CompSA, Hypoventilation, PLMs, Bradycardia and Hypotension?

[Muffy]

K-complexes can be associated with PLMD, a disorder of sleep (which, if you're having K-complexes, you have to be).

So would you say that I have jumped the fence into the PLMD paddock?

Not be PLMD, be asleep. Wake people don't have K-complexes.

That aside, you've always been in the PLM Pokey.

Muffy

[blizzardboy]

That aside, you've always been in the PLM Pokey.

Yeah but, aside from being in the PLM Pokey, do I also have the honour of entering the PLMD(isorder) inner sanctum? Or maybe because you indicate that the intrusiveness of my PLMs warrants treatment is already an indication that you consider my PLMs as constituting a Disorder?

[Muffy]

That aside, you've always been in the PLM Pokey.

Yeah but, aside from being in the PLM Pokey, do I also have the honour of entering the PLMD(isorder) inner sanctum? Or maybe because you indicate that the intrusiveness of my PLMs warrants treatment is already an indication that you consider my PLMs as constituting a Disorder?

Yes, that was pointed out as soon as the PSG appeared:

There's a lot of chaotic breathing to explain the variability on the downloads, the PLMs look nasty enough to treat, all the events appear to be central and post-arousal (pending RERA review), and I think his sleep architecture is a little worse than was scored.

Muffy

[blizzardboy]

so that exchange looks like respiratory stuff > arousal/wake > position change > improved breathing.

What, then, is the mechanism for arousal in this case given there is no significant desat associated with the the "respiratory stuff"?

[blizzardboy]

Yes, that was pointed out as soon as the PSG appeared:

Thanks for clarifying for me Muffy. Cheers,

[Rebecca R]

Just as an aside, from the age of 14 'til 18 I used to regularly be told that I looked like MJFox.

It's hard to see the resemblance when you are hanging up there like that--did you say from a wire?

Just as an aside to the aside, a bit over 3 years ago I was part of a TV show that involved a search for my Dad's car-crash site from the early 70's. Following airing of the show a former work colleague of my Dad sent a letter to the TV station in an attempt to make contact with me, and to offer me a record player that my parents gave to this person nearly 40 years ago. Well the letter was misplaced by the station until being found last week and I only recieved it yesterday, over 3 years late. I rang the person straight away (fortunately due to Oz's sophisticated time zone system COB had not yet been reached in their part of the world) and, after some cordial discourse, I declared that I would love to take possession of the record player. But, much to my amazement, this person told me that they figured that I didn't want the player because I hadn't contacted them for over 3 years so they had thrown the player out...just the day before I rang (yes, that's right, after 40 years of happy residence in the cabinet the doomsday for the player was the day before I sought to take ownership!) So the telecon was terminated in good time and this person was on the hooter to the dump, SWAT team, etc, to try and re-secure the player before it was turned into matchsticks (my SDB was slightly worse that night as I waited for the outcome - please see my DLs for the facts. ) After Windoze booted this morning at work I was relieved to read an email from this person declaring that the record player is now safe and sound and in good health. Hence soon I will become the proud owner of the only possession still in existence that once belonged to my parents - fortunately rescued from the tracks of a D9. Now isn't that a feel good story? Cheers,

That's a great story! Do you have any records to go with it?

I wouldn't wish anyone to be thrown in the PLMD paddock, but if you are, IIWY, I would push the issue of treatment with the doc. From inside the paddock, I can say that untreated PLMD is miserable!

[Muffy]

so that exchange looks like respiratory stuff > arousal/wake > position change > improved breathing.

What, then, is the mechanism for arousal in this case given there is no significant desat associated with the the "respiratory stuff"?

AASM 2008 Alternate Hypopnea Rule.

Muffy

[Muffy]

Now isn't that a feel good story?

I think that's a great story, and Muffy's cue to run (literally). I think you've got a good grasp of what's happening, your plan is sound, you're on the upward swing of improvement, and besides, Muffy's overwhelming χίλιαphobia is starting to make her a little antsy.

Good luck!

Muffy

[blizzardboy]

It's hard to see the resemblance when you are hanging up there like that--did you say from a wire?

Hi RR, I was attached to a rope, hanging back off the top of a 165' tower using a fish-eye lens. I think I lost that cutesy MJF look during my Uni years. Then I used to regularly be told I looked like one of the Finn brothers out of Crowded House. At the end of my Uni days I used to be told that I looked like Steve Waugh (Australian cricketer.) Put a picture of each of those together and I bet they don't look to similar; maybe I've been morphing.

Do you have any records to go with it?

Yes, I still have some vinyl from my youth.

I wouldn't wish anyone to be thrown in the PLMD paddock, but if you are, IIWY, I would push the issue of treatment with the doc. From inside the paddock, I can say that untreated PLMD is miserable!

Thank you for that advice. I will be most interested to see what my sleep doctor makes of my PLMs. Cheers,

[Rebecca R]

... Muffy's overwhelming χίλιαphobia is starting to make her a little antsy.

Muffy

What happens when you reach 1000 posts? Should we be afraid?

[blizzardboy]

Muffy's overwhelming χίλιαphobia is starting to make her a little antsy.

Don't be scared, its just a number!
Before you run for the hills Muffy, could you please indulge me with the summary that you would write on my PSG hypnogram if you had prepared it? Cheers,

[Rebecca R]

Muffy's overwhelming χίλιαphobia is starting to make her a little antsy.

Don't be scared, its just a number!

I dunno about that....I've heard rumors

[blizzardboy]

I've heard rumors

Now that is a classic piece of vinyl, eh?

[blizzardboy]

Good luck!

And to you. Thank you most sincerely for your efforts to date. Cheers,

[jnk]

http://www.sleepreviewmag.com/issues/ar ... -05_03.asp

In my opinion, when a bunch of stuff is going on with someone's sleep, many doctors will tend first to treat the part they consider the easiest to treat in the hopes that treating it will help everything else to improve too. Doctor's realize they may never know the definitive root cause of anything, so chasing what they can treat is considered better than doing nothing. It is part of the approach of starting conservative before going aggressive. So it can be worth it to ride out one approach before moving immediately on to another.

Please note: That paragraph is based on nothing more than the opinions of one loopy guy on the internet (me) with no medical-related training whatsoever.