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For those of you with a medical geek bent, some interesting reading:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3014237/

It's a bit deep, and I sort of ran out of brainpower partway through it, but it's interesting. I'll have to read more later.

This study sounds very interesting for treatment of some people with centrals, CSR, or PB. If it works out, it could really be a boon to some people.

It's basically an idea to increase CO2 in rebreated air to increase CO2 in the lungs and help keep your breathing reflex working. We tend to think that the more we eliminate rebreathing the better, but this points out that there may be some advantage to controlled rebreathing.

However, the idea's a little scary, so I wouldn't go experimenting with it on my own until more research is done.

Kudos to Todzo for bringing it up.

Small, highly-experimental study, in my opinion.

Key points stated that may need to be kept in mind:

Our population was highly selected

In other words, as I read it, the approach may not have application benefits for many people.

An important issue yet to be systematically evaluated is if long term use of EERS is necessary, as it is possible the only role for such approaches may be to improve initial tolerance.

In other words, as I read it, the breathing may stabilize on its own without "EERS" if the patients stay the course.

There are certain subgroups of patients for whom this approach may not be feasible or safe.

In other words, as I read it, the approach may be dangerous for some and too uncomfortable and too expensive for others. Details of why those things may be so?:

For example, obese individuals may have hypoventilation, especially during REM sleep, which may be associated with unacceptable degrees of hypercapnia. Claustrophobic patients will not likely tolerate the tight fit of the mask required. There are additional costs associated with EERS treatment, including equipment, disposables, technician training, patient education, and physician supervision effort.

Interesting stuff, in an experimental sort of way, but far from having widespread application or being proven as a useful common approach, in my opinion as someone too uneducated to have a meaningful medical opinion and too ignorant to be classified as a true geek.

My other opinion is, just as you say, that it is far from being something anyone should try at home on his own.

Definitely very complex. My immediate thought is that it would be something that might be used after a patient has failed on an ASV machine. It would be a last resort. I note that the CO2 was only being added for a short time in each breathing cycle. That would make it difficult to engineer. I would most certainly not want to try and build this at home. It seems to me that you would need to have a blood oxygen and CO2 monitor link to your machine to direct when to add one of the gases.

I am glad that my straight CPAP machine is working for me!

jnk wrote:Small, highly-experimental study, in my opinion.

Key points stated that may need to be kept in mind:

Our population was highly selected

In other words, as I read it, the approach may not have application benefits for many people.

An important issue yet to be systematically evaluated is if long term use of EERS is necessary, as it is possible the only role for such approaches may be to improve initial tolerance.

In other words, as I read it, the breathing may stabilize on its own without "EERS" if the patients stay the course.

There are certain subgroups of patients for whom this approach may not be feasible or safe.

In other words, as I read it, the approach may be dangerous for some and too uncomfortable and too expensive for others. Details of why those things may be so?:

For example, obese individuals may have hypoventilation, especially during REM sleep, which may be associated with unacceptable degrees of hypercapnia. Claustrophobic patients will not likely tolerate the tight fit of the mask required. There are additional costs associated with EERS treatment, including equipment, disposables, technician training, patient education, and physician supervision effort.

Interesting stuff, in an experimental sort of way, but far from having widespread application or being proven as a useful common approach, in my opinion as someone too uneducated to have a meaningful medical opinion and too ignorant to be classified as a true geek.

My other opinion is, just as you say, that it is far from being something anyone should try at home on his own.

Hi jnk!

When I do bring this up and point to the article I usually do so as something they should share with their doctor. The doctors I have come in contact with usually do understand a bit about Apneas and Hypopneas - but seem to have not a clue about unstable breathing or what can be done about it. The article discusses the issues and suggests a rather novel and simple solution.

At any given time not everyone with OSA is dealing with unstable breathing as well. But a decrease in weight, increase in strength, or especially an increase in stress can easily change that.

In my case the "increased stress" was brought about by living in a high crime area - being a victim of violent crime myself - and coming up time wise on the anniversary of the event. With doctor supervision I did myself implement a bit of extended re-breathing space with very notable good results. While not everyone has the skills, motivation, and need to do what I did I gotta tell you I think my choice was much better than the stroke or heart attack which was more likely to result if I had not added the re-breathing space when I did.

I have since removed the re-breathing space and left the high crime area. But, now I have lost weight – but I now find that reducing pressure will work so have no need for re-breathing space at this time.

So I hope you can see that I have found the information useful myself and hope that it may help the medical providers get their patients through hard times as well.

May we get through the hard times!

Todzo

jnk wrote:Interesting stuff, in an experimental sort of way, but far from having widespread application or being proven as a useful common approach, in my opinion as someone too uneducated to have a meaningful medical opinion and too ignorant to be classified as a true geek.

DEFINITELY not something for patients to start rolling their own modified masks and using instead of an ASV unit.