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Paper_Nanny wrote: Wondering and wondering...

To protect you from yourself, the ASV gods have locked you out of PS Min. As NM has suggested, you are are using an ASV as an atomic canon to swat a fly. And, I believe NM has further suggested your need for bi-level therapy is probably suspect. But, you may continue to drag this out until hell freezes over. You and Madalot should meet for coffee?

StillAnotherGuess wrote:

Paper_Nanny wrote: Wondering and wondering...

To protect you from yourself, the ASV gods have locked you out of PS Min. As NM has suggested, you are are using an ASV as an atomic canon to swat a fly. And, I believe NM has further suggested your need for bi-level therapy, is probably suspect. But, you may continue to drag this out until hell freezes over. You and Madalot should meet for coffee?

Did you sort out all your SDB quickly or did it take months & months (years) of your own experimenting (not something everyone can or wants to do). Also, when a thread offers valuable insights as to how the therapy is viewed by a professional and how an ordinary user interacts with a professional, there is a significant opportunity for a lot of people to watch & learn. This thread is very much in that phase of its life. Let it be

DSM

dsm wrote:

StillAnotherGuess wrote:

Paper_Nanny wrote: Wondering and wondering...

To protect you from yourself, the ASV gods have locked you out of PS Min. As NM has suggested, you are are using an ASV as an atomic canon to swat a fly. And, I believe NM has further suggested your need for bi-level therapy, is probably suspect. But, you may continue to drag this out until hell freezes over. You and Madalot should meet for coffee?

Did you sort out all your SDB quickly or did it take months & months (years) of your own experimenting (not something everyone can or wants to do). Also, when a thread offers valuable insights as to how the therapy is viewed by a professional and how an ordinary user interacts with a professional, there is a significant opportunity for a lot of people to watch & learn. This thread is very much in that phase of its life. Let it be

DSM

DSM,
With all due respect, sir. PN began this thread with an issue of variable PTB. NM has put that problem to bed. She now has 100% PTB, and at AHI 10. Her SA symptoms are less than "Mild". So what is there to continue to learn, here? She is back to her old mask, looking for how she engage PS MIn, so what are we all supposed to do? I guess we can discuss PN's dread locks and her addiction or not addiction to prescription meds. I do not think we have much more to learn here.

StillAnotherGuess wrote:
<snip>

DSM,
With all due respect, sir. PN began this thread with an issue of variable PTB. NM has put that problem to bed. She now has 100% PTB, and at AHI 10. Her SA symptoms are less than "Mild". So what is there to continue to learn, here? She is back to her old mask, looking for how she engage PS MIn, so what are we all supposed to do? I guess we can discuss PN's dread locks and her addiction or not addiction to prescription meds. I do not think we have much more to learn here.

With further due respect, sir. As long as PN & NM are willing to keep this thread going, people can learn from it, even if you haven't anything to learn from it. Surely this is their dance & you are only contributing a spoiler value !. If there is some sharing of warm fuzzies along the way by those involved, that too is value.

Also, getting personal about things people have posted is a real negative. In fact, not nice at all.

Cheers

DSM

dsm wrote: Also, getting personal about things people have posted is a real negative. In fact, not nice at all.

Point taken, But we have taken 23 pages to discover that PN may need little CPAP therapy, end of story. There is probably no reason for this thread to to go on to be TUOTMOAT. If Madalot would stop reinventing herself at every turn, she could be TUOTMOAT. As I recall, TMOAT was an ASV thread?

StillAnotherGuess wrote:She now has 100% PTB

You do realize that's because she's using her ASV in CPAP mode right now, and has her backup rate turned to "off," right? All breaths must by definition be patient-triggered if there is no backup rate.

StillAnotherGuess wrote:and at AHI 10.

Predominantly centrals, as was the case in her diagnostic, and as one might expect when you turn that backup rate off. Whether and how much to treat them remains the question that Paper_Nanny and NotMuffy are continue to discuss. No one is really arguing the severity issue.

StillAnotherGuess wrote:Her SA symptoms are less than "Mild".

No, "mild" is typically defined quantitatively as an AHI ranging between 5 and 15. That puts her untreated numbers squarely in the "mild" range. Qualitatively, she still has lots of residual daytime sleepiness. That, too, is at least a "mild" symptom. I seriously doubt Paper_Nanny continues to ask questions out of sheer boredom. Even if the answer is that straight CPAP mode is the best approach for her (possible), she's basically starting from scratch on the pressure question.

StillAnotherGuess wrote:So what is there to continue to learn, here? ... I do not think we have much more to learn here.

See above. You may choose not to learn. But for Paper_Nanny and lots of other observers, the evolution of this thread continues to be both interesting and valuable. If you aren't deriving any value from it, there's a very easy solution to that problem.

StillAnotherGuess wrote:PN began this thread with an issue of variable PTB. NM has put that problem to bed.

PTB went to 100% when I changed settings on the machine so it was working like a regular BiPAP. That was done at the suggestion of MSD and Bob, the Respironics guy.

