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jnk wrote:I'll throw an opinion out there that is based on nothing more than my liking to have opinions: Bilevels are good for UARS because you tweak the PS to the point that the user's airway gets comfortable with the pressures. So I think the SV is more likely to have the opposite effect because it plays with PS to do its thing.

I think that theory may be as tenable as the theory that SV is a superior UARS treatment platform. Neither outcome would surprise me to be perfectly honest. I don't think enough is known about UARS etiology or satisfactory mitigation to arrive at a firm syllogistic conclusion. I'm not even positive that it's UARS that Dr. Krakow was mitigating as opposed to CPAP pressure intolerance.

dsm wrote:But we can also do our own research & come to our own conclusions in advance of the published research.

I already agreed with that, Doug.

-SWS wrote:That's a powerful combination of machine examination followed by syllogism, Doug. And it works just fine for me by the way of message-board opinion formulation.

SWS



I always appreciated a well argued case - when I can find it

D

jnk wrote:I'll throw an opinion out there that is based on nothing more than my liking to have opinions: Bilevels are good for UARS because you tweak the PS to the point that the user's airway gets comfortable with the pressures. So I think the SV is more likely to have the opposite effect because it plays with PS to do its thing.

I don't really think I know what I'm talking about, but I felt like saying that anyway.

jeff

JNK

Interesting point - can you elaborate ? - have you tried this ?

Cheers

DSM

Doug,

One of these days I am going to tally up all the old broken syllogisms on this message board that adamantly began with the words "I am sure..."

In the meantime, I'm waiting for somebody/anybody in the medical community to mention the words UARS and SV together. Forget about waiting for published research. Just a passing mention would be fine.

And I thought in that other lengthy SV thread you adamantly argued that you were a plain vanilla OSA patient. Now you're a UARS patient proving SV's UARS efficacy?

-SWS wrote:Doug,

One of these days I am going to tally up all the old broken syllogisms on this message board that adamantly began with the words "I am sure..."

In the meantime, I'm waiting for somebody/anybody in the medical community to mention the words UARS and SV together. Forget about waiting for published research. Just a passing mention would be fine.

And I thought in that other lengthy SV thread you adamantly argued that you were a plain vanilla OSA patient. Now you're a UARS patient proving SV's UARS efficacy?

SWS

Now you are being cheeky

I do have flow limitations
I was told by my sleep doc I was vanilla OSA - does that mean I was - you tell me

Can you help by putting forward some reasons why SV pressure support would not benefit flow-lims. Then we can deal with something more tangible than cheek

Doug

You ole rascal

Doug, SV as a superior UARS treatment platform is your unique theory to prove---not my theory to disprove. Rather, I fall in this camp:

-SWS wrote: I don't think enough is known about UARS etiology or satisfactory mitigation to arrive at a firm syllogistic conclusion.

-SWS wrote:

Doug, SV as a superior UARS treatment platform is your unique theory to prove---not my theory to disprove. Rather, I fall in this camp:

-SWS wrote: I don't think enough is known about UARS etiology or satisfactory mitigation to arrive at a firm syllogistic conclusion.

SWS

If you have a point to debate in relation to what an SV does when a flow limitation occurs I can & will be happy to engage. If that point diverges from what I think (or see from the data) happens then hopefully we have the basis for exploring the point, at least to our mutual satisfaction.

For example, I am interested to see JNK explore his thinking re why PS would make a UARS sleeper's therapy worse. That is an opportunity for the meeting of minds

Anyway tis Fri pm here & a weekend is about to start - a busy one

Have a good one there (in Chicago )

DSM

An effective treatment for UARS:

This will keep your airway open all night :

kebsa wrote:i have complex sleep disorderd breathing and a big issue with centrals- i have tried both the resmed and the respironics machines you mention. I tried the respironics first and no matter what changes they tried i had an AHI that ranged from 94 to 104 even though i did feel a bit better than without a machine. I was beginning to think that that was the best we would be able to do and then i was switched to the Resmed and my AHI is 0.2 and AI is 0! Despite both machines being aimed at dealing with the same problems and sounding like they deal with it in a similar way i can say that they feel very different indeed from my point of view- when i was talking to the DME about it she said that they found some people did better with one and some the other, very few get similar results with both machines which i find very interesting.

kebsa, I've put in bold red a couple of things in your post that make me be not surprised at all that you get better results with the ResMed ASV than you did with the Respironics SV -- for your particular type of sleep disordered breathing.

As I understand it (limited understanding, of course) the ResMed ASV was designed primarily to treat central sleep apneas. Particularly to deal with the centrals that associated with Cheyne-Stokes respiration in CHF (Congestive Heart Failure) patients. It is most likely the champ at dealing with significant centrals in general.

