CPAPtalk.com

Kidding! (at least about the plucking part, anyway)

Some basic tenets:

• Breathing is normally controlled by the chief by-product of respiration, carbon dioxide (although pH and oxygen can influence it as well);
• The pCO2 threshold to breathe increases a few mmHg during sleep;
• Consequently, breathing may be a little unstable during Sleep-Wake Transitions;
• There are a number of different centrals that could be considered "normal" phenomena, including Sleep-Onset Centrals, Post-Arousal Centrals and (Tonic) REM Centrals; and most important
• Despite its name, Sleepyhead does not know whether or not you are, in fact, asleep. Events are not scored in Wake during NPSG, so you could have done a thousand of those during the sleep study, but if they occurred during Wake, without looking at the raw data you would never know they existed.

With that in mind, the posted waveform



shows totally disorganized breathing. One might see this if they were in the Sleep-Wake transition (drifting in and out of light sleep). ASV would not have an appreciable effect on this (although it might "pretty it up", shoving in waveforms where there are none)(but "normal" central events don't need to be "prettied up".)

Can you continue to blow it up, to some 60 second samples? There are more characteristics that need analysis (breath-by-breath). We'll probably need 30s as well.

DeltaDave, from your above list of possible causes of central apneas during sleep-wake periods, what can you say about these fom my data (I know that you need abdominal sensors and EEG for accurate replies):

The followings are ResScan and SleepyHead of the same events (I think):






Skew at action.



IS IT ORGANIZED OR DIS-ORGANIZED?

deltadave wrote:Kidding! (at least about the plucking part, anyway)

Some basic tenets:

• Breathing is normally controlled by the chief by-product of respiration, carbon dioxide (although pH and oxygen can influence it as well);
• The pCO2 threshold to breathe increases a few mmHg during sleep;
• Consequently, breathing may be a little unstable during Sleep-Wake Transitions;
• There are a number of different centrals that could be considered "normal" phenomena, including Sleep-Onset Centrals, Post-Arousal Centrals and (Tonic) REM Centrals; and most important
• Despite its name, Sleepyhead does not know whether or not you are, in fact, asleep. Events are not scored in Wake during NPSG, so you could have done a thousand of those during the sleep study, but if they occurred during Wake, without looking at the raw data you would never know they existed.

With that in mind, the posted waveform



shows totally disorganized breathing. One might see this if they were in the Sleep-Wake transition (drifting in and out of light sleep). ASV would not have an appreciable effect on this (although it might "pretty it up", shoving in waveforms where there are none)(but "normal" central events don't need to be "prettied up".)

Can you continue to blow it up, to some 60 second samples? There are more characteristics that need analysis (breath-by-breath). We'll probably need 30s as well.

MZLAURA, can you do what Dave asked to show individual respiration waves? With your respiration rate of about 20 per minute it means 10 to 20 waves across the window. I tried it in SH and could get this far:




p.s. Delta Dave is a Registered Polysomnographic Technologist™ (RPSGT) and a manager (owner?) of a Sleep Study Clinic. He is the only formal maven on this board (besides some Guests). He has been posting on this board for some 20 years under dozens of screen names. He is probably bored in his job at nights and helps us and several other sleep apnea websites. He is hard to get and likes to be difficult.

Pugsy wrote: I stayed out of this discussion because too many cooks spoil the broth and DeltaDave is head cook.

avi123 wrote:
p.s. Pugsy, I suggest that you remove the remark about DeltaDave, and become friendly with him.

Avi,
I get the impression from your posts that English is not your first language. I see nothing negative about Pugsy's statement. There's a common expression that "too many cooks spoil the broth" which basically means that when a lot of people try to do the same thing at the same time it just confuses everyone (spoils the broth). In this case it could mean that everyone offering different opinions would confuse the original poster. The reference to DeltaDave as head chef in this context would mean that if only one person was going to give an opinion it should be DeltaDave. Not insulting at all (at least not to DeltaDave).

