.

NotMuffy wrote:Lavender was shown by Goel et al to improve SWS. Use the angustifolia variety.

How does one smell it if one has a CPAP mask on?

secret agent girl wrote:

NotMuffy wrote:

secret agent girl wrote:“TS”
Someone please take pity and tell me what TS means. I get the gist from context, but details are nice, too.

Well what do you think it means?

I think it means what follows is a response to a point that's been raised, but I've no idea what the initials stand for.

"That Said"

secret agent girl wrote:I'll bring it up, but I don't know how likely it is that they'll pay any attention. I don't s'pose you have any contacts or pull out here...

No problem! Just say you got advice from NotMuffy, a multiple personality disorder virtual character on an internet advice forum...

OK, now that I see it in print, perhaps that's not such a good idea.

But the Boston guys recently published some data on EERS:

http://www.ncbi.nlm.nih.gov/pubmed/21206741

so maybe you should go with that instead:

204 patients diagnosed with continuous positive pressure (CPAP)-refractory sleep apnea between 1/1/04 and 7/1/06 were included in this retrospective review. All patients had in-lab attended polysomnography for diagnosis, conventional CPAP titration, and further assessments of added EERS. EERS volume was titrated to control of disease, which was typically obtained when end-tidal (ET) CO₂ during sleep was 1-2 mm Hg above wake eupneic CO₂ levels. The clinic records were reviewed for clinical outcomes. Poor laboratory response to, and initial clinical abandonment of CPAP, was very common (89.2%) in this group of patients, who as a group demonstrated mild resting wake hypocapnia (ETCO₂ = 38.1 ± 3.1 mm Hg). Minimizing sleep hypocapnia by adding 100-150 mL EERS (mean ETCO₂) at optimal therapy 38.6 ± 2.9 mm Hg) markedly improved polysomnographic control of sleep apnea, without inducing tachypnea or tachycardia. Follow-up (range 30-1872 days) showed improved clinical tolerance, compliance, and sustained clinical improvement. Leak and sleep fragmentation modified clinical outcomes.

Note that all of their guys were hypocapniacs. If a hypercapniac tried that, catastrophe could result.

secret agent girl wrote:

NotMuffy wrote:Lavender was shown by Goel et al to improve SWS. Use the angustifolia variety.

I've already got some of this: http://www.badgerbalm.com/p-393-sleep-balm.aspx on hand. Nice stuff, though it's hard to tell if it's making a difference for me. Can't hurt, though, and smells good.

Absolutely. And Goel only had 8 minutes of contact time prior to bedtime, so it's not like you have to snort the stuff all night.

BTW, their oximetry set-up is fershtoonk. They're pulling data like once every second and taking full percentages so the signal looks ratty. They need to get a continuous feed so they sample down to 1/10ths.

secret agent girl wrote:

NotMuffy wrote:Functional residual capacity.

Uh, I'll have to study up on what that is, unless one of our good members wants to step up and say more.

It's The Loop:

Reductions in lung volume are thought to increase plant gain since smaller lung volumes are less effective at damping changes in PaCO2 and PaO2, thus favoring instability.

secret agent girl wrote:

NotMuffy wrote:you can see there's a significant pattern of Heart Rate Variability.”

secret agent girl wrote:Yeah, I see that and it’s kinda worrisome. Do you think it’s all/mostly in response to desats due to hypopneas due to sleep instability?

Respiratory events.

Well, my heart bounces around like crazy when I'm awake, too. Resting pulse is around 75, and when I stopped at the doctor's office to check out my pulse oximeter, it clocked in at over 100. Helluva jump--I always thought I just had overactive adrenal glands or something. Is everyone like that or not? What can I do to "even it out"?

The physician's office incident was probably due to White Coat Syndrome. The causes of tachycardia and increased heart rate variability are nearly infinite, but I'd certainly start with getting to normal weight and the high end of the AHA recommendation for aerobic exercise (60 minutes most days of the week).

NotMuffy wrote:

secret agent girl wrote:

NotMuffy wrote:Functional residual capacity.

Uh, I'll have to study up on what that is, unless one of our good members wants to step up and say more.

It's The Loop:

Reductions in lung volume are thought to increase plant gain since smaller lung volumes are less effective at damping changes in PaCO2 and PaO2, thus favoring instability.

Consequently, when

SAG wrote:...if you wanna argue that CPAP increases base lung volume (Functional Residual Capacity)(FRC), and since that increases gas exchange, some people can generate centrals that way, fine. But it's not as many as you might think.

a good F/U to that would be that increasing FRC in some people may increase stability.

Did you ever notice that there's never one rule that always applies to everybody?

