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Re: question on resp rate and tidal volume, racing heart rate

Posted: Thu May 14, 2015 3:20 pm
by palerider
HanzT wrote:Could you please right click on my brain and turn on better breathing?
if I could, you can bet I would... and wouldn't even charge anywhere near what sleep docs do!!!

Re: question on resp rate and tidal volume, racing heart rate

Posted: Thu May 14, 2015 7:34 pm
by Morbius
HanzT wrote:Should I try increasing pressure or how do I work on removing the flow limit?
Get a ResMed Auto. They hate FLs!

Re: question on resp rate and tidal volume, racing heart rate

Posted: Thu May 14, 2015 7:37 pm
by Morbius
OK, seriously....

I do not participate in dial wingin' but I'm sure there will be plenty of volunteers who will.

Meanwhile, have you tried side-sleeping?

Re: question on resp rate and tidal volume, racing heart rate

Posted: Thu May 14, 2015 7:45 pm
by HanzT
The sad thing is I already sleep on my side. What other tips do you have? I wake up tired and with a slight headache, ears ringing some days. Thanks.

Re: question on resp rate and tidal volume, racing heart rate

Posted: Thu May 14, 2015 7:46 pm
by Morbius
HanzT wrote:The sad thing is I already sleep on my side.
But do you stay on your side? Do you find yourself on your back on the wake ups?

Re: question on resp rate and tidal volume, racing heart rate

Posted: Thu May 14, 2015 7:55 pm
by Morbius
In re: the FL, you don't necessarily have to hammer them all if they aren't causing a problem.

However, these are causing a problem. They are creating sleep disruption:

Image

Re: question on resp rate and tidal volume, racing heart rate

Posted: Thu May 14, 2015 7:59 pm
by Morbius
These are a little more subtle, but a problem:

Image

Re: question on resp rate and tidal volume, racing heart rate

Posted: Thu May 14, 2015 8:06 pm
by Morbius
This entire area looks pretty gnarly (all of these are still from the 9th):

Image

Re: question on resp rate and tidal volume, racing heart rate

Posted: Thu May 14, 2015 8:12 pm
by HanzT
I usually do stay on my side, but have switched to my back after waking up. I'll stop that.
What does a flow limit actually do/mean? Limit the amount of air flowing in and out, or limit the size of my breath?
I'm also seeing a lot of flow where my negative number is much larger than my positive flow number. What does that mean?
Am I correct that something that would limit my flow is a restricted airway, like my jaw moving back too far during sleep, shrinking the airway? I am thinking of wearing my dental device and using the CPAP.
Thanks again.

Re: question on resp rate and tidal volume, racing heart rate

Posted: Thu May 14, 2015 8:12 pm
by robysue
Morbius wrote:This entire area looks pretty gnarly (all of these are still from the 9th):

Image
Is the reason they look gnarly the fact that there is a slightly larger breath right after where you place the red boxes? Or is the gnarliness something else we're supposed to notice about these particular breath sequences?

And a related question: How significant is it that some of these sequences you're describing as gnarly are not scored by the machine as official flow limitations?

Re: question on resp rate and tidal volume, racing heart rate

Posted: Fri May 15, 2015 4:15 am
by Morbius
HanzT wrote:What does a flow limit actually do/mean? Limit the amount of air flowing in and out, or limit the size of my breath?
It restricts the amount of air flowing in. However, that alone is not necessarily a problem. If they go on to cause an arousal (RERA), which creates sleep disruption, then it's definitely a problem.
I'm also seeing a lot of flow where my negative number is much larger than my positive flow number. What does that mean?
Expiratory flow > inspiratory flow.
Am I correct that something that would limit my flow is a restricted airway, like my jaw moving back too far during sleep, shrinking the airway?
Yeah, and probably the base of the tongue.

Re: question on resp rate and tidal volume, racing heart rate

Posted: Fri May 15, 2015 4:22 am
by Morbius
robysue wrote:Is the reason they look gnarly the fact that there is a slightly larger breath right after where you place the red boxes?
Zactly.
How significant is it that some of these sequences you're describing as gnarly are not scored by the machine as official flow limitations?
Hanz is having twice as many events as the machine has scored. Indeed, it even did a Pcrit search in the middle of a salvo. Hysteresis was lost, resulting in two obstructive events and an awakening despite the pressure increase:

Image

Significant.

Re: question on resp rate and tidal volume, racing heart rate

Posted: Fri May 15, 2015 8:05 am
by HanzT
Thanks for the work on this. So now that I'm concerned, what should I focus on. How big of an issue is the Expiratory flow > inspiratory flow? That seems odd, along with the shape of my flow pattern during those times. I realize I need to get the events down, but all I know how to do is change pressure. Can my machine deal with these issues or do I need a more complex machine? Any suggestions on how to approach this would be appreciated.

Re: question on resp rate and tidal volume, racing heart rate

Posted: Fri May 15, 2015 6:45 pm
by guest1
HanzT wrote:Thanks for the work on this. So now that I'm concerned, what should I focus on. How big of an issue is the Expiratory flow > inspiratory flow? That seems odd, along with the shape of my flow pattern during those times. I realize I need to get the events down, but all I know how to do is change pressure. Can my machine deal with these issues or do I need a more complex machine? Any suggestions on how to approach this would be appreciated.
You should raise your minimum pressure by 0.5cm and evaluate for 7 days. The waveform that morbius illustrated is showing your airway collapsing incrementally. Your body has a RERA event which corrected the breathing pattern before it had a chance to become a full obstructive event. RERAs are as destructive to sleep architecture as OAs are. A modest increase in EPAP may be all you need to correct this. An alternate way to achieve a similar result is to switch off aflex on ur machine.

Re: question on resp rate and tidal volume, racing heart rate

Posted: Fri May 15, 2015 7:15 pm
by HanzT
Is the fact that my overall flow is so small and out is so much higher than the inflow an issue?