CPAPtalk.com

den942 wrote: Without getting too long winded or technical they told me Ikept them quite busy during my titration and that I was a complicated case with many things going on. They mentioned the two types of apnea and that at times I had both at
the same time. They said I also had some RLS problems. Somewhere around here I have a copy of the report sent to my
doctor. It was quite afew pages.

Well, for all we know breath stacking may not have even occurred during your night in the lab---despite occasionally seeming to experience breath stacking at home. But the two types of apneas (central apneas and obstructive apneas) along with RLS/PLM could have very easily kept them busy. Extremely busy. The fact that they turned Auto BPM off and left a very favorable I/E ratio for exhalation only hints at manually coping with breath stacking. No hard "breath stacking" evidence there, IMHO.

And those two types of apneas (central and obstructive) sometimes even occur interspersed together during the same sleep event(s). They are correctly referred to as "mixed apneas" when they occur during the same disordered breath or event. Those two types of apneas (and quite possibly individual "mixed apneas" thrown in) explain why you need one of the adaptive/auto servo ventilation type machines.

SWS wrote:I just knew that was going to elicit a response! I even got an implicitly reproachful PM.

SWS wrote:Now for the PM assessment that my statement was inflationary (you know who you are ).

Wow, what an interesting thread. I'm playing catch-up on message board reading/posting today and just now saw this topic. Glad I wasn't the PM'er!!

Hope things go great for you, den942. You're doing a good thing:

den942 wrote:...hand raise orphan wild life for a nature center.
---
Hand feeding critters is something I can do while I'm ridin' the rocker anyway.

rested gal wrote:Wow, what an interesting thread. I'm playing catch-up on message board reading/posting today and just now saw this topic. Glad I wasn't the PM'er!!

Well, I completely misinterpreted the PM. The fact that it was from one of my great, GREAT friends meant that I deeply respected the opinion, even when I mistakenly thought it was humorous reproach intended for me.

rested gal wrote:Wow, what an interesting thread. I'm playing catch-up on message board reading/posting today and just now saw this topic. Glad I wasn't the PM'er!!

Hope things go great for you, den942. You're doing a good thing:

den942 wrote:...hand raise orphan wild life for a nature center.
---
Hand feeding critters is something I can do while I'm ridin' the rocker anyway.

Yes, this thread was quite educational on both the Apnea part and the machine part of the situation..

Thanks for your good wishes.

den942 wrote:Several times I have woke up unable to exhale because my lungs were full but the machine was
trying to force air into me to get me to breathe. With a full face mask I pulled it off so I could
exhale and start breathing again. Is this common or rare and what causes it?
Machine is a BiPap Respironics autoSV with heated humidity.

If you can supply some nightly data I could try to help but without it you will just get speculation as to what is happening.
The SV only increases pressure to bring you back to your Target Peak Flow that you were at in the past 3 minutes.

The Bipap SV machine is sensitive to breathing flow - by this I mean that if you had nasal congestion & were breathing with some effort, the machine detects this & will change from epap to ipap before you are ready. It seems to repeat that cycle whilst it detects strained nasal breathing. The way I clear it (in one breath) is to take a deep breath through my mouth, that puts the machine back to normal flow targeting.

If you want an educated guess as to what happened to you re increasing pressure against your exhale - mine would be that you started breathing below your back-up rate and the machine went from epap to ipap mode which is the only way it knows how to try to get you to breathe at the right rate again. If you are tough enough to ignore its epap-ipap switch (I think I saw your epap-ipap gap is 4 CMs which is not that big a gap) then after another similar period of time it will repeat that epap-ipap cycle - it tries to get you to respond at the back-up rate. If you are starting to breathe but the breathing is sporadic or irregular *you will feel a gentle puff from the machine* this is triggered by the pressure support (PS or Servo Ventilation) part of the algorithm trying to get you back up to target Peak Flow - it tries to do this in 3 breathing cycles. So you appear to have a small epap to ipap gap and your breathing
gets out of synch & you react.. When this happens just take a deep breath (really deep) & exhale a good rate & the machine quickly re-synchs.

Also be very cautious about anyone telling you what the Bipap SV does when they have never used one. That is worse than a bad RT. But it happens a lot here especially of late ? -

DSM

dsm wrote:Also be very cautious about anyone telling you what the Bipap SV does when they have never used one. That is worse than a bad RT. But it happens a lot here especially of late ?

Now there's some very interesting logic: Use of the BiPAP autoSV at night somehow confers adequate expertise in treating and understanding a variety of highly challenging central disease related pathologies.

So we have expertise by nightly osmosis, my friend? By that logic a Porsche designer who has never touched a DeLorean is at a grave disadvantage understanding that car compared to the wealthy doctor who owns, drives, and avidly maintains his Delorean. And how about those theoretical physicists? By that logic they can't possibly know diddly squat. Heck, most of them can't even manage to get their hands on their work!

dsm wrote: Also be very cautious about anyone telling you what the Bipap SV does when they have never used one. That is worse than a bad RT. But it happens a lot here especially of late ? -

DSM

FYI: The arrogant aussie asshole is starting to rear its ugly head again, don't let your head explode

.

mth712 wrote:

Snoredog this is what I like about you. You are "REAL" and don't try to be anything else. You know what you are talking about to boot. Not that I agree with your comment. When I say things like that here I usually end up deleting it after a barrage of PM's from other people. Do you get the PM's asking why you are contributing to the destruction of this site.... I PM's you and SAG for an email address I could send my sleep study to-no reply from either-why not?

