CSA

rudypv wrote:

Todzo wrote: I think your system gets really upset, be it from obstructive apneas or from high respiratory control loop gain working with possible low arousal threshold likely becoming long term facilitated and so causing you to awaken in a state of long term facilitated hyperventilation. I used to wake up that way from time to time and solve it (at the time) with eucapnic breathing techniques

I'm very interested in this: when you talk about "high respiratory control loop gain working with possible low arousal threshold", is it something caused by physiological issues? As I said, usually in periods of relaxation and when I do my yogic breathing, etc... I don't have these episodes. Do you suggest me to look into the eucapnic techniques?

Respiratory control system gain appears to mix chemoreflexes (the several blood gas sensors in our body talk to the control system) muscle responsiveness, and the general state of our central nervous system which includes stress. In my case Post Traumatic Stress from a serious assault and robbery appeared to be able to raise that gain to the point of hyperventilation during the daytime.

Eucapnic breathing helped that greatly. However I think one could go to far with the techniques and become hypercapnic. As I thought about it heart rate seemed a good key as it would raise if hypocapnic or hypercapnic but would be lowest if eucapnic (the eucapnic state would have the most efficient metabolism). While searching for the breathing rates which produced the lowest heart rates with exertion held constant (at desk or on treadmill) I found that at the desk they occurred at an SpO2 of 96% and with moderate exercise on the treadmill an SpO2 of 97% would be very close to the lowest heart rates. Perhaps it was due to being in better shape or perhaps due to a change in altitude from 500' to 2500' ASL but now it is 95% and 96% respectively. I think one would always need to go through the exercise of finding the lowest heart rates to make this work if they wanted to.

But you have already found yoga and all and that is a very good approach.

I have found that long term exercise (cycling or walking for hours a day) does seem to help with arousal threshold if you do not take it too far. There just seems to be a “sweet spot” where you are tired and glad to be in bed and your system puts out the “do not disturb” sign to the small stuff. Breathing reflexes also seem to be more stable.

Life stress is a thing to consider. I am very glad I moved away from a big city I now see as dangerous. Knowing that the crime statistics are lower here simply makes it easier for me to live. I like that. Very much worth the change.

Why.. does the shoe fit?

Todzo wrote:

rudypv wrote:

Todzo wrote: I think your system gets really upset, be it from obstructive apneas or from high respiratory control loop gain working with possible low arousal threshold likely becoming long term facilitated and so causing you to awaken in a state of long term facilitated hyperventilation. I used to wake up that way from time to time and solve it (at the time) with eucapnic breathing techniques

I'm very interested in this: when you talk about "high respiratory control loop gain working with possible low arousal threshold", is it something caused by physiological issues? As I said, usually in periods of relaxation and when I do my yogic breathing, etc... I don't have these episodes. Do you suggest me to look into the eucapnic techniques?

Respiratory control system gain appears to mix chemoreflexes (the several blood gas sensors in our body talk to the control system) muscle responsiveness, and the general state of our central nervous system which includes stress. In my case Post Traumatic Stress from a serious assault and robbery appeared to be able to raise that gain to the point of hyperventilation during the daytime.

Eucapnic breathing helped that greatly. However I think one could go to far with the techniques and become hypercapnic. As I thought about it heart rate seemed a good key as it would raise if hypocapnic or hypercapnic but would be lowest if eucapnic (the eucapnic state would have the most efficient metabolism). While searching for the breathing rates which produced the lowest heart rates with exertion held constant (at desk or on treadmill) I found that at the desk they occurred at an SpO2 of 96% and with moderate exercise on the treadmill an SpO2 of 97% would be very close to the lowest heart rates. Perhaps it was due to being in better shape or perhaps due to a change in altitude from 500' to 2500' ASL but now it is 95% and 96% respectively. I think one would always need to go through the exercise of finding the lowest heart rates to make this work if they wanted to.

But you have already found yoga and all and that is a very good approach.

I have found that long term exercise (cycling or walking for hours a day) does seem to help with arousal threshold if you do not take it too far. There just seems to be a “sweet spot” where you are tired and glad to be in bed and your system puts out the “do not disturb” sign to the small stuff. Breathing reflexes also seem to be more stable.

