New PSG - Question - Update post psg

Wadja do to prevent mouth leaks? Isn't that what usually causes a raw throat for pappers?

I also wonder if the questions about fish oil and tuna were only on your questionaire because someone at the clinic has seen your avatars?

If you did better at a clinic than at home, I wonder if you could have an allergy to someting in your home?

That's the extent of my crazy ideas at this point.

Browser wrote:Hello - Here is what I got last night with the swift lt at 15 and Cflex = 3, so I do not see how I could have had a good night at the hospital except that I only slept a few hours there... I know I was leaking at the hospital worse than I did here. My throat is a little raw this morning. I don't think the Swift Lt is going to be the mask for me although I really like it. I do not feel the "pressure" like I do with a nasal mask instead I just feel air rushing through my nose and down my throat. Maybe that air is all that is needed though. Not sure.

VB% was 50%:

Browser, I really wonder how much better you did at the clinic than at home last night. Reading between the lines it sounds as if they just might have discounted some of your central apneas. Based on what you said it sounds as if they didn't count the central apneas that occurred after sleep position changes. I wonder what other events they might have discounted as well. Did they discount post-arousal central apneas in general, for instance?

Also Jeff mentioned that leaks may contribute to your scored variable breathing. Let's assume for a moment that you are a patient who experiences autonomic arousals to sensory input in general. Don't leaks constitute potentially disruptive sensory input on two counts? Leaks potentially constitute sensory disruption on two bases: 1) tactile sensory input, or touch, and 2) auditory sensory input, or sound. I don't think leaks alone can consistently account for your high VB by simply skewing flow-signal---otherwise we'd have very many VB rates being reported here as incredibly high as yours. But I do suspect that leaks have the sensory-input potential to be more sleep-devastating or perhaps more autonomic-arousal inducing to some of us than others. And if you happen to be experiencing sensory-input based central apneas in the Encore chart above, they are going to be so inherently fleeting that they will score on the OA line above rather than the NR line.

Also, I would suggest that you ask for your own copy of that sleep study. Tell them that you want not only the summary, but that you would like the complete set of NPSG files on disc. That gives you the option of submitting the complete NPSG data set for a second opinion---should you ever elect to do so. It also makes the data handy should any of the researchers investigating the topic of autonomic arousals ever request your data and you would genuinely like for them to have a peek.


Browser's other current thread pertaining to Variable Breathing:
viewtopic.php?f=1&t=36784&start=0

Very good points, -SWS.

I was imagining Browser making variable-speed-motorboat noises all night, alternating with bronx cheer/raspberry noises, with his lip flutters. But I guess that would show up on the leak lines, wouldn't it?

I look forward to the mystery being solved!

jnk wrote:I was imagining Browser making variable-speed-motorboat noises all night, alternating with bronx cheer/raspberry noises, with his lip flutters. But I guess that would show up on the leak lines, wouldn't it?

Jeff, I agree all that hypothetical leak nose and lip flutter should show up on the leak line. Also a comment that OutaSync also experiences significantly more scored events than many of us when she experiences leaks. And I believe she scored HSP-positive as well. She also scored some significant Variable Breating rates, albeit nowhere near as high as Browser's. But there just may be an issue with sensory input providing more autonomic arousals and/or sleep architecture disturbances for some of us who are sensory sensitive.

Also, I'd like to to straighten this comment out:

-SWS wrote: And if you happen to be experiencing sensory-input based central apneas in the Encore chart above, they are going to be so inherently fleeting that they will score on the OA line above rather than the NR line.

Just to comment that the above fixed-pressure chart will never score NR events because APAP modality is turned off. However, anyone should bear in mind that all fleeting central apneas will still manage to score on the OA line in the Encore data set when APAP modality is enabled. There is no central differentiation in the RemStar Auto or Encore data set. The NR line simply designates apneas and/or hypopneas that didn't respond to three pressure increments above 8cm.

So when the PSG detects central apneas relative to Browser's sleep position changes, Encore will score OA events. When the PSG sees post-arousal central apneas---perhaps in response to a sensory disturbance---Encore will once again score one or more OA events.