Actually, I don't get a lot of PM's but I also make it a habit NOT to respond or analyze one's data via PM's, I feel if it is done via PM's others on the board don't benefit or learn from the discussion. Discussed in a public setting everyone can learn from it and it makes for a better forum.

Besides, if I suggest something that isn't quite right there will be plenty of people to chime in to let me (and you) know it isn't quite right, the result is more accurate information.

Snoredog - I understand what you are saying about more people learning and others being able to make suggestions as well, if data is posted here. I agree. I certainly have learned a lot by seeing other's data posted, both about my own data and how others might make adjustments to improve their data and, hopefully, their sleep! It is definitely most helpful

The thing is that some people don't know how to post their data. They do well to get to PM and send an email with an attachment. If I had not had help, via email through PMs, I wouldn't be where I am in terms of managing my sleep apnea well. I have since learned how to post here as well.

With all the help you can and do give, maybe when people PM you asking to email you their data, you could ask for their permission to post the data here yourself so others can learn and help. Another alternative would be to email them or PM them with instructions as to how to post here.

How to post here has been described several times I know but, sleep challenged people sometimes just can't process the procedure and some others may not be all that computer literate either, or want to be. They just want help towards better sleep.

-SWS wrote:

dsm wrote:Also be very cautious about anyone telling you what the Bipap SV does when they have never used one. That is worse than a bad RT. But it happens a lot here especially of late ?

Now there's some very interesting logic: Use of the BiPAP autoSV at night somehow confers adequate expertise in treating and understanding a variety of highly challenging central disease related pathologies.

So we have expertise by nightly osmosis, my friend? By that logic a Porsche designer who has never touched a DeLorean is at a grave disadvantage understanding that car compared to the wealthy doctor who owns, drives, and avidly maintains his Delorean. And how about those theoretical physicists? By that logic they can't possibly know diddly squat. Heck, most of them can't even manage to get their hands on their work!

SWS,

Your slant is fair comment re the principles of a particular machine. But if someone who hasn't used a machine like the SV states to a newcomer that the machine will behave in a particular way for the newcomer when those of us with one see it behave quite differently, then one can rightly wonder why the claimant makes such statements.

The person in question has made his feelings quite clear & that 'nice' reaction typifies why discussing such issues with such a person, is such a waste of time. So often that type offensive attack really is a self criticism . What psyches call 'projection'

Cheers

D

Snoredog wrote:

dsm wrote: Also be very cautious about anyone telling you what the Bipap SV does when they have never used one. That is worse than a bad RT. But it happens a lot here especially of late ? -

DSM

FYI: The arrogant aussie asshole is starting to rear its ugly head again, don't let your head explode

Snores,

Sorry sport but I fear the election & meltdown are getting the better of you (among other things ). Sorry I offended you.

D

PS

Dictionary ...
projection A defense mechanism, operating unconsciously, in which what is emotionally unacceptable in the self is unconsciously rejected and attributed (projected) to others.

Let's laugh it all off and forge ahead, guys! Differences of opinion honestly expressed and without anger are downright healthy for this message board IMHO. But let's try to stay away from personal characterizations if at all possible...

Besides, Mom said that we should play "Scrabble" today... not "Squabble".

There's going to be plenty of wrong technical characterizations handed out by all of us. It would be a tight contest to see, of the three of us, who had the most technical blunders looming in past posts. I'm sure my past posts contain more than anyone can possibly count. But that's why we need to make sure that all of our experts can comfortably share conflicting opinions in the same threads. It's conceivably a matter of life and death. Literally.

-SWS wrote:Let's laugh it all off and forge ahead, guys! Differences of opinion honestly expressed and without anger are downright healthy for this message board IMHO. But let's try to stay away from personal characterizations if at all possible...

Besides, Mom said that we should play "Scrabble" today... not "Squabble".

There's going to be plenty of wrong technical characterizations handed out by all of us. It would be a tight contest to see, of the three of us, who had the most technical blunders looming in past posts. I'm sure my past posts contain more than anyone can possibly count. But that's why we need to make sure that all of our experts can comfortably share conflicting opinions in the same threads. It's conceivably a matter of life and death. Literally.

Spoken like a gentleman and a scholar

You are a champion

DSM

-SWS wrote:

den942 wrote: Without getting too long winded or technical they told me Ikept them quite busy during my titration and that I was a complicated case with many things going on. They mentioned the two types of apnea and that at times I had both at
the same time. They said I also had some RLS problems. Somewhere around here I have a copy of the report sent to my
doctor. It was quite afew pages.

Well, for all we know breath stacking may not have even occurred during your night in the lab---despite occasionally seeming to experience breath stacking at home. But the two types of apneas (central apneas and obstructive apneas) along with RLS/PLM could have very easily kept them busy. Extremely busy. The fact that they turned Auto BPM off and left a very favorable I/E ratio for exhalation only hints at manually coping with breath stacking. No hard "breath stacking" evidence there, IMHO.

And those two types of apneas (central and obstructive) sometimes even occur interspersed together during the same sleep event(s). They are correctly referred to as "mixed apneas" when they occur during the same disordered breath or event. Those two types of apneas (and quite possibly individual "mixed apneas" thrown in) explain why you need one of the adaptive/auto servo ventilation type machines.

They did tell me that sometimes after a central apnea ocurrance I had difficulty starting breathing again due to the obsrtuctive apnea. I guess that would be mixed apneas?