"please keep me updated about oximeters "
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cpap pressure setting for UARS???????
curious as to what pressures, typically, UARS patients experience relief......a pressure of 7cm works for me in SWS sleep (deep) but not so much in REM.....ready to start cranking it up.
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Replies to This Discussion
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Permalink Reply by Steven Y. Park, MD on
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j_n_k,
Thanks for the link to Dr. Krakow's blog post. It was informative and it seems like we're saying essentially the same thing with a few with a few minor variations. I'm approaching it from an anatomic standpoint, and he's approaching it from a sleep medical/sleep medicine standpoint. What it comes down to is that even partial obstructions to breathing at night can disrupt your sleep.
If you look at Dr. Guilleminault's original paper on UARS, most of his subjects seemed to respond to CPAP, but at relatively low pressures (5-7). I've spoken to Dr. Guilleminault about this and he admits that UARS patients in general can't tolerate being on CPAP, which goes along with OSA/CPAP studies showing that people with lower AHIs tend not to tolerate CPAP as well. Dr. G. talks about UARS patients having and "intact" nervous system, whereas OSA patients have "diminished' nervous systems (this is why patients with severe OSA tend to tolerate CPAP better, even at higher pressures).
My feeling is that UARS patients have a normal or hypersensitive nervous system, which makes them wake up more with any mask, straps or devices. However, it doesn't mean CPAP won't work. I've had many UARS patients that did well with CPAP—it's just that not as many do as well compared with OSA patients. Many do well with oral appliances as well. Some do well with surgery. Everyone's anatomy and needs are different. It seems like Dr. Guilleminault is more excited about palatal expansion and structural modifications in the early stages (such as with children), rather than waiting until full-blown OSA has developed. Since this is initially an anatomic narrow jaw problem, it makes sense.
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Permalink Reply by RockRpsgt on
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Me too. i think I have learned more about RERAs and UARS in the last 2 weeks than I have in 18 months of practice.
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Permalink Reply by Duane McDade on
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Wait a minute let's not get carried away now! ZOE can't tell what stage of sleep you're in ! When are you people going to get it? Machines are not good enough yet ! Maybe someday in the future sure but they do not have enough input to do the job.
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LOL Duane, i was wondering when you were going to chime in on it.
Duane McDade said:Wait a minute let's not get carried away now! ZOE can't tell what stage of sleep you're in ! When are you people going to get it? Machines are not good enough yet ! Maybe someday in the future sure but they do not have enough input to do the job.
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Permalink Reply by sleepsurfer on
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sorry duane, YOU ARE WRONG! have you used a ZEO? have you even heard of a ZEO before this discussion? the ZEO sleep monitor does work very well. the daily results i get mirror the results from my numerous PSG's. As patients we appreciate all of the useful information we get from the many professionals in the industry who comment on this site. however, in this case you are doing more harm than good. i'm sure you have a vast knowledge of sleep disordered breathing and all of the possible treatments, but in this case you are commenting on something that you obviously do not know much about..... it's not a zero or a zoe (sense of humor?) it's a ZEO.
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Permalink Reply by bigsky on
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I tend to agree with Sleepsurfer. I've been using the Zeo for two months now. Although I'm sure it's not perfect, I have noticed when I wake up from a dream and look at my Zeo graph, the Zeo does show the cycle as REM to Wake. One of the reasons I purchased this device is the fact that my last sleep study showed no N3/4 and only 7% REM and I didn't believe this to be true while sleeping at home. According to the Zeo, when I sleep at home my numbers are completely different. I do plan on showing my weekly/monthly stats to my sleep physician. Whether or not he takes it with a grain of salt is his decision.
sleepsurfer said:sorry duane, YOU ARE WRONG! have you used a ZEO? have you even heard of a ZEO before this discussion? the ZEO sleep monitor does work very well. the daily results i get mirror the results from my numerous PSG's. As patients we appreciate all of the useful information we get from the many professionals in the industry who comment on this site. however, in this case you are doing more harm than good. i'm sure you have a vast knowledge of sleep disordered breathing and all of the possible treatments, but in this case you are commenting on something that you obviously do not know much about..... it's not a zero or a zoe (sense of humor?) it's a ZEO.
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Mollete said:
um, that sounds like a lot of work......while using a cpap, my shortwave(deep sleep) is almost arrousal free.....however, at my present pressure(7cm) my REM sleep is still very fragmented.....this is evident on both my PSG's(4 total) and the ZEO....also the percentages are quite similar and the time of night when the different stages occur was the same.....when i let my wife use the ZEO, i got to see what it looks like when a person without sleep disabled breathing uses it......this isn't rocket science folks.....sleepsurfer said:the daily results i get mirror the results from my numerous PSG's.
How many PSGs have you had? Can you post the architectures from the PSGs and the Zeo downloads?
mollete
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NO I AM RIGHT DO YOU KNOW WHATS INVOLVED HERE! MAYBE THE TECHS DOING YOUR PSG's ARE AUTO SCORING THEY'RE TEST. DONT BELIEVE THE HYPE DUDE.......OR DO IT'S YOUR LIFE, GO AHAEAD AND LET A MACHINE RUN IT, THE BLIND LEADING THE BLIND, THATS NOTHING NEW. DONT EVER SAY I'M DOING MORE HARM THAN GOOD. HOW DARE YOU! DO YOU SELL THESE ZOE'S OR SOMETHING?! THERE ARE WAY TO MANY VARIABLES FOR YOUR "ZOE" TO SCORE A TEST I'VE ONLY DONE 5-6000 SLEEP STUDIES. YOU DON'T HAVE ANY IDEA, COME TO MY SLEEP LAB AND TELL ME I DONT KNOW WHAT I'M TALKING ABOUT, TELL THE DOCTOR I WORK FOR !!!
sleepsurfer said:sorry duane, YOU ARE WRONG! have you used a ZEO? have you even heard of a ZEO before this discussion? the ZEO sleep monitor does work very well. the daily results i get mirror the results from my numerous PSG's. As patients we appreciate all of the useful information we get from the many professionals in the industry who comment on this site. however, in this case you are doing more harm than good. i'm sure you have a vast knowledge of sleep disordered breathing and all of the possible treatments, but in this case you are commenting on something that you obviously do not know much about..... it's not a zero or a zoe (sense of humor?) it's a ZEO.
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you are so right!!!!!
Mollete said:Well then, if Zeo is as accurate as a sleep study, then why would anybody who had a sleep study buy a Zeo? 400 dollars is a lot of money. Wouldn't it make more sense to just flush 200 dollars down the crapper instead? You'd still be ahead 200 bucks.
mollete
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You can tell me. I'll let the Doctors know. I can't give out that information, What?
j n k said:Mollete, I agree that anyone who lives at a lab and gets a PSG every night has no need for other equipment. Good point!
Duane, would you mind sending me the number and office hours of the doc you work for? I have a few things to tell him.
;-)
jeff
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And exactly what would you say to Duane's doc jnk? That you know better than he does? That your personal experience overshadows his years of training and practice? For every one doc that likes autos I will show you 100 that do not. Auto setting is not better. It is a personal preference. It is a comfort setting like flex technology. On an auto pap your AHI and arousal index will be higher. The proof is in the numbers which unlike the majority of you I get to see everyday. I would never walk into your job and claim to be better at it than you, yet that is what many people on these sites do to me and the other techs everyday.
j n k said:Mollete, I agree that anyone who lives at a lab and gets a PSG every night has no need for other equipment. Good point!
Duane, would you mind sending me the number and office hours of the doc you work for? I have a few things to tell him.
;-)
jeff
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