SWS, it is interesting that you've mentioned asking for a CD

-SWS wrote: ... Also, I would suggest that you ask for your own copy of that sleep study. Tell them that you want not only the summary, but that you would like the complete set of NPSG files on disc. That gives you the option of submitting the complete NPSG data set for a second opinion---should you ever elect to do so. ...

Supposedly, not all sleep centers - or all professional PSG software - are able to produce such a CD. I've asked both my local sleep lab AND Mayo Clinic, MN, for such a CD and have been told they are unable to produce one. I'm waiting for word from Mayo whether the person who told me that was correct or not. But it was my local sleep lab manager who told me that her sleep lab would not be able to produce one. She was aware I wanted to take such a CD to Mayo.

Also, I am assuming that NPSG = nocturnal polysomnography as opposed to a daytime PSG?

Slinky, any software that records an entire data set does so to computer files. Period. I suppose it's conceivable that those clinicians simply don't know how to render your data or file set onto disc. But then again it also happens to be highly convenient for any clinic to claim that they can't do that for you.

Do you like alliteration? Because it really sounds to me as if those folks suffer from: Clinically Convenient Capability Curtailment.

Policy may restrict them from making that data disc for you, but technology sure doesn't. Truth is, with malpractice suits through the roof these days, I'm not surprised to hear clinics claiming that they can't give you the raw NPSG data. Correct about the nocturnal part of that acronym.

SWS and all - I was thinking about this and I wore earplugs last night and my wifes alarm goes off around 5am, I will have to ask her where it was set. I didn't wake up from the alarm as far as I know but I probably was brought out of a deep sleep. I did wakeup however when she turned the bathroom light on. At that point I tossed and turned a little trying to fall back to sleep. Then in the next two hour period she would have been getting the kids ready for school. But if you look at my data it looks better up until I wake up that first time??? I did take a .5 mg of Clonazapam an hour before bed because I was anxious.

I didn't want to mention this for fear of ridicule but I was fine at the sleep study up until the Tech. started to clean spots and glue leads to me. At that point when I smelled the cleaner or glue I felt real anxious and short of breath which made me more anxious. I also felt light headed or a little dizzy and had a burning in my throat that lasted till last night and I still feel it today but it is better. I then felt like I was going in to a panic attack and got real warm and started sweating and heart racing. I mentioned it to the Tech. while looking real calm and he said it was probably the fumes. Then when I layed down I could smell it and on top of that I couldn't fall asleep and was fighting this panic feeling of wanting to rip everything off and just go home. I fell asleep according to them because I spoke out that I need to pee and when he came in he said I had slept 45 minutes. I got up and went pee and then laid down and couldn't get to sleep again for anything and fought this urge to tell them I needed to get out of there because I thought if I laid there much more I was going to freak out and have a full blown panic attack. I guess I finally fell asleep and then woke up and had to pee AGAIN and called them. I went pee and then fought the panic urge again and fell asleep and then they woke me up to hook me up to cpap.

I never thought I would fall asleep on cpap and this was about 6am I think so all of the above was between 2AM and 6AM. I did fall asleep and woke up around 9:45AM and I thought I hadn't been asleep very long and laid there trying to go to sleep and my cell phone rang "OOOOPPPS" I forgot to turn it off. They then called me and told me it was 9:45AM and asked if I was ready to go and I was shocked it was so late cause I didn't think much time had passed and I said yes.

So then all day yesterday felt anxious and like I was going to panic. I needed a shower but was on here. I did take a shower around 430PM and found 6 things stuck to me and a lot of glue on my scalp. I cleaned real good and then for the next 5 hours I was still very anxious and short and had a dreadful feeling of dread and then around 10PM it started to lift. I then said hell with it and took .5 mg of Klonopin and went to bed around 1AM.

So I wonder if I am allergic to the glue or fumes or something. They used acetone to clean some off in the morning and it bothered me also. So was it just me or was it the fumes or what, I do not know. I have very severe allergies to grass,pollen,ragweed,cats,dogs everything...

I feel weak minded because of things like this and it bugs me... I just want it all to stop.

