Tidal volume and Flow limitations

[palerider]

provoke

If only you could *provoke* less.

[AmSleepnBetta]

Two roughly related images are shown below.

1) New and of interest:

The first image is an abstract of a report about tidal volume drops which was presented at a symposium in 2014. The full report is behind a pay wall. The abstract below, in my view, does not provide sufficient detail about the selection of test subjects' inspiratory wave shapes. Nevertheless, this is the first research I've seen presenting quantitatively the tidal volume loss observed for specific different wave shapes. As I understand the abstract and graphs, the 25%, 25-50% and 50% losses were the drops in flow from low limitation dosages relative to flow without the dosage. The role of elevated duty cycle ratio is not stated but implicit in the testing centered on high levels of negative effort dependence (NED).

2) Here is follow-up of the first item listed in the spreadsheet which was inadvertently omitted: https://www.cpaptalk.com/viewtopic/t183 ... 0#p1406339

The second graphic below shows the image that initiated this thread as presented by dataq1. Palerider, deemed or acting as forum leader, was first to reply, as shown, within 2 hours. There are two dips in the TV curve (one is slight) before the recovery breathing.

Morbius indicated my and dataq1's examples of tidal volume loss from flow limitations fell short of showing that loss. In response to Morbius' claim I countered by posting in this thread a list of the post dates and times and FL-TVd times. The small image below provides the first listed item, which I inadvertently omitted from the post with the listing. Morbius' unsupported and refuted claim re lack of showing TV at FL is here: https://www.cpaptalk.com/viewtopic/t183 ... 0#p1406145

ItoE&dC-ratios-table&figure-2.gif (154.63 KiB) Viewed 720 times

Post-1-image-PR&dataq1.GIF (40.33 KiB) Viewed 720 times

[Morbius]

Two roughly related images are shown below.

1) New and of interest:

The first image is an abstract of a report about tidal volume drops which was presented at a symposium in 2014. The full report is behind a pay wall. The abstract below, in my view, does not provide sufficient detail about the selection of test subjects' inspiratory wave shapes. Nevertheless, this is the first research I've seen presenting quantitatively the tidal volume loss observed for specific different wave shapes. As I understand the abstract and graphs, the 25%, 25-50% and 50% losses were the drops in flow from low limitation dosages relative to flow without the dosage. The role of elevated duty cycle ratio is not stated but implicit in the testing centered on high levels of negative effort dependence (NED).

2) Here is follow-up of the first item listed in the spreadsheet which was inadvertently omitted: https://www.cpaptalk.com/viewtopic/t183 ... 0#p1406339

The second graphic below shows the image that initiated this thread as presented by dataq1. Palerider, deemed or acting as forum leader, was first to reply, as shown, within 2 hours. There are two dips in the TV curve (one is slight) before the recovery breathing.

Morbius indicated my and dataq1's examples of tidal volume loss from flow limitations fell short of showing that loss. In response to Morbius' claim I countered by posting in this thread a list of the post dates and times and FL-TVd times. The small image below provides the first listed item, which I inadvertently omitted from the post with the listing. Morbius' unsupported and refuted claim re lack of showing TV at FL is here: https://www.cpaptalk.com/viewtopic/t183 ... 0#p1406145


ItoE&dC-ratios-table&figure-2.gif Post-1-image-PR&dataq1.GIF

As it appears some SAG characters (slightly) exceeded the 1000 post limit I do not feel hypocritical, nor guilty, about tossing in a couple more.

1. There is nothing in that abstract about tidal volume reductions. If you want to pursue this buy the article, send it to me and I'll review it.

2. Dayquill's image does NOT show tidal volume reduction. It's insignificant. It's non-existent. It's absurd. It's IDK how to explain it to you that there's nothing there.

3. Trying to analyze tidal volume from that flow curve is completely worthless anyway because of the inaccuracy of the extrapolated data as previously mentioned. If I wanted to look at tidal volume data I'd be looking at RIP belts.

