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Re: My first night on ASV

Posted: Mon Nov 24, 2008 12:35 am
by Snoredog
jskinner wrote:
Snoredog wrote:What was the pressure on your Cflex that produced the lowest AHI vs. Pressure curve report?
It was 9cm. See chart below:

Image
That 9.0 cm is what I would have used for EPAP. Now I was going to suggest maybe have someone else
look at your data, but I think we already know how that would turn out
Ring.... Ring.... Ring....

Hello!

"Ohio State Insane Asylum for Shopping Center Sleep Mangers"

Hi this is SAG is Ahmed in?

One moment SAG I will connect you... In local Ohio news, only 3 Sleep Managers shot themselves in the head today, this number down from yesterday where 5 committed the novel act.

...Ring ....Ring

This is Ahmed..., SAG!! you old POS ka-pas O man!

did you review that stuff I sent you?

Oh wow man that last batch of maui wowi was too good

Oh you mean the AHI=2 point 1????

That's what I thought

Click.
Just another case like Bev's where the Sleep lab and doctor totally let the patient down. While your AHI can be brought down, it has no bearing on the quality of sleep you get.

Re: My first night on ASV

Posted: Mon Nov 24, 2008 9:34 am
by Banned
Ok, had a good night, just got off the hose. As in Laryssa's case, James current settings have all of his respiration being driven by SV. SV is only meant to "normalize pt. ventilation during sleep disordered breathing events". I still think things will look better when James raises IPAP Min.

Banned

Re: My first night on ASV

Posted: Mon Nov 24, 2008 3:05 pm
by dsm
Banned wrote:Ok, had a good night, just got off the hose. As in Laryssa's case, James current settings have all of his respiration being driven by SV. SV is only meant to "normalize pt. ventilation during sleep disordered breathing events". I still thinkthings will look better when James raises IPAP Min.

Banned

Banned,

And what if turns out to not make an improvement ?. SWS made a good point when he said that James is a long time user of therapy who delved deep enough to write some significant software on interpreting data. But even if not for that reason - just let James settle in with the machine - surely he can be left to consider variations once he is used to the machine.

DSM

Re: My first night on ASV

Posted: Mon Nov 24, 2008 8:52 pm
by Banned
dsm wrote: And what if turns out to not make an improvement ?. SWS made a good point when he said that James is a long time user of therapy who delved deep enough to write some significant software on interpreting data.
I have never disputed James ability to write great SW. But with all due respect dsm and SWS, I cannot, for the life in me, figure how you two fairly knowledgeable individuals can look at James' charts and behave as if everything is fine.

Banned

Re: My first night on ASV

Posted: Mon Nov 24, 2008 9:09 pm
by -SWS
Banned wrote:
dsm wrote: And what if turns out to not make an improvement ?. SWS made a good point when he said that James is a long time user of therapy who delved deep enough to write some significant software on interpreting data.
I have never disputed James ability to write great SW. But with all due respect dsm and SWS, I cannot, for the life in me, figure how you two fairly knowledgeable individuals can look at James' charts and behave as if everything is fine.

Banned
James has already mentioned that he may decide to make changes next week. It sounds to me as if James decided that he wants a baseline of more than a couple nights, Banned.

His scant AHI of 2.0 and a couple PB tick marks here and there don't exactly constitute an emergency to the best of my knowledge. So where's the firetruck, good sir?

Re: My first night on ASV

Posted: Mon Nov 24, 2008 9:36 pm
by Banned
-SWS wrote: James has already mentioned that he may decide to make changes next week. It sounds to me as if James decided that he wants a baseline of more than a couple nights, Banned.

His scant AHI of 2.0 and a couple PB tick marks here and there don't exactly constitute an emergency to the best of my knowledge. So where's the firetruck, good sir?
Oh.. Ok..