Thanks, -SWS. That's what I was thinking. I can see mebbe the sleep lab didn't invest in a CD/DVD RW drive for their 'puters. But Mayo??? Uh, uh. I don't buy it. I have sent a written request to Mayo's Med Recs department requesting the complete record using the HIPAA request form letter w/the inclusion of the specific info I was asking for so we shall see what transpires. Mayo has always been so open I will be VERY SURPRISED if it isn't forthcoming.

Slinky, good for you for filling out that HIPAA request! Let us know how that turns out.

Browser, I can tell you with absolute certainty those traits do not imply that you are weak minded. The one person I know who manifests those traits you mentioned more than anyone else, is formally trained as a nuclear physicist and a computer scientist. He's a large masculine man who has absolutely no problem taking care of himself or his loved ones. And yet he is a great father and family man, in addition to being one of the most sensitive and ethical people I have ever met. Weak minded? I don't think so. But he happens to manifest many of those same traits you described.

So I have a question for you about your OCD diagnosis. I noticed that diagnosis came only after Marine service in the Persian Gulf. And I noticed "intrusive thoughts" seemed to be central to your OCD diagnosis. Was there anything else to clinch that OCD diagnosis besides those "persistent thoughts"? The reason I ask, is because I think that deep-feeling, deep-sensing, deep-thinking nuclear physicist I happen to know would also suffer from persistent thoughts, had he been directly exposed to the psychological and sensory experiences of war in the Persian Gulf. Bear in mind he is a former military child and a patriot, who has served in yet other ways. My hunch is that many people who process both sensory experiences and ideas very deeply are going to be very inclined to have persistent thoughts after directly experiencing war.

And I would be inclined to guess that some of those people are going to receive OCD diagnoses when, in fact, they would not otherwise match the OCD phenotype. Some of those people undoubtedly cognitively and psychologically process both experiences and sensory input more deeply than others---and I believe those types can be a bit more obsessive. Some of those people, such as the nuclear physicist I mentioned above, are obsessive problem solvers for instance. And many of those inherently persistent thinkers don't actually possess the sufficient traits to properly manifest an obsessive compulsive disorder.

I would wonder whether your OCD diagnosis is accurate. I would also wonder if psychologically and cognitively sensitive people can experience more autonomic arousals related to SDB, after going through an unsettling life experience. Some of Dr. Krakow's SDB and PTSD research seems to hint at that possibility. I would wonder if a psychologically life-altering experience, for instance, can't literally alter a psychologically defensive bias that makes us more prone to autonomic arousals during sleep than prior to that ongoing experience. I would even go so far as to wonder if there might be some genetic survival value to that sleep-defensive response across one or more genetic phenotypes in our species.

Browser - I know you are not alone in that anxious feeling that comes with a sleep study. Who wouldn't be anxious and a bit panicky when they start putting all those wires on you and then something over you face with air blowing out of it into your nose!?!

I certainly felt that way when I had my first sleep study 6 years ago. When I had my second, this past April, I knew what to expect so it wasn't as bad. It still wasn't a pleasant experience. I didn't sleep much during either study and made 2 bathroom trips both studies!

The whole thing is enough to make anyone anxious! You are not alone! I'm sure most, if not everyone here, can relate.

SWS - I need to correct something-Sorry. I was called up soon after the birth of our first son and only went to a base in California to fill in for people who were in the gulf. I never went to the gulf and it all ended before I had to. Still a stressful event but I had the depression/ocd/breakdown issue prior to this. The thoughts may be related to sleep deprivation but they are for sure OCD and some call it "pure O". I will not repeat the first thoughts that I had because people would say I was nuts. Here is an example, lets say that if you can think of a thought you wouldn't want,for instance, you picture yourself dropping your newborn on the ground and you wonder why you had that thought and then you have it over and over and soon you don't want to touch the baby for fear you are losing your mind and might drop the baby. Image you become consumed with this thought to the point you can't function because you think you must be nuts.

I suspect I will never know what came first the chicken(sleep issues) or the egg(mental issues).

