Mouth sealed completely--AHIs go through roof

And get a load of this:



The variable breathing component is now recorded in real time, and there's a ton of it. This (plus simply taking Paul's word that he's awake) gives additional support to the SAGpothesis that the OA salvos should be treated as wake artifact (this is from one of those areas). However, need at least two more examples-- a salvo of real obstructive events, and a salvo of centrals, preferably with periodic breathing characteristics.

And while this could be a unique constellation of circumstances, another explanation could also simply be reduced nasal patency. It would be quite telling to see the download of a well-tuned Liberty or Hybrid.

SAG

Note to self: Rise and Inspiratory Times in re: pressure intolerance.

Yikes! 11 below zero!

Oh well, God hates a coward...

SAG

Uh, SAG, when you come back from your run (after defreezing of course) could you tell us what it is that we're getting a load of?
Recorded when? Reported by?

Thanks
O.

ziggytosh wrote:.......this forum has been way more helpful to me than my sleep doctor or the DME. .........

And that is why most of us are here.

ozij wrote:Uh, SAG, when you come back from your run (after defreezing of course) could you tell us what it is that we're getting a load of?
Recorded when? Reported by?

Uhng. Ma lipz r frzn.

That was a segment from Paul on the 1/3/09 download, in the middle of a salvo of "OA"s. There's a bunch of OAs, and a bunch of VB. Leak rate on a minute-to-minute basis is WNL.

I believe Paul's perception of wake periods is accurate, so the OAs can't be OAs, but they could be (probably are) CAs (plain ol' pauses following a little hyperventilation, done during wake or maybe borderline sleep onset). The next step would be to try to define if the criteria for VB is erratic, periodic or either characteristic, hence, gotta find a known periodic breather from somewhere.

But I think this lends further support to the proposal that the "OA"s

SAG wrote:...are caused by a conscious breathing pattern that is unnatural, pressure intolerance, a little compensation for wake hyperventilation, perhaps some sleep-onset central phenomenon and maybe a little CompSAS. In other words, all those events are a heap o' wake-generated garbage.

and that simply, the setup that generates the best perception of sleep with a leak rate that looks relatively stable and within factory recommendations (less than 2x predicted "planned leak") is fine. Treat the patient, not the numbers, using "Common Sense" (right, the Thomas Paine thing).

SAG

[quote="StillAnotherGuest gotta find a known periodic breather from somewhere.

/quote]

Are you looking for a volunteer to try out some new software,or something? Do I qualify? I still wake up many times during the night and don't know why.

Bev

OutaSync wrote: I still wake up many times during the night and don't know why.

Oh hey I do that. You mean we're not sposed to? Still have nite sweats too. Or is that male menopause? My sleep doc says I am well treated, cuz my numba's are below 1.

OutaSync wrote:Are you looking for a volunteer to try out some new software,or something? Do I qualify? I still wake up many times during the night and don't know why.

Actually, we're just looking for "Easter eggs" hidden in the existing software (Encore).

Did you get rid of at least half the medications and supplements (probably doesn't matter which half)?

Did you ever get a drug-free NPSG and MSLT?

SAG

StillAnotherGuest wrote:

OutaSync wrote:Are you looking for a volunteer to try out some new software,or something? Do I qualify? I still wake up many times during the night and don't know why.

Actually, we're just looking for "Easter eggs" hidden in the existing software (Encore).

Did you get rid of at least half the medications and supplements (probably doesn't matter which half)?

Did you ever get a drug-free NPSG and MSLT?

SAG

A drug-free PSG? Hah! If I hadn't taken my Ambien I wouldn't have slept at all and it would have been a complete waste.

However - got something interesting, I think. I've been on sleeping pills for about 20 years and antidepressants longer than that. I periodically try to cut down the dosage and it has never worked. With the ambien I always skipped Friday and Saturday nights to reduce dependency (and I could sleep late in the am).