Both machines (ResMed ASV and Respironics Bi-PAP Auto SV) are not aimed at dealing with exactly the same problems, imho. The ResMed machine is aimed primarily at treating centrals. The Respironics machine is aimed at primarily (imho) treating obstructive apneas and handling centrals as a secondary goal. There's a difference, in my mind, as to the "main" treatment aim of those two machines. But I may not be understanding them well.

I think there are probably considerable differences in the way those two machines are designed to deal with centrals. So, again, I'm not surprised that the machine, which has as its primary design emphasis, treating centrals is the machine that you get good results from -- since you said central apneas were a very big part of your diagnosis.

Sounds to me like you already have the right machine for your particular type of sleep breathing disorder, kebsa. Hope all keeps going better and better for you. You certainly have a lot on your plate to deal with besides SDB.

I was glad to see -SWS, whom I consider to be, by far, the most knowledgeable person on this board about how all these machines work and what they are designed to best treat (insofar as anyone who is not directly involved in the actual design at the companies can be) bring his carefully considered thoughts into this thread.

dsm wrote:SWS If you have a point to debate in relation to what an SV does when a flow limitation occurs I can & will be happy to engage.

Doug, what on earth ever made you think I have a point to debate? I thought I was clear with these two comments:

-SWS wrote:That's a powerful combination of machine examination followed by syllogism, Doug. And it works just fine for me by the way of message-board opinion formulation.

-SWS wrote:I don't think enough is known about UARS etiology or satisfactory mitigation to arrive at a firm syllogistic conclusion.

Seriously, I said your opinion floats just fine for me. What are you angling for? Are you asking me to promote your view from "formulated opinion" to "inescapable conclusion"? I'm fine with your projected opinion that SV is a superior UARS treatment method----despite the fact that the medical community is struggling like hell to understand not only UARS as a unique condition, but its successful mitigation as well.

Flow limitation not only occurs in both the UARS and non-UARS patient populations, but flow limitation also occurs in the general population as well. Having flow limitations don't necessarily equate to having the more extensive UARS pathophysiology. Mitigating UARS pathophysiologic disturbances just may entail considerably more than mitigating a stuffy nose.

So for anyone on this message board to say that SV is a superior UARS treatment method because they have analyzed their own stuffy nose while using an SV machine can only float as a message-board opinion for me. But I don't plan on promoting that opinion to the stature of "inescapable SV/UARS conclusion". Again, as an opinion it works just fine for me. It truly does. Sorry, Doug, I won't chase your UARS/SV theory to either logically prove it or disprove it. I honestly don't see either proposition as being syllogistically feasible given the present lack of UARS understanding in the medical community. Rather, I'm happy to sit back and keep reading until I finally see something that might change my own message-board formulated opinion.



Mike, that's very funny stuff! And it even includes medical proof!

I thought Mike's (MrSandman's) was a safe altenative to mouth taping.

Thank you, Kebsa, for clarifying the details about your machine.


O.

MrSandman wrote:An effective treatment for UARS:

This will keep your airway open all night :. . .

I believe I read somewhere that GERD could be considered a contraindication for sword therapy, though.

(No, dsm, I can't prove that engaging statement, either. )

jnk wrote:

MrSandman wrote:An effective treatment for UARS:

This will keep your airway open all night :. . .

I believe I read somewhere that GERD could be considered a contraindication for sword therapy, though.

(No, dsm, I can't prove that engaging statement, either. )

Stands to reason - the effect of all that acid on the blade.... yech. Swallowing all those swordoxides would be pretty bad for the stomach lining... nope, I would'n't recommned swords for people with bad GERD....

O.

jnk wrote:I believe I read somewhere that GERD could be considered a contraindication for sword therapy, though.

Glad you clarified that...

When I read that paper I mistakenly thought it was filled with typos. At the time I figured they were talking about an "acrid reflex" problem. So my wife promptly agreed to take swords off our grocery shopping list. We both think there are far better ways to get iron in our diet.




j/k

dsm wrote: My point here is, that just because not many people are promoting SVs today as a better device for Flow limitations doesn't mean it isn't true.

But I do agree that outside this forum we needs lots of research & someone to do it & papers need to be written. But we can also do our own
research & come to our own conclusions in advance of the published research.

DSM

Couldn't agree more. Also, in respect to flow limitations, I think SV could be particularly helpful when the flow limitations show temporal variations. Many people with UARS have "cyclical" flow limitations. The optimal pressures between these cycles versus during the cycle would be different. Furthermore, the cycles themselves get progressively worse as the night goes on. The cycles happen to occur when my body is trying to get into level 3/4 sleep. At those points, the flow limitations are worse than when I am in level 1/2 sleep. I assume the progressively worse conditions happen because I because nasal congestion increases as the night progresses. In any event, I concur with the observation that SV should help with such situations.