UARS Insomnia

[migraine-]

Well last night was the first night with the card in, just had a look at the data.

AHI - 0
RERA - 0
Vibratory snores - 12

Don't expect there's much point uploading graphs given those numbers, and the fact I slept really well.

Settings on the machine are APAP mode, Min 13.5 (I've basically titrated this to something close to the 90% pressures I've got previously, don't know if that's the right thing to have done but seems to be working and is comfortable) Max 20. Flex on A-flex and set at 3.

Fingers crossed things continue like this

[slowriter]

Don't expect there's much point uploading graphs given those numbers, and the fact I slept really well.

Post it anyway. There can be valuable info there despite the 0s.

[migraine-]

I think those are the right ones, lemme know if not. Cheers.

[slowriter]

For future reference, you also want to include the left sidebar, but without the calendar or pie chart.

In the meantime, can you posted a minute or so close up of the "flow rate"; one that shows 5-10 individual breaths, say around midnight?

[migraine-]

Thanks!

[slowriter]

The top of those breaths indicates when you're breathing in; inspiration.

In normal breathing, they are rounded.

You can see your's are not rounded, but kind of flat, which indicates flow limitation; aka breathing restriction which can result in arousals (RERAs) that fragment sleep.

This just emphasizes my point above that if you go in for the lab study, you want them to test you with a bilevel (ideally a Resmed VAuto), which should better address this.

[migraine-]

The top of those breaths indicates when you're breathing in; inspiration.

In normal breathing, they are rounded.

You can see your's are not rounded, but kind of flat, which indicates flow limitation; aka breathing restriction which can result in arousals (RERAs) that fragment sleep.

This just emphasizes my point above that if you go in for the lab study, you want them to test you with a bilevel (ideally a Resmed VAuto), which should better address this.

Thanks.

I increased my pressure to 15.0 (still with flex of 3, a-flex setting).



Here's a run of breaths from a similar time of the night. I can't tell if that's better, worse or about the same.

Also last night I had a 4 minute 18 second period that OSCAR flagged as periodic breathing:



As seen above. Interestingly my fiance had said to me this morning to check what was happening around 04:28 with my breathing as I was jerking my legs oddly at that time. Any ideas on that anyone?

[slowriter]

... my fiance had said to me this morning to check what was happening around 04:28 with my breathing as I was jerking my legs oddly at that time. Any ideas on that anyone?

While I don't have any experience with it myself, PLMD.

Another thing you might want to have checked during an in lab study.

If you have that, it adds an additional complexity on top of the UARS/OSA.

[kteague]

Interestingly my fiance had said to me this morning to check what was happening around 04:28 with my breathing as I was jerking my legs oddly at that time. Any ideas on that anyone?

I'm not knowledgeable about what the charts would look like, but I'm with slowriter on thinking of PLMD since your fiance mentioned your legs. If you don't want to wait for the appt. you could video your feet and legs while asleep. (Hint: Don't put the camera at the foot of the bed. Not flattering. Just look at my video. ) Do discuss with your doctor before the test so they can order the lab to wire your legs during the study. Not sure if that is standard procedure where you are. I know when my legs were jerking badly I had a tendency to hold my breath during movements, and as the movements were beginning sometimes it was like a jerk where my whole body tensed briefly, resulting it what I can only describe as a gaspy startle. Remembering this makes me wonder if maybe this is what you are experiencing every time you doze off. PLMD movements generally happen when asleep, but there's a fine line between fully relaxed and crossing over into what technically qualifies as sleep. In this drifting time I had movements that weren't included in my study stats because I was technically awake. Ask the tech to make a note to specifically look for this (movements immediately preceding sleep onset). I think you are a prime candidate for an in lab study. If the right questions are asked, a sleep study should give clarity as to what is going on with you. If it turns out you have PLMD, we can talk more. I feel your desperation. Been there. Please do not give up hope for a better life. If I were you I would continue to use your CPAP and once you get more information, add to your game plan.

Thanks Zonker for the heads up!

[zonker]

Thanks Zonker for the heads up!

meerkat.gif

hat-tip.gif

i know you don't hang put here as compulsively as i do and that this condition is right up your knowledgeable alley! thanks for coming in to share.

[migraine-]

My leak rate is consistently as shown on the graph up the page, but I can't feel any air leaking (other than what comes out the perforated bit at the front of the mask - F and P simplus). AHI remains <1. Don't get any large leak flags unless i take the mask off whilst the machine is on. Is the leak rate a problem?

[Okie bipap]

The leak rate is no problem at all. Respironics machines show the total leak rate including the programmed leak through the ventilation holes in the mask.

[migraine-]

The leak rate is no problem at all. Respironics machines show the total leak rate including the programmed leak through the ventilation holes in the mask.

Thanks

[musculus]

The top of those breaths indicates when you're breathing in; inspiration.

In normal breathing, they are rounded.

You can see your's are not rounded, but kind of flat, which indicates flow limitation; aka breathing restriction which can result in arousals (RERAs) that fragment sleep.

This just emphasizes my point above that if you go in for the lab study, you want them to test you with a bilevel (ideally a Resmed VAuto), which should better address this.

Thanks.

I increased my pressure to 15.0 (still with flex of 3, a-flex setting).



Here's a run of breaths from a similar time of the night. I can't tell if that's better, worse or about the same.

Also last night I had a 4 minute 18 second period that OSCAR flagged as periodic breathing:



As seen above. Interestingly my fiance had said to me this morning to check what was happening around 04:28 with my breathing as I was jerking my legs oddly at that time. Any ideas on that anyone?

This is not too bad though you did have flow limitations during that time, i.e., the flattening or ragged shape of airlow peaks (instead of smooth up and down). Flow limitations might cause microarousals so that might explain the leg jerking.

[musculus]

you can see the flow limitations at 4:24 clearly caused some kind of arousal as the air flow came back to ~normal briefly.

for monitoring the effectiveness of CPAP, I suggest looking at the flow limitation report closely and expand to look at flow charts like in this chart. Slowly increase pressure to see if that improves over time

also, at such high pressure, the only thing that might cause the flow limitation would be at the tongue base level.