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Morbius wrote:
So:

Does the addition of xPAP therapy alter the ability of one to permit the pCO2 rise, and perhaps (further) destabilize the sleep-wake interface? Does the addition of ramp do more than simply provide a lower pressure to deal with, namely, keep ventilation lower? Does aggressive xPAP therapy serve to prevent the taking of sleep through lowering of pCO2? Is this concept one of the reasons responsible for a generally poor compliance of disorder therapy?

Inquiring minds....

Since BIPAP, I have never had a problem falling asleep (my problem was before), and I turned off ramp the first week and went straight to my 15/11 pressures due to the not enough air feeling with ramp. But It does make sense to use the ramp and allow a more natural ventilation change to promote sleep. It might be a trade off between increased AHI , with lower pressures, for a quicker sleep onset.

palerider wrote:

postitnote wrote:So those nose hairs can filter the air in.

but, why the 'out through the mouth' part?

I'm just guessing but probably coz the mouth is closer to the lungs or so you don't dirty up those nose hairs again,

I really have no clue but if I remember I will ask my daughter tonight. She'll know.

postitnote wrote:

palerider wrote:

postitnote wrote:So those nose hairs can filter the air in.

but, why the 'out through the mouth' part?

I'm just guessing but probably coz the mouth is closer to the lungs or so you don't dirty up those nose hairs again,

I really have no clue but if I remember I will ask my daughter tonight. She'll know.

while googling breathing, and once again trying to narrow down what part in the back of the mouth controls where the air goes (when it's working)(I think it's a combination between the pharynx and the soft palet) I saw something about breathing that said something to the effect of "when exhaling, exhale through the nose so the slight back pressure helps to increase the ability of the lungs to extract oxygen from the air".

so, maybe exhaling through the mouth cuts down on that slightly while doing those slow breathing exercises???

looking forward to what your daughter says

I have been told at my pulmonary rehab that I am to breathe out thru the mouth as it is the best way to get the CO2 out of my lungs so that I can get oxygen back into them. Oxygen good, carbon dioxide bad.

palerider wrote:

postitnote wrote:So those nose hairs can filter the air in.

but, why the 'out through the mouth' part?

It has something to do with engaging the muscles in the diaphragm. My PT has me inhaling through the nose for 8, holding for 8 and then releasing with a "hah" sound through the mouth with my pelvic floor and stomach muscles engaged.

cancun wrote:I have been told at my pulmonary rehab that I am to breathe out thru the mouth as it is the best way to get the CO2 out of my lungs so that I can get oxygen back into them. Oxygen good, carbon dioxide bad.

While that makes sense I been thinking about how I breathe and I inhale and exhale via my nose unless I am stuffed up or other nasal issues. I sleep with nasal pillows and mouth closed so I do the same at night. But when I exercise or work out in the garden and start to breathe heavier I open my mouth to exhale. Not much but I do. I just watered my plants outside and it's 84 outside with no breeze and noticed that. I bet it is the carbon dioxide especially when we breathe harder. Easier to get out from the mouth and maybe faster emptying of lungs too. Again, I'm just guessing.

Sonya wrote:

palerider wrote:

postitnote wrote:So those nose hairs can filter the air in.

but, why the 'out through the mouth' part?

It has something to do with engaging the muscles in the diaphragm. My PT has me inhaling through the nose for 8, holding for 8 and then releasing with a "hah" sound through the mouth with my pelvic floor and stomach muscles engaged.

Of course exhaling with the "hah" sound and the engaged pelvic floor and stomach muscles is a very, very active form of breathing. And as such, it's not likely to help you fall asleep while you are breathing in that fashion.

For what it's worth, every mediation class I've taken has focused on breathing through the nose on both inhalation and exhalation. And has taught us to NOT hold the breath in between the inhalations and exhalations. The focus has been on keeping the inhalations and exhalations as even as possible and to keep the circle of inhale-exhale as smooth as possible and to keep a nice steady (and SLOW) pace of inhalations and exhalations. Now some of the yoga classes I've taken have covered the much more active breathing where you're breathing in through the nose and exhaling (loudly with a "Hah") through the mouth. Sometimes we hold the breath before the loud, exhale through the mouth. Sometimes we don't. And the active "Hah" breathing is only used in some of the yoga poses. In most of the poses, the focus remains on even, slow breathing through the nose with no pauses between the inhalations and the exhalations.

postitnote wrote:

cancun wrote:I have been told at my pulmonary rehab that I am to breathe out thru the mouth as it is the best way to get the CO2 out of my lungs so that I can get oxygen back into them. Oxygen good, carbon dioxide bad.

While that makes sense I been thinking about how I breathe and I inhale and exhale via my nose unless I am stuffed up or other nasal issues. I sleep with nasal pillows and mouth closed so I do the same at night. But when I exercise or work out in the garden and start to breathe heavier I open my mouth to exhale. Not much but I do. I just watered my plants outside and it's 84 outside with no breeze and noticed that. I bet it is the carbon dioxide especially when we breathe harder. Easier to get out from the mouth and maybe faster emptying of lungs too. Again, I'm just guessing.

along those lines, I came across this... which makes sense:

4. We breathe in and out of our nose during a yoga practice for a few reasons but the main one is that when we breathe like this we can’t take in so much air or expel so much air. So if we have to resort to opening our mouth to get more air it is an indicator that we have stepped into stressing or pushing our bodies. When we practice yoga, we don’t want to stress our bodies by doing open mouth breathing. Our practice should be a balance of effort with ease.

Long, detailed, too many words I'd have to Google story... daughter said you exhale more efficiently via the mouth and something about carbon dioxide. I really didn't want to ask her to repeat or explain further, lol.

The CO2 explanation for the mouth breathing sounds good, but there are some airflow sensors in the nasal cavity that are tied into the part of the nervous system that regulates breathing and heart rate. There might be some nervous system effects as well as the mechanical ones.

I also note that they say to keep your tongue against the roof of your mouth and exhale around it. Maybe back pressure is part of the process.

Prescribed breathing is a relaxation technique. One of the things I notice with clients is that if I have them practice some sort of relaxation technique that they frequently fall asleep if insomnia is one of their complaints (of course, maybe it is just the dulcet tone of my voice as I count for them). When someone who is sleep deprived relaxes, they frequently fall asleep. Before my apnea was treated, I sometimes fell asleep (now THAT was embarassing).

I did and taught breathing exercises and wile I relax deeply with them they don't help me fall asleep as in instantly in 60 secs! They do help relax me and get my body in sleep mode but it takes more then a few breathes to get my mind to let go.