CompSA, Hypoventilation, PLMs, Bradycardia and Hypotension?

Muffy wrote:If you're talking about the respiratory rate thing, keep in mind that you did that once, and it had no clinical significance.

Although if the machine was double-cycling, then it could have clinical significance. In the epoch presented, however, you were sleeping through it.

Dang.

I better go back and see if there are any other loose ends to tie up or points to hedge on...

Muffy

Muffy wrote:Under similar magnification:

Hi Muffy, Yes I can see that LP filtering would be likely applied prior to letting the waveform loose on the algorithm. Its just that I am not convinced that my bimodal resp rate is real when I opt for fixed CPAP on the Adapt SV, e.g.
especially when I see the high RR corresponding to regions of flow reduction, and in the light of the Adapt SV effectively double breathing for me at times as evidenced in the ASV PSG data you have displayed.

Muffy wrote:Oh no!...Only 7 more to go!

BTW, an asteroid (or part thereof) will be crashing into the atmosphere above my state tonight...will bb live to see the light of day?

blizzardboy wrote:Its just that I am not convinced that my bimodal resp rate is real when I opt for fixed CPAP on the Adapt SV... especially when I see the high RR corresponding to regions of flow reduction, and in the light of the Adapt SV effectively double breathing for me at times as evidenced in the ASV PSG data you have displayed.

I think those high RR areas are just plain ol' junk.

Muffy

Muffy wrote:I think those high RR areas are just plain ol' junk.

I wonder if the omnipresence of the Maker of the Sacred ASV reaches into the nooks of this forum? Maybe the Salvador needs some work?

blizzardboy wrote:

Muffy wrote:I think those high RR areas are just plain ol' junk.

I wonder if the omnipresence of the Maker of the Sacred ASV reaches into the nooks of this forum? Maybe the Saviour needs some work?

Even though those areas are undoubtedly artifact, I believe they may still provide insight.

They are areas where you need some work.

Muffy

Muffy wrote:I believe they may still provide insight. They are areas where you need some work.

BB reaches over and pulls the handle and buckets and buckets of shiny gold coins teem to the floor. Raising his eyes in disbelief BB sees the number that he never thought would ever grace his screen: 1000!

Please Muffy, please, find the blue print for my work and I shall fly like an eagle.

Muffy? Are you still with us? Muffy? Muffy?

Hi all, Today I saw my new GP. He is convinced that something is not right with me (phew!) I had a whole bunch of new bloods taken today, and a chest x-ray. I am going to have a full PFT (inc. diffusion) this Friday. I have to fill a 5-litre container with number ones over one twenty-four-hour-period to measure 5-HIAA. Apparently this GP likes to keep on going until all avenues of testing are exhausted. Quite a relief for me.

I am going to present my sleep doctor with my PSG data this Wednesday morning.

Let's see what comes of it all. My joint pain has been getting worse at night, with pulsating sharp pain in my shoulders and constant pain in hands and feet waking me during the night. Sometimes I struggle to pour milk for the kids in the morning and put their shoes on due to pain in my hands; I have started to get swollen knuckles.

No change in my ASV DLs - still displaying unstable respiration.

blizzardboy wrote: I have to fill a 5-litre container with number ones over one twenty-four-hour-period to measure 5-HIAA.

And keep the jug in the refrigerator?

Hope you get some answers soon!

Muffy wrote:As you've probably noted through your research, the jury's still out on the clinical significance of alpha intrusion.

Did you run alpha intrusion by your sleep people?

Hi Muffy, I saw my sleep doctor again today, giving him my PSG data and discussing points raised through this thread. I did mentioned that the Very-Helpful-Sleep-Clinic-Manager-on-a-Leading-CPAP-Forum had shown that my delta waves were infected with alpha waves. His response was that the mechanism for this was not well understood, and that he would review my PSGs and ring me next week. I also told him that the Very-Helpful-Sleep-Clinic-Manager (at this stage of the consultation now simply referred to as "he") had also suggested that my PLMs were intrusive enough to warrant treatment and that my centrals did not need treating as they were naturally associated with arousals - the issue was my arousals. I also noted that "he" had commented that my "Sleep Efficiency classification should be downgraded from Sorta Sucks to Really Sucks." He commented that "self help forums can be very helpful nowadays."

I left the appointment feeling most grateful that I had been empowered through the information passed on to me through this forum. Thank you (you know who you are.) Cheers,

Did they ever look at your sleep studies to see if your PLMS were respiratory-related or not? Before you would consider treating PLMS with dopaminergics or anti-seizure meds, you would consider going off Fluoxetine, which might be causing them, correct?

SleepingUgly wrote:Did they ever look at your sleep studies to see if your PLMS were respiratory-related or not?

Hi SU, Sleep doc is going to have a very close look at PLMs/arousals in my PSGs to try to work out where to put the Chicken and the Egg stickers. He agrees that we shouldn't be racing out and filling me with anti-PLM chemicals just yet.

SleepingUgly wrote:...you would consider going off Fluoxetine, which might be causing them, correct?

Being convinced that my current issues are sleep related I took myself of fluoxetine 2 weeks ago. Dr BB agreed with my course of action, so all is well, I am sure, I think. Nothing ventured, nothing gained? If I start getting paranoid that everyone in this forum is picking on me you will know that Dr BB is not a real Dr... Cheers (from Down Under)

blizzardboy wrote:I took myself of fluoxetine 2 weeks ago.

You are tapering off fluoxetine, not going cold turkey, right?? Are you doing this under the supervision of the doctor who prescribed the fluoxetine? If there is reason to think that you still need an antidepressant, maybe the doctor can get you on another one (e.g., Wellbutrin? I don't know). Maybe there is even a way of doing some sort of cross-tapering?

How will you know if your PLMS have remitted once you are fully off fluoxetine and it's all washed out? Are you going to do another sleep study?

I would NOT be in a hurry to introduce any medications for treatment of PLMS until you're sure that you still have them well after Fluoxetine is washed out, and that they are the cause of your arousals.

BTW, I started going down very slowly on my dose of Neurontin after I was told that my PLMS are not true PLMS (they are respiratory-related muscle contractions) -- although I still don't know how that can be known with any certainty given that I was on 1200mg of Neurontin during the sleep study (couldn't the Neurontin have been treating the "true" PLMS and all that was left for them to see were the respiratory-related leg movements?). I got down to 700mg and I started having a lot of pain (carpal tunnel flaring, etc.). I didn't have most of these pains before I went on Neurontin (I did have some carpal tunnel). I would like to get off it because I don't know if the Neurontin is making me less alert during the day. Still, given what I've read about augmentation with dopaminergics, and given your recent pain, if the pain doesn't remit, perhaps you would want to consider Neurontin before considering dopaminergics.

But let me re-reiterate: I don't think you want to go down this road AT ALL until you are 100% sure that you have PLMS apart from Fluoxetine-induced, and they are responsible for your symptoms. Medications can cause a whole host of other problems, and who needs that?!

Aww, BB, you've got my profound sympathy and best wishes for discovery of an effective treatment. Where's 'House' when ya need a great diagnostician?

blizzardboy wrote:He commented that "self help forums can be very helpful nowadays."

Well isn't he special!

blizzardboy wrote:I did mentioned that the Very-Helpful-Sleep-Clinic-Manager-on-a-Leading-CPAP-Forum...

It's a center!!

Muffy