Banned

Re: My first night on ASV

Posted: Mon Nov 24, 2008 9:42 pm
by dsm
Banned wrote:
dsm wrote: And what if turns out to not make an improvement ?. SWS made a good point when he said that James is a long time user of therapy who delved deep enough to write some significant software on interpreting data.
I have never disputed James ability to write great SW. But with all due respect dsm and SWS, I cannot, for the life in me, figure how you two fairly knowledgeable individuals can look at James' charts and behave as if everything is fine.

Banned
Banned,

We know it isn't fine - but we also know of the extraordinary complications James has been through including people being concerned for his survival. James is someone who well knows he has to act carefully. We need to respect that.

Cheers

DSM

Re: My first night on ASV

Posted: Tue Nov 25, 2008 1:40 pm
by georgepds
jskinner wrote:... Here are the results:

http://james.istop.com/apnea/reports/ASVfirstNight.pdf

...
Newbie here...

In row 2 of the pdf there are sleep therapy flags identified ( PB,AP, and H) . Can someone please tell me what these indicate.

TIA

--G

Re: My first night on ASV

Posted: Tue Nov 25, 2008 1:43 pm
by georgepds
Sorry.. found it on the bottom of the pdf

PB periodic breathing
AP apnea
H Hyopopnea

I get AP and H, but is not all breathing periodic, or do they mean just the opposite..i.e. that breathing stops

Re: My first night on ASV

Posted: Tue Nov 25, 2008 2:06 pm
by georgepds
PB clue here

"...Since breathing is usually regular, periodic breathing, with its clusters of breaths separated by intervals of apnea or near-apnea, has fascinated physicians for years. The pattern of periodic breathing can vary considerably. Cheyne–Stokes respiration is characterized by rhythmic rises and falls in tidal volume and breathing frequency and is usually observed in patients with congestive heart failure."

http://content.nejm.org/cgi/content/short/341/13/985

Re: My first night on ASV

Posted: Tue Nov 25, 2008 2:12 pm
by georgepds
In my search for a clue , I googled "Periodic Breathing sleep apnea". Most of the topics indicate heart problems are associated with this condition. I need some perspective here, obviously a little PB does not indicate heart failure, but I count 4 PB events in the first night pdf report... shouldn't this event be cause for alarm?


TIA
--g

Re: My first night on ASV

Posted: Tue Nov 25, 2008 2:15 pm
by georgepds
http://www.circ.ahajournals.org/cgi/con ... ll/113/1/9

Gives a better description

"In the 19th century, Cheyne and Stokes described a pattern of periodic breathing in patients with heart failure, but over the past few decades, particular attention has been given to the occurrence of periodic breathing during sleep. Central sleep apnea, also referred to as Cheyne-Stokes respiration, is an abnormal periodic breathing pattern in which central apneas and hypopneas alternate with periods of hyperventilation that have a waxing-waning pattern of tidal volume that classically has been associated with severe decompensated heart failure."

which brings up the question again.. should not PB set off alarm bells?

Re: My first night on ASV

Posted: Tue Nov 25, 2008 2:40 pm
by dsm
Your research is good & have been through the same discovery - Periodic Breathing can have many forms but the overarching aspect is

"Periods of breathing interspersed with apnea (usually descrbed as centrals). And CSR has a waxing & waning & at the peak is typically leads to hyperventilation which then triggers a waning until the trough is reached. Respironics have a chart on their web site showing in graphic form their definitions.

DSM

Re: My first night on ASV

Posted: Tue Nov 25, 2008 2:46 pm
by dsm
Here is a worthwhile link that works for me

http://bipapautosv.respironics.com/

We have an ongoing problem in the discussions that confuse VB with PB when there is a difference. I won't disagree that PB may be classified as a sub variant ov VB but if we do that we dilute the meaning of VB so much it loses meaning (IMHO).
Respironics (who refer to VB in their patents), certainly make a distinction & so will I.

DSM

Re: My first night on ASV

Posted: Tue Nov 25, 2008 2:56 pm
by dsm
VB is covered in this Respironics patent.

http://www.google.com/patents?id=lcB-AA ... xy_is=2008

DSM