Message for Avi

avi123 wrote:As to SU, she used a four letter word on me when I mentioned to her that her new (at the time) Avatar was an infringement of trademarks.

You mean this?

SleepingUgly wrote:I just would like to say to Avi........YOU gave me shit for MY avatar????!!!! You saved Rested Gal's photo and are using it as YOUR avatar?! I don't know about copyright infringement, but that is just plain wrong (unless you had her permission, in which case, I revise my opinion to say that she must have temporarily lost her mind...which I doubt).

I don't know if that qualifies as using a four letter word ON you, but I guess I should have said, "YOU gave me poop for MY avatar????!!!!"

avi123 wrote:Hi, I came up with the stent idea for CPAP treatment by intuition. I made a mistake mentioning it next to a poster's name. Apparently it was misunderstood. So I am going to delete that post and transfer the content to my own post. Sorry if any one took it to heart.

IMO, distending the upper airway could be done with a stent similarly to the way stents are used in heart's clogged coronary arteries. In such a case the stent would be a metal spring at about 3/4" in dia, coated with Silicone, and placed inside the throat . Initially the stent is collapsed to a smaller size and inserted into the throat by forceps led by an inflated small balloon, where it is let to expand and keep the airway open for the night. To pull it out in the morning, there is a thin plastic wire coming out from the mouth. Pulling this string collapses the stent back to its smaller size. If I could get used to it then I could give up the CPAP.

The system as I described above is presently used instead of doing TURPS (transurethral prostate surgery) quite successfully.

See here:

http://en.wikipedia.org/wiki/Stent

and here

http://www.americanmedicalsystems.com/m ... stric.html

Engineers and gadgeteers, where are you?

Your idea is a poor variant of the nasal trumpet: http://www.google.com/search?q=nasal+tr ... =firefox-a , which is itself already a poor solution.

However, nasal trumpets have been used to great advantage in coma patients with sleep apnea.

ozij wrote:Hi John,
Suppose your airway is not stented.
Your muscles relax, your airway collapses. You've got a 30 second apnea.
Now think of the same apnea, but stent the airway with pressure.
Your muscles relax, the pressure keeps your airway from collapsing, this works for about 15 seconds
Your muscles continue relaxing, against the supplied pressure.
Now the pressure is no longer enough, your airway collapses. However, for 15 seconds, the pressure worked, and now you've got a 15 second apnea instead of a 30 second one.
The pressure doesn't "cut the apnea short " after it starts. Rather, it supplies the resistance that delays the beginning of an apnea..
The effect, time-wise is a "shorter apnea' but it's shorter because the stinting kept it from happening for part of the time.

That is a specious example.

In the first case it took the patient being in apnea 30 seconds to arouse and flex the airway open.

In the second case it took the patient being in apnea 15 seconds to arouse and flex the airway open.

In truth the length of apneas is determined only by how long it takes the subject to arouse and flex the airway open.

I maintain that your example is incorrect.

70sSanO wrote:While this is not exactly related to avi's predicament, I am trying to understand the concept that higher CPAP/APAP pressure does not open an airway, but it can make an obstructive apnea shorter.

If the higher pressure doesn't assist in some way with opening the airway, how can it shorten an event?

I have personally noticed fewer obstructive events with higher pressure, which I can understand under the stent premise. But I have also noticed shorter events with the higher pressure, which I can't explain under the stent premise.

Can someone explain?

Thanks!

John

"Stenting" with CPAP does not shorten apneas. Someone is making this "science" up as they go.

Now if someone wants to argue that a higher pressure causes discomfort that makes some patients sleep less soundly and are therefore prone to quicker arousals and from this they will arouse from apneas more quickly, I will listen to their argument. (Sorry about the clumsy sentence. Gotta go for now.)

People with ResMed machines can track the length of their apnea, and how it is affected by pressure - and have done so.
The same people can keep track of how well they sleep when their pressure is higher and their apneas short - they have done that as well.

NightMonkey wrote:

ozij wrote:Hi John,
Suppose your airway is not stented.
Your muscles relax, your airway collapses. You've got a 30 second apnea.
Now think of the same apnea, but stent the airway with pressure.
Your muscles relax, the pressure keeps your airway from collapsing, this works for about 15 seconds
Your muscles continue relaxing, against the supplied pressure.
Now the pressure is no longer enough, your airway collapses. However, for 15 seconds, the pressure worked, and now you've got a 15 second apnea instead of a 30 second one.
The pressure doesn't "cut the apnea short " after it starts. Rather, it supplies the resistance that delays the beginning of an apnea [apnea onset].
The effect, time-wise is a "shorter apnea' but it's shorter because the stinting kept it from happening for part of the time.

That is a specious example.

In the first case it took the patient being in apnea 30 seconds to arouse and flex the airway open [apnea termination].

In the second case it took the patient being in apnea 15 seconds to arouse and flex the airway open [apnea termination].

I'll have to disagree with your disagreement, NightMonkey. Look at the red and blue text I have highlighted above. Length of anything requires two reference points. Ozij correctly describes that suboptimal CPAP pressure can delay onset of an obstructive apnea---which is based in upper-airway transluminal pressure dynamics. You counter ozij's apnea-onset description by citing only what occurs at the tail end of an apnea with respect to a terminating physiologic stimulus/response....

NightMonkey wrote: In truth the length of apneas is determined only by how long it takes the subject to arouse and flex the airway open.

In truth the length of an apnea is NOT determined only by an apnea's terminating sequence... Rather, the length of an apnea is determined by these two references: 1)the apnea's onset time (delayed or otherwise), subtracted from 2) the apnea's termination time. Starling Resistor modeling supports what ozij described about the onset of an apnea being delayed by suboptimal stenting pressure.