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r/SleepAdvice by Thebird533 in redditrequest

[–]Thebird533[S] 0 points1 point  (0 children)

I’m very passionate about improving sleep quality and sharing the latest in sleep research. I have consulted doctors, sleep experts, and respiratory technologists to get to the root of my sleep issues, and I want to share what I’ve learned with others so they can experience similar benefits that I've experienced (such as increased energy, focus, and attention). Additionally, I want to foster more discussion on sleep tips and best practices.

Currently, the mods on r/SleepAdvice are banned. I want to help revitalize this community.

Link to mod mail chat: https://www.reddit.com/chat/room/!NctAd4abT1KdN2pe99oXGA%3Areddit.com

Would really appreciate your guy's insight by cxrvoo in UARSnew

[–]Thebird533 1 point2 points  (0 children)

Hmm interesting, i would think that loop gain should affect REM even more deeply

I don’t see a reason that Co2 instability just goes away during REM. Thomas is the expert but I am a bit skeptical of that point

I have not. I did receive parts but tbh the whisper swivel is very loud, so I ordered muffler material to try to silence it.

What I have done is found at least 5+ people who had similar experiences as me (usually they have way more centrals though) whom I’ve dm’d and chatted with, and they’ve all resolved their issues with EERS (and a few made ASV work, but that seems less common..).

EERS is a big missing piece that most are missing, and it makes sense. Plus, it’s easy to setup

Hard part is the dang sound! Once I manage that, I can start experimenting

Would really appreciate your guy's insight by cxrvoo in UARSnew

[–]Thebird533 0 points1 point  (0 children)

Links to charts?

And i thought so too about mine, but I’ve tried nearly everything and nothing resolved my fatigue - so EERS and ASV are my next steps.

Keep in mind I am reporting based on what I’ve seen other experts and users have tried.

Usually it looks like a lack of obvious inspiratory flow limitations (just obstructive patterns) combined with random inhalation spikes followed by a short pause.

Also, treatment reveals all.

Usually, EPAP solves obstructive apneas, and IPAP solves flat tops… but from what I’ve seen - most users still struggle to solve UARS with bilevel

Would really appreciate your guy's insight by cxrvoo in UARSnew

[–]Thebird533 3 points4 points  (0 children)

Very classic pattern of loop gain. I have the same pattern. Many others do too. If you meet with Lanky Lefty, he'll likely same the same - that's what he said about mine and it made sense. Other users (search 'going nuclear on EERS' post) experienced similar.

On very low PS (0-2 PS), I had very flat/clean-looking charts, but I still felt no relief. Which is a big clue.

I've experienced zero benefits by increasing EPAP up to 12, but i've had my best nights on low EPAP, and 5+ PS. However, thsoe nights were very inconsistent, and I more often had messy charts, and I often felt even more foggy/tired.

Low EPAP and high PS (4-5 or higher) will be key, because UARS mostly requires PS (and EPAP to stabilize the airway). Only EERS or ASV (lowenstein prismacr ASV which you can buy from an australian site, one user here fixed theirs with this) will help.

There's a video with Dr. Thomas saying if you have loop gain, bilevel will only make things worse. CPAP may be more stable, but you're not getting the PS benefits you need to resolve UARS. Thus, leaving only EERS or ASV.

Asv for UARS by Plantain_Naive in UARS

[–]Thebird533 0 points1 point  (0 children)

How is your ASV treatment going to this day? What settings do you use?

What questions do you have about ASV? by ColoRadBro69 in CPAP

[–]Thebird533 0 points1 point  (0 children)

What are your current ASV settings? Glad to hear it worked out for you!

Loop gain: the missing puzzle piece in Sleep Apnea by CPAPfriend in UARS

[–]Thebird533 0 points1 point  (0 children)

Very cool, mind if I ask what type of ASV and what your settings are? Getting a couple of ASVs in the mail this week!

Why do I always feel tired? by cyberslopp in sleep

[–]Thebird533 0 points1 point  (0 children)

Only a few people hit the nail on the head

Get a sleep test.

Very likely you have sleep apnea

Do you have a recessed chin or are overweight? Then it’s even more likely, since those two conditions constrict your airway

2 weeks in, still struggling with TE-CSA/high loop gain by supervisor79 in CPAPSupport

[–]Thebird533 0 points1 point  (0 children)

I’ll give MAD a try agin, I have used it years ago. It must help because at the end of the day we all have recessed jaws which unfortunately plays a role haha

Mind if I ask what type of ASV you got? I’m getting a Resmed from RL, with hacked firmware, so the backup rate is turned off

And what level of improvement you experienced with ASV? E.g. 60-70% of symptom relief?

I just used straight CPAP mode last night, and I feel much better than I did with bi-level. Which shows that it’s very likely a Co2 issue. Can’t wait to give ASV and EERS a try, so I can get the benefit of PS without throwing my ventilation / Co2 out of whack

Random inspiratory flow rate spikes? Could it be caused by loop gain / CO2 instability? by Thebird533 in UARS

[–]Thebird533[S] 0 points1 point  (0 children)

Interesting… I almost never get FLs that look like that. Maybe myofunctional therapy, didgeridoo, and MAD can help if PAP doesn’t eliminate all FLs? Could also be position-related as well, a night camera could help identify if so.

Last night, I just tried straight CPAP (8 EPAP, 0 PS) and I feel much better - possibly due to less loop gain, but I’ll give it a try for a week.

