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Permalink Reply by RockRpsgt on May 29, 2010 at 3:49pm

OSA is a complete cessation in breathing. Sometimes with hypopneas that cause desats. UARS is a little more different in that it causes more arousals than o2 desats. Usually the events that are presented with UARS are Respiratory Effort Related Arousals or RERAS. A RERA is caused by flow limitation in the airway that ends with an arousal. Apneas and hypopneas are not as common with this diagnosis but can be seen. I am not an MD. It is my opinion that RERAs occur as a defense mechanism to keep an apnea, or hypopnea from occurring. Thus they prevent the desat from happening. The problem with this this type of event is the arousal. While you may not have the same health problems (depends on the extent), the arousals will cost you sleep. The loss of sleep (as I am sure that you are well aware of.) will eventually cause the problems.

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Permalink Reply by RockRpsgt on May 31, 2010 at 2:35pm

it is just that OSAS disturbs sleep when the airway closes and UARS disturbs sleep BEFORE the airway closes. Or, at least, that is one simple way of looking at it as a patient.

Wonderful explanation jnk! If I had your great use of the english language I would be dangerous!

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Permalink Reply by RockRpsgt on May 31, 2010 at 3:28pm

Those docs view the airway as going through a stage of hypersensitivity before reaching a stage of a loss of sensitivity--kind of like how rubbing a spot on your hand will create a blister before it becomes a callus, only in this case it is the nervous system that becomes twitchy then eventually ignores the signals from the airway.

To me, that model makes sense, because it takes into consideration how the body adapts to changing circumstances--in this case, at first, sacrificing sleep in an attempt to maintain oxygenation (as in UARS) and then sacrificing oxygenation in an attempt to maintain sleep (allowing apneas), until both problems become critical (obstructive sleep apnea syndrome).

This is a good theory or model to go by. It would be hard to prove without sacrificing a few individuals. What the hell it's all in the name of science tight?! ;)

I think we should take all of the claims adjusters and put them in an isolated room for six weeks to sleep. In this room we would cut the o2 by 10% and wake them up every hour. Do you think it would make a difference?

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Permalink Reply by RChatty on June 1, 2010 at 12:57pm

Thank you so much. It's making a world more sense now. All those ABC's get rather confusing at times. Funny thing is, I remember waking up shaking and gasping when I was very little, like 9-10 years old and I never considered it to be something I should worry about. I'm 19 now and no one could make sense of all my health problems ie. hypertension, chest pain, heart attack symptoms etc. etc until I got a doctor who asked me if I ever woke up in the night. My reply was "Yes, all the time but I don't know why."

Another thing is my sleep study was NOT natural and I woke up a couple hours after going to sleep and laid awake for hours both times. I had 1 CSA and 1 OSA and 14 RERAS per hour. They told me this was mild, but I feel like I wake up at home WAY more than that. It's annoying to say the least.

I can't wait until I get the machine because the 2nd night in the lab was enough to convince me. Even though I didn't sleep well, I felt better when I woke up than the 1st night in the lab. I imagine it will be even better when it's in a familiar place.

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Permalink Reply by RL on June 1, 2010 at 1:54pm

LOL - I'll donate my old pillow!

Thanks, you guys, for your explanations, descriptions, and cautions. This helps me understand this subject a lot better too. Understanding helps us explain what we, as patients, are experiencing when we speak with our own medical teams, hopefully in a way that allows them to make a better diagnosis and with adjusting our treatment. Keep up the good work!

j n k said:

You've got my vote! :-)

I say push a pillow over their face for a minute or so exactly four times an hour. If they complain about it, explain to them that they have no basis for complaint, since their simulated AHI has not yet reached 5.

Rock Hinkle said:

Those docs view the airway as going through a stage of hypersensitivity before reaching a stage of a loss of sensitivity--kind of like how rubbing a spot on your hand will create a blister before it becomes a callus, only in this case it is the nervous system that becomes twitchy then eventually ignores the signals from the airway.

To me, that model makes sense, because it takes into consideration how the body adapts to changing circumstances--in this case, at first, sacrificing sleep in an attempt to maintain oxygenation (as in UARS) and then sacrificing oxygenation in an attempt to maintain sleep (allowing apneas), until both problems become critical (obstructive sleep apnea syndrome).

This is a good theory or model to go by. It would be hard to prove without sacrificing a few individuals. What the hell it's all in the name of science tight?! ;)

I think we should take all of the claims adjusters and put them in an isolated room for six weeks to sleep. In this room we would cut the o2 by 10% and wake them up every hour. Do you think it would make a difference?

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Permalink Reply by Renee on June 3, 2010 at 6:51pm

Hello Jeff ~

You sure have me laughing here ! ! ! What a perfectly wonderful idea you have conjured up !

Renee
____________________________________________________________________________

j n k said:

You've got my vote! :-)

I say push a pillow over their face for a minute or so exactly four times an hour. If they complain about it, explain to them that they have no basis for complaint, since their simulated AHI has not yet reached 5.

Rock Hinkle said:

Those docs view the airway as going through a stage of hypersensitivity before reaching a stage of a loss of sensitivity--kind of like how rubbing a spot on your hand will create a blister before it becomes a callus, only in this case it is the nervous system that becomes twitchy then eventually ignores the signals from the airway.

To me, that model makes sense, because it takes into consideration how the body adapts to changing circumstances--in this case, at first, sacrificing sleep in an attempt to maintain oxygenation (as in UARS) and then sacrificing oxygenation in an attempt to maintain sleep (allowing apneas), until both problems become critical (obstructive sleep apnea syndrome).

This is a good theory or model to go by. It would be hard to prove without sacrificing a few individuals. What the hell it's all in the name of science tight?! ;)

I think we should take all of the claims adjusters and put them in an isolated room for six weeks to sleep. In this room we would cut the o2 by 10% and wake them up every hour. Do you think it would make a difference?

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Permalink Reply by Renee on June 3, 2010 at 7:06pm

Hey Rock ~

Thanks for this really good understanding.

Best,
Renee
___________________________________

Rock Hinkle said:

OSA is a complete cessation in breathing. Sometimes with hypopneas that cause desats. UARS is a little more different in that it causes more arousals than o2 desats. Usually the events that are presented with UARS are Respiratory Effort Related Arousals or RERAS. A RERA is caused by flow limitation in the airway that ends with an arousal. Apneas and hypopneas are not as common with this diagnosis but can be seen. I am not an MD. It is my opinion that RERAs occur as a defense mechanism to keep an apnea, or hypopnea from occurring. Thus they prevent the desat from happening. The problem with this this type of event is the arousal. While you may not have the same health problems (depends on the extent), the arousals will cost you sleep. The loss of sleep (as I am sure that you are well aware of.) will eventually cause the problems.

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