-SWS wrote:Well Mary spoke of three overnight oximtery collections that each returned no desaturatons. How does that reflect poorly on the doctor?
Try this simple experiment.
1. Put an oximeter on your finger. Let it warm up and stabilize.
2. Inhale, and then hold your breath for 30 seconds. Use a wristwatch.
3. Check your oximeter. Should be no change.
4. Give yourself another 30 seconds to recover.
5. Exhale, then hold your breath for 30 seconds. Again, use a wristwatch.
6. Check your oximeter. See how many of these cycles it takes before it migrates two points downwards and stays there.
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Meanwhile, how ya feeling?
If you're a deep-sea free-diver: no problem
But if you're middle-aged or older, not in the greatest shape, each of these breath holds will become more and more harrowing, especially the exhales and holds.
You'll likely see that it takes quite a while before these cycles affect your saturation by two points.
Now compare the feeling you have now with that of having to pee.
For many people, if they are sleeping, and it's past time too urinate, they will often dream of having to urinate, and eventually wake up.
It's not hard to extrapolate that "uncomfortable" feeling to the very panicked feeling you get when you can't breath, or hold your breath too long and too often.
That a current day RRT doesn't see "the change in sleep architecture" on their screen, is, imho, meaningless.
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I believe that the current metrics for measuring sleep architecture in a standard sleep lab are pretty primitive.
There is vastly more to sleep than the stages described in the now out-of-date literature.
Research sleep labs often have 64 channels of info, and, in a few labs, they have a CT or an MRI geared to measure glucose uptake via a titrated contrast media.
Plus other goodies, both now, and being developed.
So, without hard evidence behind me (yet!), I think it's safe to make the bet I'm making.
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No desats, and no observed fractures of SA doesn't automatically translate into restful, restorative sleep.
Krakow's research associate told me as much. They had patients with what the RRTs thought was a perfect night, at least it was from the perspective of the current diagnostics.
But when the patient awoke in the morning and they asked him how GGGGgggreat! he clearly must feel, they were shocked to see how often the answer was along the lines of: "I feel awful".
And this was using their top-of-the-line, breath-for-perfectly-sinusoidal-breath ResMed ASV protocol.
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