And if you do a sort of topics based on replies, this thread is up to Page 2 of 1042 pages already?

I hope that people don't start filling up this thread with spacefiller posts to artificially inflate the total.

NotMuffy, perhaps a slight correction...

The oximeters in the $100 range report the data every second, however the sampling rate is usually at least twice the maximum heart rate for the unit. If the maximum heart rate for the unit is 250 beats per minute, that would put a minimum sampling rate at 8.33 hZ. The question is what do they do with the 8+ data points before it is dumped to the 1 second report.

HoseCrusher wrote: The question is what do they do with the 8+ data points before it is dumped to the 1 second report.

The latter would be 1-second "averaging" of that higher-frequency "sampling". And to confuse matters, well-respected oximetry literature often uses the term "sampling rate" when they really mean "averaging rate".

That said, NotMuffy's colloquial comment about coarse granularity and percentage-rounding works okay for me...

NotMuffy wrote: a good F/U to that would be that increasing FRC in some people may increase stability.

CPAP/PEEP increase lung capacity. Considering that CompSAS is (CPAP) treatment emergent, there seems to be an overriding factor/confounder in CompSAS causing the treatment-emergent central instability.

SleepingUgly wrote:

NotMuffy wrote:Lavender was shown by Goel et al to improve SWS. Use the angustifolia variety.

How does one smell it if one has a CPAP mask on?

Usually an applicator pad or tray placed beneath the CPAP machine's air intake.

-SWS wrote:

HoseCrusher wrote: The question is what do they do with the 8+ data points before it is dumped to the 1 second report.

The latter would be 1-second "averaging" of that higher-frequency "sampling". And to confuse matters, well-respected oximetry literature often uses the term "sampling rate" when they really mean "averaging rate".

RIght! Besides sampling rates, averaging rates and reporting rates, then you have the acquistion rate of the PSG software. Now that's OK on SecAgGirl's PSG cause it's set at 32Hz (unnecessarily high actually).

So clearly the oximeter is only sending out one point per second (1 second per tick mark):



and it's averaged to a whole number. So not only are they using the more aggressive desaturation rule (3%) but now they could be getting some 2.5 - 2.9s (which do NOT qualify).

OK, as usual, discussion has fallen into a pile of techno mumbo-jumbo and we've lost the OP...

...again...

... but here's some stuff that should prove interesting.

While the initial perusal of NPSG did not seem to seem to show an FL pattern, the CPAP portion struck me as being a little odd, and I was really hoping to get a Flattening DL to support (or disprove this), but obviously that couldn't happen.

For a little background, processing software in NPSG can do anything you want it to, and one has to be little careful there.

So anyway, further analysis of the CPAP waveform showed this:



which is very significant FL on the CPAP Flow channel.

So now I'm going, OK, the hookah has been out for quite a while, so WTH did that come from?

Digging deeper, its absence was generated by setting the high filter to 0.1. This results in taking the FL and turning it into a "normal" waveform, as can be seen in the background:



As it turns out, this filter setting occured only in acquisition, so it may be that FLs would not be seen during titration. That would be a REAL good thing to check.

But before we get to an AHA! Epiphany, we have to analyze the significance of these FLs, especially if they are responsive or fixed.

And this will still not supercede the discussion re: correcting Bad Sleep.

.

secret agent girl wrote: Lavender
http://informahealthcare.com/doi/abs/10 ... 0500263276:
“…Lavender increased the percentage of deep or slow-wave sleep (SWS) in men and women. All subjects reported higher vigor the morning after lavender exposure, corroborating the restorative SWS increase…”
“…Lavender also increased stage 2 (light) sleep, and decreased rapid-eye movement (REM) sleep and the amount of time to reach wake after first falling asleep (wake after sleep onset latency) in women, with opposite effects in men…”

So if my SWS is increased that might result in fewer arousals and middle of the night insomnia? It goes on to say that the women in the study also experienced decreased REM and wake after SOL. Is SWS the deepest “level” of sleep? Isn’t that where REM occurs? I’m pretty sure that I have no impairment of my SOL 99.9% of the time.

Hmmm, interesting... So lavender increases SWS (that's good), increased stage 2 sleep (isn't that bad?), decreased REM (from my perspective of highly REM-dependent OSA, that's good), and decreased the amount of time to reach wake after first falling asleep (isn't that bad?). Very confusing. Still, I'd be willing to try it. I found something stating that Red Mandarin was found to work better than lavender, but I couldn't find the actual study they were referring to. Personally, I'm more a fan of the citrus scents than lavender, but hey, whatever works best!

No, REM doesn't occur in SWS. It's a separate stage.

Wish I could help with the practical aspects of this, but I'm pretty lost myself.