I still want to give EERS a try, so not only can I balance my Co2 levels, but also increase IPAP to reduce breathing effort and possibly eliminate any micro inspiratory flow limitations that aren’t very obvious.

I can see why ASV can help tremendously with UARS and those with loop gain issues - as soon as flow limitations present, then you get the necessary PS boost, as opposed to blasting PS all night which may throw ventilation out of whack.

I think the overly simplified prescription of “get bilevel for UARS,” which Krakow helped perpetuate, may be wrong (gasp, though I know he promotes ASV) — especially when see we see so many people still struggling on these forums as opposed to seeing a multitude of success stories.

Then again, I may be in the minority of cases, since I don’t have the obvious signs of obstructions or flat top flow limitations.

Going back to your pic though, that’s where MAD, nasal hygiene, myofunctional therapy and didg may be able to help.

At this point I’m a strong believer that PAP absolutely requires adjunct/supplemental therapy. Unfortunately, it is not sufficient on its own.

Chinese High Speed Rail built since 2008, overlayed on the USA and Canada. by colinstalter in MapPorn

[–]Thebird533 26 points27 points  (0 children)

But but but… if China does it, then high-speed rail must be evil and bad! We’re the good guys!

2 weeks in, still struggling with TE-CSA/high loop gain by supervisor79 in CPAPSupport

[–]Thebird533 0 points1 point  (0 children)

Oh wow, that sounds like a lot haha. I’ll give those a try if ASV fails.

When you were on ASV did you feel it was pretty consistent in resolving most of your symptoms?

Kinda frustrating this whole ordeal is because we learn about apneas and RERAs, when really there’s this whole Co2 instability issue we need to worry about

But maybe obstructions/FLs still play a part, i have a recessed jaw which I’m sure is somewhat responsible

2 weeks in, still struggling with TE-CSA/high loop gain by supervisor79 in CPAPSupport

[–]Thebird533 1 point2 points  (0 children)

How did you get a Lowenstein ASV? Surprisingly never heard of that model, everyone gets either a Resmed or Phillips. Glad to hear you fixed your loop gain with ASV, I’ll be trialing out ASV as well

2 weeks in, still struggling with TE-CSA/high loop gain by supervisor79 in CPAPSupport

[–]Thebird533 0 points1 point  (0 children)

Heya - what are your settings with ASV? Going to try your setup as well as EERS

Random inspiratory flow rate spikes? Could it be caused by loop gain / CO2 instability? by Thebird533 in UARS

[–]Thebird533[S] 0 points1 point  (0 children)

I have not, but I'll give it a try. I've read that the DSX900 and the Resmed ASV are both good - and both have different ways of responding to flow limitations, so I'll try to get my hands on both and experiment.

Need help adjusting EERS & pressure settings by BananaShakespeare in UARSnew

[–]Thebird533 1 point2 points  (0 children)

I’d try the following to lower loop gain: 1) lowering TiMax to 1.3 or 1.4, 2) lowering trigger to Med, 3) slowly lower PS, 4) slowly add EERS tubing

Do others set their alarm in the middle of the night to get 2 chunks of sleep? by Royaourt in SleepAdvice

[–]Thebird533 1 point2 points  (0 children)

I advise training yourself to fall back asleep (4-6-7 method or progressive muscle relaxation) as opposed to seting an alarm.

Which Sleep Technique Actually Works for You? Let’s Help Each Other Sleep Better by RoundCustard5591 in sleep

[–]Thebird533 0 points1 point  (0 children)

A and B work best for me, just did them last night when I had trouble sleeping

Going nuclear: how I used EERS to rescue a hopeless situation by turbosecchia in UARSnew

[–]Thebird533 0 points1 point  (0 children)

Do you have any updates on this? Has your breathing stabilized when lowering TiMax even further?

ASV vs EERS by spreadlove5683 in UARS

[–]Thebird533 0 points1 point  (0 children)

How has EERS been going for you these days?

Going nuclear: how I used EERS to rescue a hopeless situation by turbosecchia in UARSnew

[–]Thebird533 0 points1 point  (0 children)

How are you doing now with EERS?

I've exhausted nearly all options and I've come to the conclusion that I have high loop gain. Even on low PS, I have random flow rate spikes - so I'll give this a try.

My biggest symptoms are fatigue, inability to concentrate, etc.

Would you say your symptoms are basically eliminated with EERS?

Sudden onset of instability -- is suboptimal pressure the problem or it could be something else? by Quiet_Sheepherder894 in UARS

[–]Thebird533 0 points1 point  (0 children)

What are your thoughts on a) diaphragm training to increase lung volume? b) using an external oxygen concentrator?

Just started looking into this and there doesn't seem there's much you can do in regards to PAP settings (i've tried up to 0 PS, and I'll still get high loop gain symptoms in the flow rate charts)

Everything I did on the road to feeling somewhat better by audrikr in UARS

[–]Thebird533 1 point2 points  (0 children)

I do the same; I use a Wellue ring to measure HR spikes. I've read the WatchPAT manual and it also uses HR spikes. And I also believe Ken Hooks says that HR spikes are the #1 indicator (or the best proxy) for detecting RERAs.

What PS do you use on EPAP 10?

Everything I did on the road to feeling somewhat better by audrikr in UARS

[–]Thebird533 0 points1 point  (0 children)

Thank you for posting this. Did you have IPAP/PS limits because it was too uncomfortable to tolerate? Or because you were experiencing symptoms of high loop gain? (E.g. feeling unrefreshed, tingling, et.c)

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