StillAnotherGuess wrote: She now has 100% PTB, and at AHI 10. Her SA symptoms are less than "Mild".

With an AHI of 10, yes, my sleep apnea is in the mild range. As for my symptoms, I am curious as to how you came to the conclusion that they are "less than "Mild"?

StillAnotherGuess wrote:She is back to her old mask, looking for how she engage PS MIn,

Yup, back to the old mask after a couple nights with the Quattro so Not Muffy could get some information about the dead space. He got the information, said it looked good on paper, but not so much in reality. From that, I concluded that there was no reason to keep using the Quattro, so I went back to my old mask. It is more comfortable, especially for the still hurting broken nose, and it doesn't leak as much.

Looking to engage PS min because tPS min= 4 is how the settings were on my old machine. At least I am pretty sure that's how it was. No reason to change settings just because I got a new machine. Well, except the humidity settings. Now I can change those all over the place, thanks to my PR System One BiPAP ASV.

StillAmotherGuess wrote:I guess we can discuss PN's dread locks and her addiction or not addiction to prescription meds. I do not think we have much more to learn here.

If you don't think you have much more to learn here, you don't have to stay. As for a discussion about my dread locks, sure, I'll go for that. Start a separate thread and I'll join you. Have some coffee. Invite Madalot.

Addiction or not addiction to prescription medications. Also an interesting topic. But before that can be discussed, you would need to explain why it matters and to which medications specifically you are referring.

Once upon a time, I was on Darvocet. When my neurologist suggested that medication, I was hesitant. She told me yes, I might become addicted to it, but so what? In the grand scheme of things, would it really matter if my body required the use of the that medication? I decided that it probably didn't. Because I needed the medication to stop the dystonia going on in my mouth and throat.

Had anyone asked me, "Do you eat with that mouth?" before the Darvocet, I would have emphatically said, "Hell, no!!!" But, no one would have known that's what I said. Because the dystonia was so bad my speech was usually fairly unintelligible. So, I took a low dose of Darvocet for years. I could talk. i could swallow. I could eat with that mouth. I don't know if i was addicted or not. But what if I had been? Would that have mattered??

Eventually the dystonia resolved itself and I was weaned from the Darvocet. No harm, no foul?

Oh, and buy the bye, that is the true story of why I got a PEG tube. I couldn't eat because I was choking so much. But thanks to those pretty pink pills, I was able to have the tube taken out after awhile and eat without choking. Hurray for Drugs!!

Deborah

edit to add missing information

Paper_Nanny wrote: Looking to engage PS min because tPS min= 4 is how the settings were on my old machine. At least I am pretty sure that's how it was. No reason to change settings just because I got a new machine.

Exactly my point. You either do not listen to NM or you have a selective reading skill set. I don't think NM suggested that bi-level therapy was what you need.

StillAnotherGuess wrote:

Paper_Nanny wrote: Looking to engage PS min because tPS min= 4 is how the settings were on my old machine. At least I am pretty sure that's how it was. No reason to change settings just because I got a new machine.

Exactly my point. You either do not listen to NM or you have a selective reading skill set. I don't think NM suggested that bi-level therapy was what you need.

Were you able to always follow every point / issue NM raised when you started ? - I think not.

D

dsm wrote: Were you able to always follow every point / issue NM raised when you started ? - I think not.

In the original name for this thread, PN asked for help with "Variable Patient Triggered Breathing". With NMs input, PNs variable PTB has been addressed and mitigated with CPAP therapy. PN then chose to rename her thread (Unlike Madalot who just generates another thread). Since PN original premise for this thread has been successfully addressed, let me re-raise the next NM question to PN, which NM raised to PN sometime ago in this thread... "What is your problem"?

OK, I need everybody to take a deep breath.

No, seriously, take a big, deep breath, exhale and hold that exhalation until you feel the urge to inhale again. Count the number of seconds from the end of that exhalation to the beginning of the needed inhalation.

Deleted - Defer to NM

If that time span was 10 seconds or more, that was a central apnea (not really, you'd need to be asleep, but pretend).

Anyway, you only breathe when you need to (insert 47 exceptions here later). The response to the large breath was normal. The body needs to build up CO2 and then a regular breathing pattern resumes. This phenomenon occurs following an "arousal" - a sleep disturbance that causes a deep breath, or "sigh" followed by a compensatory pause. On the waveforms, it looks like this:



Those need to be left alone. I would imagine if you tried to attack it with an ASV, the already low pCO2 would be driven lower no matter how aggressive the attack is, and a run of chain centrals could occur (you would probably need to have some of that "increased chemoresponsiveness" for that to really perpetuate. Normal chemoresponsiveness is like a shock absorber. Hit a bump and you only bounce once).

Anyway, cross out all those centrals in the waveforms and recalculate your AHI.

This "hypopnea" is just a bunch of artifact:



Probably something like a body movement (perhaps involving a tarp). Cross out that and the post-arousal central.