I remember when I first had issues and tried to talk to my Step Dad he told me to suck it up. Then over the years he has referred to me as weak minded. He is a good man but does things like this that hurt. Like he gives everyone a nickname and to be honest at some point they sometimes bother you since they are usually related to some physical quirk.

Hawthorn - I have had 5 studies over the years and never reacted like I did this time. I am still anxious right now as I type this. I really hate the anxious feeling. I did some reading on Kava Kava root and was thinking about trying this. Prior to all this starting I never ever took any kind of drugs and really prefer not to now. But yes my self esteem is terrible and has been for some time. I guess I have this fear that if people only knew the real me and all the problems I have they wouldn't like me so I feel like a weak person and I am pretty sure my low self esteem shows to everyone around me.

I am being probably too honest here but I hope it helps someone to know they aren't alone.

Browser, thanks for that clarification. I follow that example as being typical of OCD intrusive thoughts. I wish your stepfather had a better knack for nicknames. I'm glad he was a good guy in general, though.


Back to that possibility that there may be some people who experience autonomic arousals more easily than others... Let's theoretically assume that happens. Remember that study I linked to describing normal sleepers being subjected to autonomic arousals, complements of traffic noise? Well, perhaps it's possible that neurologically "light sleepers" can experience autonomic arousals from more subtle sensory input that tends not to bother most people during sleep. Let's assume you may be one such person.

In this hypothetical case it would be a no-brainer that you should minimize potential sensory-based sleep intrusions---while also maximizing sleep comfort just as much as possible. In other words, making the sleep environment comfortable and pleasant for sleep probably extends beyond just ridding the environment of intrusions. But I'm also thinking this type of cognitively/neurologically active person may also need to curtail over-stimulating television, over-stimulating literature, over-stimulating conversation, and even over-stimulating thought patterns as evening approaches. That great movie or book at noon may turn out to be adversely sleep impacting at nine p.m.

When I think about what Dr. Krakow seemed to emphasize for many of his patients, it boiled down to making just as many factors as possible conducive to restful sleep. I don't think earplugs alone would suffice, for instance. And I'm even thinking earplugs may provide their own sensory/psychological discomfort for some people---that is if earplugs somehow don't feel "right". I would love to know what "sleep psychology" may come up with say three or four generations from now, by the way of identifying all environmental and psychological factors most conducive to sleep.

One of the things you mentioned -SWS also hit a note with me. My sleep issues really got worse after my dad passed away - it was a very stressful time (I flew back and forth across the atlantic several times for this, spent several weeks at the hospital, ate very poorly, and just the general stress that goes with losing someone). Afterwards I remember at work being completely exhausted going up 1 flight of stairs, my computer felt heaver than normal when I was carrying it around, and in my blood tests I had a very high amount of inflammation (and high CRP? is that the right term?). I never really got back to feeling normal again, after that (except now slowly, since starting the CPAP). I think for me that was the triggering event. But I am sure I have had OSA for a long, long time. So for whatever that's worth...

I also identify with the mild OCD like issues that you talk about Browser, as well as the weird thoughts. I'm not going to go into detail here, but I (think I) know what you mean. I'm also a control freak about my environment (certain amount of order or cleanliness is needed or I flip out, I get upset if someone 'moves my cheese'). Other times I am extremely flexible.

Along the HSP lines, I cannot watch the news just before bed, or even have a simple discussion about important issues because I get all worked up and then I cannot sleep (even non-important but trigger issues have the same effect).

-SWS is right, we shouldn't underestimate environment causes of arousal especially if you're a highly sensory-sensitive type. I know for me it makes a difference. For several years I lived in an apartment with lots of noises from the neighbors, and I was in a constant state of anxiety because of that. I am sure it affected my sleep. I never understood how others could just go about their business like normal with all that noise (it never bothered my partner).

Hi Echo -Thanks. All I want to say right now is I can relate to everything you said-everything. We really have a lot in common in regards to what we have said on this board. I think if I married someone like me I would be nuts and divorced,maybe.

I also read the book "who moved my cheese" and I don't like my cheese being moved and it is hard to adjust to changes. I like to be in control and have an exit strategy in mind wherever I am.