Two months ago I got my pdoc to write me a script for "Deplin" (not a "drug" but a prescription-only l-methylfolate). This is apparently one of the end-products of the body's metabilism of folic acid and is the only form of folic acid that crosses the blood-brain barrier and is important for serotonin, dopamine and noepinephrine production. According the the company that sells it, about 50-75% of depressed people don't properly convert folic acid to l-methylfolate and they suggest this is an "augmentation" for antidepressants. I've been hearing that they're finding that people are actually getting off antidepressants with this stuff. It takes about a month to start showing effects. (see http://www.deplin.com for more info).

In any case, for the past month I've been off ambien and have *no* trouble falling asleep and if I wake up during the night it's only if I have a big leak or had too many fluids at bedtime. I feel better than I ever have. I've cut back ever so slightly on zoloft and with my pdoc's ok, plan to keep trying to reduce the zoloft.

So - I just wanted to pass this on for those who are having trouble sleepingm have depression and might want to consider a side-effect and drug-free way of getting sleep without sleeping pills. With l-methylfolate I have also been able to eliminate the 5-HTP I had been taking at bedtime (precursor of melatonin).

Mindy

[quote="StillAnotherGuest
Did you get rid of at least half the medications and supplements (probably doesn't matter which half)?

Did you ever get a drug-free NPSG and MSLT?

SAG[/quote]

I stopped taking Ambien Jan 4. I still take 3mg of melatonin, but never really saw any difference if I took it or not, so could easily give it up. I still take omeprazole to keep the acid from creeping up during the day.

My sleep center was supposed to be setting up a new NPSG, but I think the Dr. is kinda mad at me. I don't see how I could do a MSLT, as I am not the kind of person that can fall asleep quickly. It feels like I lie awake for hours some nights and I stay up later than I should, trying to avoid those sleepless hours. I've never been one to take naps for fear it would keep me awake even longer at night. I have to be pretty sick inorder to be able to sleep during the day.

I wonder if my insurance would cover it if I came up to your sleep center. Oh wait, it's probably colder up there than it is down here. I don't even want to leave the house until it warms up some.

Bev

OutaSync wrote:I stopped taking Ambien Jan 4.

That is excellent news. As those following the Bev saga may recall, she has extremely long (1) obstructive apneas during ambient NPSG and (2) central apneas during titration, especially at the beginning of each study. At least one person believes that the length of these respiratory events is due at least partially if not entirely to Ambien and its depressive effect on the arousal threshold, so F/U will be very interesting to see.

OutaSync wrote:I don't see how I could do a MSLT, as I am not the kind of person that can fall asleep quickly.

On the other hand, if there were 5 naps without sleep, there'd be no REM periods, and then the guy who thinks narcolepsy might be underfoot would have to shut his face, wouldn't he?

mindy wrote:A drug-free PSG? Hah! If I hadn't taken my Ambien I wouldn't have slept at all and it would have been a complete waste.

Well, certainly plenty of people get benefit from sleep medications. And Paul here, who reports terrible sleep maintenance and by history a sleep efficiency of 56% during NPSG even with Ambien 5 mg. and a sleep efficiency of 21.7% during titration would seem to be a prime candidate for pharmaceutical intervention.

But I think I would really want to take a close look at the NPSG done under the influence of Ambien to see if it had an effect, and really really REALLY carefully consider handing it out on a regular basis to an octogenarian without being absolutely sure what the response was going to be.

Since you asked, try Cognitive Behavioral Therapy (CBT) first.

SAG

StillAnotherGuest wrote:Since you asked, try Cognitive Behavioral Therapy (CBT) first.

SAG

Tried that, too along with just about everything else - had very stubborn insomnia for *many* years. Have now been off all sleep meds for the past month after being on Deplin for the previous month. And no winter blues either. Feeling better than I ever have!

Mindy

On page one of this thread, I had written:

Velbor wrote:I have also had the experience of much higher respiratory event indices when using a nasal mask and mouth taping (and an AutoPAP), than when using the same mask without taping (leak rates are NOT sufficient to impair therapy or machine sensors) or when using a full face mask. I am still finalizing data collection and analysis; I hope to be able to post hard data about this within a few weeks.

I have now posted that information. Please see:
viewtopic.php?f=1&t=37954

Velbor