djam's therapy thread

[djams]

You guys are topping me in terms of the experiments you are willing to try. No way in hell am I going to suck on a mimi.
I am glad to know that I have someone around who is worse than I am about trying weird crap.

You just put me on the floor Pugsy!

But really - you need to open your mind to these innovative thought processes going on in this thread.

[Pugsy]

But really - you need to open your mind to these innovative thought processes going on in this thread.

Nope...you all got that well covered. Don't need me. Time for me to relinquish that "honor"....and gladly.

awwww c'mon, just the once.. but have Henry send me a pic (I need it for your entry in my contacts list )

And you know what you can do with that idea....

You know I don't do pictures of any sort....I have Scopophobia.

[zonker]

I think I saw something advertised with a longer nipple, though a quick check of Amazon just now didn't turn up anything. I hate to go poking around too much looking for this stuff because I'm starting to get weird pop up ads


I did notice, though, that there were only two of these left on Amazon. Someone's been buying them up. I don't think it was Zonker, but I dunno.

mu-ha-ha!!! yes, it's all part of my evil plan to become the adult pacifier tycoon. soon, they will ALL be turning to me and i'll become a billionaire!

[zonker]

get out! seriously?

i'm amazed at the things you'll try and the efforts you go through to try to improve sleep.

Says the man who mummifies his head every night. (we assume it's only at night..., and only his head)

Perhaps we should start referring to zonker as Pharaoh?

paraoh man, pharaoh man,
does whatever a pharaoh can.

[zonker]

You know I don't do pictures of any sort....I have Scopophobia.

well, i'll be! you just forced my to learn something.

scopophobia, huh?

[Pugsy]

well, i'll be! you just forced my to learn something.

scopophobia, huh?

New word for the day for people to learn....and don't feel bad...I had to go find it myself to use it when someone asked me to do something that involved a video and I knew I could never do that unless I took a boatload of Valium first. Scared the hell out of me just having to think about maybe doing it.

[djams]

well, i'll be! you just forced my to learn something.

scopophobia, huh?

New word for the day for people to learn....and don't feel bad...I had to go find it myself to use it when someone asked me to do something that involved a video and I knew I could never do that unless I took a boatload of Valium first. Scared the hell out of me just having to think about maybe doing it.

Huh! It's a real thing. I figured it was a cutesy catch-word Pugsy dreamed up. She didn't want to be under the microscope.

I *did* just learn something new.

[djams]

NOTE: there *is* a question at the end of this post. I've been noticing that questions will get lost in my overly wordy posts.

I had 3 very bad leak nights in a row with the P10. None of these leaks woke me up, but they do awaken my wife, which is unacceptable. Chased her off to the guest room.

This was with my swing-lamp hose management system AND the suspenders clip on the short hose to eliminate hose tug, AND the lip tape. So I know the leaks aren't due to hose tug, or mouth leaks. Prompted me to try to simulate the large leaks while awake. At 9 pressure, I found the only way to get up into the leak range I'm seeing is to partially dislocate the mask. And that's noisy as hell, can't believe it doesn't wake me up. I know the pillows didn't come off completely - I can see good breathing in the flow rate chart.

Allowing my wife to get good sleep is on equal footing with everything else here. Snoring is the reason I sought treatment (because "I don't have sleep apnea" ). Seeing this as an emergency situation, I went off in search of a nasal mask with stable headgear. Ordered the dreamwear gel pillow mask, and had it overnighted. I've tried the dreamwear FFM and liked it except for leaks. Gotta say, after a week or so with the P10 - the dreamwear headgear felt like I was putting on a football helmet.

First night was rainout. It woke us both up, I was blowing water out the front barrel vent. My tape was wet and soggy. Made a hose blanket from strips of an old bath towel and zip ties. Has fixed the rainout. The pillows on this mask are making my the outside bottom of my nose sore. They're significantly different from the Resmed pillows.

So far(3 nights), I can tell that I'm not sleeping as well with the dreamwear. I haven't run my wife out of bed with it though. The search continues. I've realized that I never slept in my normal bed with the Swift FX. Since using the FX, I've learned how to apply the lip tape better and have immobilized the short hose. I'm betting that the FX is going to be the one that works out best for both of us.

Here's a chart from the 2nd night with the dreamwear. I awoke my wife "around 2:30 and once more later on". Definitely more FL activity every night with this mask. More arousals in the Flow Rate chart as well.

Question is about the flow rate chart from 11:20 to midnight. I've never seen this before, and have no idea what might cause this. Maybe from side sleeping and cutting the air flow on one side of the head gear? My breath shapes completely change, flow is reduced, respiratory rate is basically unchanged.

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This is the breath shapes during the 40 minute timeframe. Very consistent throughout.

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Here is the breathing immediately preceeding the 40 minute timeframe. This is followed immediately by a hefty arousal, and when the flow evens out from the arousal, the pattern above starts. Pretty strong circumstantial evidence that I rolled onto my side and cut the airflow?

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[Pugsy]

Pretty strong circumstantial evidence that I rolled onto my side and cut the airflow?

Maybe...
Maybe not...

I am primarily a side sleeper and have used the various DreamWear masks...and I don't remember ever seeing that sort of air flow.

Supposedly any restriction in airflow when compressing the DreamWear frame (the side that is down when sleeping on one's side) is compensated for by increased flow on the other side. Pressure is maintained by adequate compensation in the way of increasing flow rate adjustments and the flow rate (your own breathing) really isn't changed by air flow...think about it...if air flow itself changed the respiration then we would expect to see individual breath difference with pressure changes. We don't see it.
If you cut your pressure in half...it doesn't really change your own breathing until the airway collapses... your actual respiration pattern won't change no matter what the pressure until the airway maybe collapses somewhat.