Life stress is a thing to consider. I am very glad I moved away from a big city I now see as dangerous. Knowing that the crime statistics are lower here simply makes it easier for me to live. I like that. Very much worth the change.

Thanks again for sharing your experiences.

I'm aware that, in period of apneas, I have a quite increased arousal threshold (I wake up with every sound, etc,... with slight tachycardia). That's what led me to AF last year, a strong door slam during the night.

My other weird symptom is that I wake up suddenly and abruptly in the morning... like from 0 to 100 in a millisecond, always with slight tachycardia.

rudypv wrote:
Thanks again for sharing your experiences.

I'm aware that, in period of apneas, I have a quite increased arousal threshold (I wake up with every sound, etc,... with slight tachycardia). That's what led me to AF last year, a strong door slam during the night.

My other weird symptom is that I wake up suddenly and abruptly in the morning... like from 0 to 100 in a millisecond, always with slight tachycardia.

This reminds me of a time when I was tracking down some morning breathing instability while using CPAP. I hooked up a "Sonic Ear" (see: http://www.amazon.com/SuperEar-Personal ... B000X2H8G4 ) to my netbook and used an open source program called Audacity (an audio recording and wave for editing program) to record and "see" events and be able to hear what was going on during them. It turned out that my neighbors were arguing when I had the problems. Ear plugs helped but they soon were gone. Another time it was a loud motorcycle starting up in the morning.

I am thankful for my quiet neighborhood. Moving was such a good choice for me.

Todzo wrote:

Julie wrote:And for what it's worth (seeing as you're a newbie) the odd person on this forum may tend to be pushy when it comes to alternative health 'answers' and give the same answers to any and everyone who writes in with problems regardless of relevance... so don't assume (even if you can make sense of their notes) that all have great advice for you... stick with those who make sense.

stop the personal attacks

It is not a "personal attack" when someone expresses a valid concern about the credibility of certain posters who just seem to "make up crap" in order to "look smart".

Thanks guys for your opinions.
Unfortunately, since the medical world is very fragmented and compartmentalized, sometimes it's difficult to find an honest and complete perspective from a specialist.
Mostly in a case such as this one - including a variety of symptoms. So every opinion is a valuable perspective to listen to.

rudypv wrote:Thanks guys for your opinions.
Unfortunately, since the medical world is very fragmented and compartmentalized, sometimes it's difficult to find an honest and complete perspective from a specialist.
Mostly in a case such as this one - including a variety of symptoms. So every opinion is a valuable perspective to listen to.

Western medicine has made itself into an ineffective mess. So here they try to shill and troll thier way through.

I have found reflexology, accupressure, and acupuncture of value. With what you are dealing with I think that they would be worth a try.

Todzo... I think you are well intentioned and well informed in many things. However, I also think those need to be applied where relevant, and by that I mean that if you understood the body more completely, the anatomy and physiology, etc., as well as the how mental and emotional states can impact which parts of your system, you'd be in a better place to advise people.

There are certain aspects of your system that are not going to be affected by vitamins, reflexology, etc. no matter how much you might want them to be.. think of them as being 'mechanical' if you want, and Cpap addresses the fact that airways in people come in the sizes they come in, and need prescribed air pressures to keep them open.

They are narrow due to anatomical structure, extra fat, posture, etc., and while it's great to be in the best all around health you can by exercising, eating right and e.g. meditating, it's unlikely that odd breathing techniques or some other alternative, progressive as they might be) therapies will change them.

Apnea is also a respiratory problem, often triggered by neurological factors, but the fixes are limited by mechanical factors, occasionally sleep position, but not by how you eat (except where GERD is a factor), or accupressure, etc. Those modalities may be terrific when applied as the 'hammer' to appropriate nails, but apnea really doesn't seem to be one of those nails.

Todzo wrote: Western medicine has made itself into an ineffective mess. So here they try to shill and troll thier way through.

I have found reflexology, accupressure, and acupuncture of value. With what you are dealing with I think that they would be worth a try.

No NO NO.
I studied that stuff, it is wonderful - to help with recovery, pain control, and stress. No certified practitioner worth going to will say any different. It is an adjunct to Western medical care. I practised all that stuff and I still have severe OSA.

BlackSpinner wrote:

Todzo wrote: Western medicine has made itself into an ineffective mess. So here they try to shill and troll thier way through.

