Interpretation-periodic breathing and CA events

Last night I used a chinstrap for the first time. The leak chart is definitely flatter, and the AHI is half or less than anything I have seen before.

Pardon my newbie questions, but is this actually better therapy, or better event detection?
The strap was more comfortable than I thought it would be, even though this was a basic neoprene affair I got from my RT. Is there better? I'm amazed at how much paraphenalia you can wear on your head, and still fall asleep. A tribute to human adaptability, and modern chemistry (sleeping pills). I guess I'll continue with the strap, and look for a day in the future when I might be trained enough to do without it.
All in all, it looks like a step in the right direction. I'll be traveling the next 5 days, and might not get to post charts until I get back home again, but I can still read posts. I'm curious if the data will improve with a few days to settle in. Thanks so much for everyone's help. If there is a lead on a better chinstrap, I'd appreciate it.

stevealive wrote:Last night I used a chinstrap for the first time. The leak chart is definitely flatter, and the AHI is half or less than anything I have seen before.
...Pardon my newbie questions, but is this actually better therapy, or better event detection?

Well, first understand that your periodic breathing and central apneas are the result of unstable ventilatory control in a CO2-based closed-loop system-control model---the most commonly employed central-dyscontrol model in sleep medicine today.

That model essentially describes your initial breathing perturbations/disturbances as being over-magnified by the way of resulting periodic breathing (PB) and central apneas (CA). So in that closed-loop ventilatory control system, those initial breathing disturbances are magnified on the system's output side (resulting in PB and CA) because that control system's disordered loop-gain is greater than one. In reality the disordered loop gain is either transient or continuously dynamic.

Anyway, back to your leak-related question:

stevealive wrote:Last night I used a chinstrap for the first time. The leak chart is definitely flatter, and the AHI is half or less than anything I have seen before.
...Pardon my newbie questions, but is this actually better therapy, or better event detection?

The leaks stand to either serve-as or result-in perturbations or disturbances that can, in turn, be magnified as subsequent periodic breathing and central apneas---when disordered loop-gain is greater than one. I would suggest that you try to heuristically spot patterns in your own sleep position, mouth leaks, nasal resistance, etc. that might introduce excessive breathing perturbations----which, in turn, might serve as catalyst for subsequent PB and CA precisely BECAUSE disordered loop-gain is in all likelihood greater than one in your case. Then experimentally try to MANAGE those potential breathing perturbations.

Again I would suggest pursuing an ASV trial with a knowledgeable sleep-medicine doctor. Good luck!


http://ajrccm.atsjournals.org/cgi/conte ... 72/11/1363

SWS, thanks for your continued interest and support. Your explanation seems right to the point. I agree an ASV titration would be best, but while I am working towards that, I'll pay attention to what you suggest.

stevealive wrote: The nurse's recommendation was to go back to the 9cm cpap that I was on in the past, and follow up with overnight oximetry after a few days... Her next recourse would be supplemental oxygen, which I expressed a desire to avoid.

Well, depending on just how low your basal O2 happens to sit---as you sleep at Durango's heightened altitude---experimentally raising that basal O2 a couple or more percentage points via supplemental O2 might actually be a good thing to try...

If you don't have an oximeter already, and would like your own, then consider the SPO7500, which has a very nice data set:
http://www.turnermedical.com/SPO_PulseO ... imeter.htm

I have no affiliation with the SPO7500 manufacturer or the above supplier, BTW.