So we see an obvious change in the respiration pattern...as to why...I don't know the answer.
REM maybe...lots of potential maybes but no way to know for sure but I don't think it is related to one side of the DreamWear frame not moving much air.
Maybe do an awake experiment and simply pinch off one side of the DreamWear frame and look at the subsequent respiration pattern???

[palerider]

First, djams, I'd like to compliment you on starting a trend...

"djam's therapy thread", the "xxxx therapy thread" seems to be starting to be a thing, and I think it's a great idea, since the original starting question often morphs into many other things in a person's thread. I've seen a couple other people doing the same thing, I think it's good.

As to your question... I'm going to make a *guess* and say I think you were breathing out through your mouth.

The part of the flow line above zero (inhale) looks like it's a larger volume than the amount below zero (exhale).

Do you see any changes in the other charts that we normally ignore, ie, TV, MV, inspiration, expiration times?

[djams]

Pretty strong circumstantial evidence that I rolled onto my side and cut the airflow?

Maybe...
Maybe not...

But of course!

So we see an obvious change in the respiration pattern...as to why...I don't know the answer.
REM maybe...lots of potential maybes but no way to know for sure but I don't think it is related to one side of the DreamWear frame not moving much air.
Maybe do an awake experiment and simply pinch off one side of the DreamWear frame and look at the subsequent respiration pattern???

I'll do this, but with my crappy erratic awake breathing I don't know. It's a good idea. All the dreamwear documentation states what you said - air flow increases on the other side. And I don't see anything like this during my 3 week trial of the dreamwear FFM a few months back.

[djams]

First, djams, I'd like to compliment you on starting a trend...

"djam's therapy thread", the "xxxx therapy thread" seems to be starting to be a thing, and I think it's a great idea, since the original starting question often morphs into many other things in a person's thread. I've seen a couple other people doing the same thing, I think it's good.

Why thanks! I've noticed a few others doing it as well. I just got tired of looking at the non-applicable thread title and decided to name it how I view it. First time I've ever been considered a trend setter!

As to your question... I'm going to make a *guess* and say I think you were breathing out through your mouth.

The part of the flow line above zero (inhale) looks like it's a larger volume than the amount below zero (exhale).

Do you see any changes in the other charts that we normally ignore, ie, TV, MV, inspiration, expiration times?

This is an interesting guess. I don't know if you've looked at the SomniFix tape - it's got a breathing slot in the center, which I used to cover over but haven't been lately. Entirely possible that I was breathing through this hole, which despite my best efforts is still at least partially open. Here's a pic.

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My exhalation time was higher than inhalation time by a factor of 2 during this epoch (<-- new word I learned in David_Y's thread! ). So I guess my I:E ratio was noticeably lower than normal. I'd (very roughly) estimate that it normally runs .7 - .9 Difficult for me to state for sure, I look at the averages in the left pane most days and I tend to think of it backwards (E:I). Aside from this, all of the respiratory charts are lacking the normal variations. A bunch of nearly straight lines compared to what I normally see.

There's a I:E ratio waveform in SH preferences and I've got the box checked. But I've never seen the chart on my screen. Is there a trick to turning this on?

[Jay Aitchsee]

I'd say it's a good guess you are mouth breathing through the hole in the device. It looks to me as if your expiration is restricted. It starts, drops to a level, remains fairly level, and then stops. Like a shallow, elongated, U shape. Exhaling through pursed lips would seem to render the same result.

Don't be too concerned with I:E. It is not a diagnostic metric. I:E is used in ventilators to control the patient's blood oxygenation by controlling the times of inhale and exhale. A ventilator is set to provide a certain I:E, or inverse I:E, to achieve the desired result. In other words, it is a setting not a measure. I:E has little practical value in non-ventilator applications.

[palerider]

So I guess my I:E ratio was noticeably lower than normal. I'd (very roughly) estimate that it normally runs .7 - .9 Difficult for me to state for sure, I look at the averages in the left pane most days and I tend to think of it backwards (E:I). Aside from this, all of the respiratory charts are lacking the normal variations. A bunch of nearly straight lines compared to what I normally see.

There's a I:E ratio waveform in SH preferences and I've got the box checked. But I've never seen the chart on my screen. Is there a trick to turning this on?

I:E is another of those things I wish wasn't in sleepyhead, (along with RR and the AHI chart) it doesn't seem to have any value for what we do here (that I've ever heard) but it continues to confuse and confound people.

It's the I and E charts I was wondering about. Too bad there's no Ivolume and Evolume.. .but normally, those should be 1:1... if it was showing you were inhaling more than exhaling, then mouth exhalations would be confirmed. (or, you exploded like a balloon and didn't notice )

[djams]

I'd say it's a good guess you are mouth breathing through the hole in the device. It looks to me as if your expiration is restricted. It starts, drops to a level, remains fairly level, and then stops. Like a shallow, elongated, U shape. Exhaling through pursed lips would seem to render the same result.

This is a great explanation - thanks!

I:E is another of those things I wish wasn't in sleepyhead, (along with RR and the AHI chart) it doesn't seem to have any value for what we do here (that I've ever heard) but it continues to confuse and confound people.

It's the I and E charts I was wondering about. Too bad there's no Ivolume and Evolume.. .but normally, those should be 1:1... if it was showing you were inhaling more than exhaling, then mouth exhalations would be confirmed. (or, you exploded like a balloon and didn't notice )

The I:E ratio isn't something I'm concerned about. I do look at the averages, but that's it. Somewhere along the line I got the idea that it was normal for exhalation time to be greater than inhalation while sleeping. Is this a correct perception?

The Wyze cam detected no exploding heads during the night in question.

Just for the record, here's the I and E charts. You can see that the insp time is slightly below the average for the night and exp time is slightly above during the time.

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