I have found reflexology, accupressure, and acupuncture of value. With what you are dealing with I think that they would be worth a try.

No NO NO.
I studied that stuff, it is wonderful - to help with recovery, pain control, and stress. No certified practitioner worth going to will say any different. It is an adjunct to Western medical care. I practised all that stuff and I still have severe OSA.

We do not know if rudypv has OSA or not.

We do know that rudypv deals with issues of stress.

If rudypv has OSA CPAP may well be contraindicated by nonanatomic sources[1,2]

While you say that you have tried these things others testify of cure via TCM in various forms. As well TCM has been around much longer than western medicine.


[1] Danny J. Eckert, David P. White, Amy S. Jordan, Atul Malhotra, and Andrew Wellman "Defining Phenotypic Causes of Obstructive Sleep Apnea. Identification of Novel Therapeutic Targets", American Journal of Respiratory and Critical Care Medicine, Vol. 188, No. 8 (2013), pp. 996-1004. doi: 10.1164/rccm.201303-0448OC

[2] Sairam Parthasarathy M.D., Emergence of Obstructive Sleep Apnea Phenotyping. From Weak to Strong! American Journal of Respitory and Critical Care Medicine VOL 188 2013
-- critical closing pressure [Pcrit] - Arousal Threshold - ventilatory control Loop gain - and genioglossal Muscle responsiveness. Pcrit, Loop, Arousal, Muscle (PALM)--

Todzo wrote: We do not know if rudypv has OSA or not.

We do know that rudypv deals with issues of stress.

If rudypv has OSA CPAP may well be contraindicated by nonanatomic sources[1,2]

While you say that you have tried these things others testify of cure via TCM in various forms. As well TCM has been around much longer than western medicine.

NO I STUDIED them. I have certification. Yes there is lots of anecdotal data. Yes some acupuncture has been proven to help some issues.

Blood letting has been around for a long time too and so has drilling holes in the head.

Black Spinner - please take this in the spirit in which it's meant - '
Trepanning (drilling head holes) is still done today in major teaching hospitals by neurosurgeons to relieve pressure when necessary, though not done quite in the same way as it was in the (?) Stone Age!

Todzo wrote:

BlackSpinner wrote:

Todzo wrote: Western medicine has made itself into an ineffective mess. So here they try to shill and troll thier way through.

I have found reflexology, accupressure, and acupuncture of value. With what you are dealing with I think that they would be worth a try.

No NO NO.
I studied that stuff, it is wonderful - to help with recovery, pain control, and stress. No certified practitioner worth going to will say any different. It is an adjunct to Western medical care. I practised all that stuff and I still have severe OSA.

We do not know if rudypv has OSA or not.

We do know that rudypv deals with issues of stress.

If rudypv has OSA CPAP may well be contraindicated by nonanatomic sources[1,2]

While you say that you have tried these things others testify of cure via TCM in various forms. As well TCM has been around much longer than western medicine.


[1] Danny J. Eckert, David P. White, Amy S. Jordan, Atul Malhotra, and Andrew Wellman "Defining Phenotypic Causes of Obstructive Sleep Apnea. Identification of Novel Therapeutic Targets", American Journal of Respiratory and Critical Care Medicine, Vol. 188, No. 8 (2013), pp. 996-1004. doi: 10.1164/rccm.201303-0448OC

[2] Sairam Parthasarathy M.D., Emergence of Obstructive Sleep Apnea Phenotyping. From Weak to Strong! American Journal of Respitory and Critical Care Medicine VOL 188 2013
-- critical closing pressure [Pcrit] - Arousal Threshold - ventilatory control Loop gain - and genioglossal Muscle responsiveness. Pcrit, Loop, Arousal, Muscle (PALM)--

I forgot to add that even if he is proscribed CPAP the use of TCM may help with enough of the issues of stress to help CPAP work for him. As you know there are very serious usability issues to the extent that almost if not more than half of the people find that they cannot use CPAP long term (over a year looking at honest objective data).

But that's because people do not get properly introduced to their equipment by providers... no education is given, and the average 'patient' may not have knowledgable doctors to inform them of anything else but to keep trying with the inadequate set up doled out by their DME's... once people are helped to find the right stuff, they usually are very happy they found help for their problem so their stress goes away.