Obstructive sleep apnea - which kept you from sleeping and is now being treated
Periodic Leg Movements - that are now jerking you out of sleep. The fact that they affect your breathing is meaningless - the fact they cause arousals is critical.

I can't imagine "positions" that will control the PLM's, but this could be my lack of imagination or knowledge.
Ask your physician about weighted blankets: https://curaofsweden.com/en/

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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by Rubicon » Wed Jan 31, 2024 5:08 am

Albatros wrote:Therefore, even if it looks obvious, a good practice might be to learn getting body positions which limit the movements ?
In that case, a better practice would be to use a body position app.
Albatros wrote: It seems that the process is as follows: the movements (turning right left/left tight, I assume) lead to strong disturbances of the Flow rate, which degenerate into apneas.
What you are describing is a post-arousal central apnea, which is usually quite distinguishable by simply looking at the flow rate.

Your proposal would only have potential if the devices were, for all intents and purposes, absolutely synced. One would need to know if a respiratory event causes an arousal, or is caused by arousal, and that time duration is seconds. Without that knowledge, the information noted above is obvious and redundant ("Oh look! The respiratory waveform shows body movement!" "Yes! I can confirm that with the pulse oximeter!")

If (when) the devices are integrated then accuracy can be improved.
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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by Rubicon » Wed Jan 31, 2024 5:15 am

OK I confess. The idea of an integrated system has been around forever. I thought WatchPAT might have combined with somebody and put something together using PAT. Maybe it'll still happen. Or maybe the necessity of creating such a product (read: "market") isn't there.

PLMs?

Yeah, they thought about it:
The present invention detects and distinguishes PLM and/or PLM arousals by means of comparing sub-cortical arousals inferred from blood pressure variations with cortical
arousals (EEG). Cortical arousals are used to distinguish sleep-fragmentation and neurological related arousals versus sub-cortical arousals which generally include both sleep fragmentation and neurological related arousals and PLM-related arousals.
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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by ozij » Wed Jan 31, 2024 6:17 am

Rubicon wrote:
Wed Jan 31, 2024 5:15 am
OK I confess. The idea of an integrated system has been around forever. I thought WatchPAT might have combined with somebody and put something together using PAT. Maybe it'll still happen. Or maybe the necessity of creating such a product (read: "market") isn't there.

PLMs?

Yeah, they thought about it:
The present invention detects and distinguishes PLM and/or PLM arousals by means of comparing sub-cortical arousals inferred from blood pressure variations with cortical
arousals (EEG). Cortical arousals are used to distinguish sleep-fragmentation and neurological related arousals versus sub-cortical arousals which generally include both sleep fragmentation and neurological related arousals and PLM-related arousals.
Had to read this about 3 times. And I'm still not sure I got it.

-----Cortical arousals are ------- used to distinguish sleep-fragmentation and neurological related arousals
sub-cortical arousals which generally include both sleep fragmentation and neurological related arousals and PLM-related arousals

Duh. :? :? :?
So if an arousal is sub-cortical, how do they know it's a PLM and not the one of the first two? Or do they mean there has to be a cortical arousal accompanying the sub-cortical in order to distinguish it from a PLM, and a PLM arousal is only sub-cortical? Meaning sub-cortical without cortical has to a be a PLM?

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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by Rubicon » Wed Jan 31, 2024 6:56 am

ozij wrote:
Wed Jan 31, 2024 6:17 am
So if an arousal is sub-cortical, how do they know it's a PLM and not the one of the first two? Or do they mean there has to be a cortical arousal accompanying the sub-cortical in order to distinguish it from a PLM, and a PLM arousal is only sub-cortical? Meaning sub-cortical without cortical has to a be a PLM?
In addition, their decision tree would also have to incorporate AASM Scoring Rules For PLMs. The above excerpt is from the ResMed US 8,069,852 B2 patent, but I assume it would be nearly identical to the WatchPAT algorithm-- PAT changes w/o breathing changes then it's a piece o'cake. Will try to find that image...
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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by Rubicon » Wed Jan 31, 2024 7:12 am

OK so here are sub-cortical arousals determined by PAT:

Image

Although there's no EEG it's very doubtful that there are cortical arousals as breathing is quite stable.
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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by Rubicon » Wed Jan 31, 2024 9:18 am

FYI actigraph and leg = PLMs.
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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by Max46 » Wed Jan 31, 2024 9:27 am

Rubicon wrote:
Wed Jan 31, 2024 4:04 am
They've scurried under the refrigerator.
Give 'em a couple more days.
That, or they realized
it's a stupid idea.
No scurring here, just watchful waiting to see how you justify that movement and oximetry data incorporation would be a stupid idea.
Still waiting

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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by ozij » Wed Jan 31, 2024 9:32 am

Rubicon wrote:
Wed Jan 31, 2024 9:18 am
FYI actigraph and leg = PLMs.
NAF = Nasal Air Flow?

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And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by Rubicon » Wed Jan 31, 2024 9:44 am

ozij wrote:
Wed Jan 31, 2024 9:32 am
Rubicon wrote:
Wed Jan 31, 2024 9:18 am
FYI actigraph and leg = PLMs.
NAF = Nasal Air Flow?
Yup!
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by Rubicon » Wed Jan 31, 2024 9:48 am

Max46 wrote:
Wed Jan 31, 2024 9:27 am

No scurring here, just watchful waiting to see how you justify that movement and oximetry data incorporation would be a stupid idea.
Still waiting
"Scurrying "

Did explain it, but as surmised, you and the AH wouldn't understand it.
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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by Albatros » Wed Jan 31, 2024 9:49 am

Rubicon wrote:
Wed Jan 31, 2024 7:12 am
OK so here are sub-cortical arousals determined by PAT:

Image

Although there's no EEG it's very doubtful that there are cortical arousals as breathing is quite stable.
Quite interesting !
How do they get the datas about the Legs moves and what are NAF and ABD ?
You are using a watchPat ?
Thank you

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Re: Strong correlation between movements, flow rate dislocations and appearance of apneas?

Post by lazarus » Wed Jan 31, 2024 9:58 am

Max46 wrote:
Wed Jan 31, 2024 9:27 am
Still waiting
I recommend settling in.

D. Byrne has been "still waiting" since around 1980 or so:
"Working by hindsight
Got the message from the oxygen"
https://youtu.be/z92avHmgDRA?si=kAMD_vQn-DpfXr5g
The people who confuse "entomology" and "etymology" really bug me beyond words.
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