I would have let this go except that you are now posting in other threads demanding a retraction of a statement that I believe you misunderstood.

Midnightowl

DD is not only head cook but he's also chief bottle washer! Avi, those are friendly terms used to describe someone who's a leader . Midnight Owl, I think you may have a good point, never thought of that.

DoriC wrote:DD is not only head cook but he's also chief bottle washer!

DD neither cooks nor washes bottles. AAMOF, he doesn't even rinse prior to recycling (AAMOF2, he doesn't even bother to recycle. He believes "recycling" should be done centrally (bring everything to the processing plants and sort there. Then it becomes 100% efficient, requires less labor (hey, how about my time?) as well as giving much needed jobs a a large number of people (Give Jobs Not Handouts!)).

DD, is it possible that you are a secret moderator on this board?

May be Johnny and Caroline allowed you to browse and delete posts as you see fit?

Also, if I look closely at your recent Avatar, it looks to me as you camouflaged yourself as a Native North or South American?

Unfortunately for the rest of us ....someone has foot in mouth disease again.......or......mouth in motion, mind at stop.

Avi, shame on you! If Dave wanted his photo on display here he would have done it himself. It seems to me you've invaded his privacy.

deltadave wrote:[This has the appearance of Sleep-Wake junk.

I'm not always on board with every one of your recommendations or opinions, deltadave, but I do like the phrase "Sleep-Wake junk". Did you come up with that or did you read it somewhere? It perfectly sums up what I was trying to say in my earlier post. A HUGE amount of people on this site, mostly newbies, worry needlessly about Sleep-Wake Junk (SWJ?) especially when their AHI is <5.0 ... thanks for summing it up!

PS. Avi123, I don't think DeltaDave;s avatar is a Native American... that's Vlad the Impaler, unless I'm mistaken. Lot's of levels of complexity if so.

Sir NoddinOff wrote:I'm not always on board with every one of your recommendations or opinions, deltadave, but I do like the phrase "Sleep-Wake junk". Did you come up with that or did you read it somewhere?

A Google search shows only one result for "sleep wake junk".

The defense rests.

Don't like my R&Os? I'm so offended! Like what?

mzlaura1884 wrote:I once again went back to sleep this morning for a nap for a lousy 4 hours. I was very shaken up when i realized yes while i was sleeping i was in REM definitely my trouble spot. Reason i know is the horrid nightmare i was having where i was shaking, practically crying upon waking up too, and just frightened still am. Based on my nightmares and what it was about "someone passing away" i woke up and checked my data card right away was this nightmare somehow linked to what was going on in my body at the time..very scary for me.

All 11 of these events took place during my "nap" once again thankful i chose to put the mask back on... was debating it.
11 events all centrals, low leaks... all within 20 minutes?

Hi mzlaura1884!

One way or the other, your breathing became unstable.

Your Minute Volume shot up during the events. So, although you stopped breathing many times your average use of air was way up!! Probably you did wash out too much CO2 and the apneas allowed your body to bring the level back up a bit.

I do not recall seeing such a cluster of events in my own data. I do recall that during the season of the anniversary of an severe assault and robbery upon my person my breathing tended to become unstable. Outside stress, I think, has a lot to do with how much the added pressure of using a PAP causes one's breathing to become unstable. Certainly there are many other things such as stimulants, sugar (simple carbs), lack of sleep, job stress, lack of aerobic and interval training exercise, pollution, allergens, etc ... - which contribute to unstable breathing. But the greatest, in my experience, was the reminder of the trauma and concerns over the health of my family members with me incapacitated.

Moving to a low crime environment helped, in my case, a lot!!!!!!!

I think breathing instability is a result of many things. Kind of like (PAP pressure) + (Stress!!) + (lack of exercise) + (stimulants) + (simple carbs) + (CNS activation by violent media) + (lack of sleep) + (lack of kindness) = (too much stuff!! Breathing Unstable!!).

The answers for me have been found in working on the above “list”.

May you find good and restful sleep soon!

Todzo