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So anyway, Morbius, now that we have that sorted out, what are your thoughts on Uncle Flapp's flow wave chart? You know...the OP.

Forgive my ignorance - are these Dr. Who references? It isn't often that I get out-nerded but I never got into that show.

Got the oximeter. Had a rough night last night and am looking forward to getting real data (yay).



Every one of those HYP clusters has the same flow rate anomalies.

- Flappy

doctor who, and then into forbidden planet

Jay Aitchsee wrote:...what are your thoughts on Uncle Flapp's flow wave chart?

But I gave it already:

Well, not if those are post-arousal centrals. If that's the case, what you've done is wipe out the compensation mechanism and created a problem, not solved it.

Specifically:

• Initially, there is some FL, although seemingly benign.
• Two sudden large spontaneous breaths appear, as might be seen from a spontaneous arousal.
• Ventilatory needs are temporarily met, so there should be a norrmal compensatory central apnea.
• The ASV, however, sees this as a problem and tries to drive 3 breaths into it.
• This is mostly unsuccessful (from the machine's perspective) as there is no/little expiratory limb. Some of the fourth breath comes through.
• There is a single large spontaneous breath. This would seem to be from another arousal.
• There is now overshoot (the thing ASV was designed not to do) as ASV takes control of respiration for 2.5 minutes (except for one misplaced respiration, again potentially due to arousal).
• The final pattern looks to be one of Wake as arousal threshold has changed (resulting in a brief period of hyperventilation) and irregular breathing.

palerider wrote:doctor who, and then into forbidden planet

Along with quick swipes at Dr. Michael Morbius and The Blob

Morbius wrote:

Jay Aitchsee wrote:...what are your thoughts on Uncle Flapp's flow wave chart?

But I gave it already:

Well, not if those are post-arousal centrals. If that's the case, what you've done is wipe out the compensation mechanism and created a problem, not solved it.

Specifically:

• Initially, there is some FL, although seemingly benign.
• Two sudden large spontaneous breaths appear, as might be seen from a spontaneous arousal.
• Ventilatory needs are temporarily met, so there should be a norrmal compensatory central apnea.
• The ASV, however, sees this as a problem and tries to drive 3 breaths into it.
• This is mostly unsuccessful (from the machine's perspective) as there is no/little expiratory limb. Some of the fourth breath comes through.
• There is a single large spontaneous breath. This would seem to be from another arousal.
• There is now overshoot (the thing ASV was designed not to do) as ASV takes control of respiration for 2.5 minutes (except for one misplaced respiration, again potentially due to arousal).
• The final pattern looks to be one of Wake as arousal threshold has changed (resulting in a brief period of hyperventilation) and irregular breathing.

Thanks, Morbius.
I have little knowledge of ASV, in this case do you think it is set to respond too aggressively or perhaps even not needed? Or, is this just an example of typical (normal) ASV therapy?

Jay Aitchsee wrote:and The Blob

I missed that one, I thought you were just referring to some kind of sludge or other glop

this was the first transformation I'd been present for, and missed the warning signs.

palerider wrote:...some kind of sludge

Yeah, some kind

Jay Aitchsee wrote:I have little knowledge of ASV, in this case do you think it is set to respond too aggressively or perhaps even not needed?

Not needed and launching inappropriate attacks.

Morbius wrote:

Jay Aitchsee wrote:I have little knowledge of ASV, in this case do you think it is set to respond too aggressively or perhaps even not needed?

Not needed and launching inappropriate attacks.

Thanks. I just reviewed Uncle's Journey and other posts, rather interesting.

Morbius wrote:Not needed and launching inappropriate attacks.

Just for clarity, are you saying I shouldn't be on ASV at all just that ASV is interfering with those episodes? I tried CPAP, BiPAP and, after a third sleep study, got an Rx for the current ASV machine.

Tried the oximeter last night but I question the accuracy. Wearing while awake and relaxed spO2 was 95%. Mrs. Flappy, RN tried it and hers too was 95%. "Should have been 98 or more," she said. I didn't get the synch quite right in SH (first try) but for the night I had only one drop down to 89 when I rolled over and likely bumped the probe. Everything else was at or around 95. I also had a pretty good night with only one of those funky wave things and it lasted just a few minutes.

Uncle Flapp wrote:

Morbius wrote:Not needed and launching inappropriate attacks.

Just for clarity, are you saying I shouldn't be on ASV at all just that ASV is interfering with those episodes?

The discussion of that episode is restricted to that episode.

Uncle Flapp wrote:Tried the oximeter last night but I question the accuracy.

You probably would get a lot more bang for the buck if you got an EEG signal and synced it to SH:

I still don't know for sure if it is REM, swj (and/or ASV overcompensating), or even a childhood cootie relapse but either way I have not been feeling well rested lately so it is time for a visit with my sleep doc. Next available is in a couple weeks. We'll see if he recommends a sleep study for that EEG. I still average 2-3 of these episodes per night.





- Flappy

Flappy, I don't think we can dismiss this as SWJ, and I apologize for raising that earlier. Could you review your history of therapy treatment and prescriptions? Have you ever tried prescriptions with less pressure support (less fluctuation between IPAP/EPAP? Do I recall correctly you experience some problems with higher EPAP?