4. Don't even try to infer that I denied a relationship between tidal volume exists. Also previously noted as obstruction increases FL > hypopnea > apnea and if we WERE using RIP belts at apnea VT = 0.

5. You clearly have NFI what you're talking about and I'd really appreciate it if you'd just stop.

oxoxoxox

[Morbius]

DPW
FRC
AAMOF
SWS (I may know, but not sure of its meaning)
compSAS

David P. White, functional residual capacity, as a matter of fact, complex sleep apnea syndrome.

Morbius deftly avoided that nonsense, preferring I expect, to avoid being called out by some reader of equally certified stature. He wrote, "Because in actuality I didn't say palerider was right, nor did I say he was wrong."

Morbius didn't deftly anything. You were in such a BF hurry to post something clever that you didn't bother to pay attention to what was being said.

[Morbius]

If I wanted to look at tidal volume data I'd be looking at RIP belts.

Or a pneumotach.

If I had one.

But I don't.

And then you'd have to put it distal to the xPAP exhalation port, then getting that old Respironics inline port to remove the intentional leak, but now you got a whole bunch of dead space...

[Morbius]

Your investigation has been enlightening and informative and exactly what I intended to provoke - a deeper look into that potential relationship.

Please share what you now think you understand.

[Morbius]

Trying to analyze tidal volume from that flow curve is completely worthless anyway because of the inaccuracy of the extrapolated data as previously mentioned.

On top of that with a 5 breath moving average the VT graph is a meaningless squiggle.

I liken you coming up with these ridiculous formulas to somebody trying to fix a fine Swiss timepiece with a hammer.

[Morbius]

But if you're asking me for my opinion (based on "Go do equivalent legitimate work somewhere") I need to respond with another "Well duh!" as FLs progress in severity through hypopnea and eventually to apnea, Vt eventually falls to -0-.

Oh look!

The 25th anniversary of "Duh!" is coming up!

If the increased airway resistance achieved is sufficiently high, the tidal volume will fall. In turn, if the high upper airway resistance and reduced tidal volume persist, then sleep-disordered breathing events will occur in the form of hypopneas (over a few breaths) or even prolonged alveolar hypoventilation might ensue with associated CO2 retention and arterial hypoxemia and disrupted sleep state.

My man Jerome...

[zonker]

<sigh>

sometimes you just have to let art flow over you.

[Jlfinkels]

<sigh>

sometimes you just have to let art flow over you.

You dropped an “f”…

[zonker]

<sigh>

sometimes you just have to let art flow over you.

You dropped an “f”…

with dataq1 watching, one must be careful where one places an "f".

[AmSleepnBetta]

Morbius wrote and I respond in italics:
1. There is nothing in that abstract about tidal volume reductions. If you want to pursue this buy the article, send it to me and I'll review it.

Wow, what a word usage quibble and lack of understanding. So what would you call the abstract's "%NED% drops in flow (25, 25-50 and 50%) which caused,of course, (obvious unstated) commensurate drops in tidal volume? Simple integration of the FR curve (0.04 sec time slices x flow rate) produces, as it must a volume curve shape with areas identical in form to that of the FR curve. Yeah, you have to filter cardio to find I-time starts, just as Resmed shows in a patent. Are you here as elsewhere indicating the FR curve we rely on and try to decipher for better sleep is meaningless? Maybe so in high leaks, but not elsewhere.


2. Dayquill's image does NOT show tidal volume reduction. It's insignificant. It's non-existent. It's absurd. It's IDK how to explain it to you that there's nothing there.

You keep hoisting yourself of your own petards. We have "does Not show tidal volume reduction", "It's insignificant" (Yes, insignificant though present I'm pleased we agree. It's one thing you have correct from a sleeper's point of view, POV, but not from the analytical POV of post #1 or of mine.) and "It's non-existent", and "It's absurd " besides. In war they once used fog machines to hide troops placements just as squids eject ink to protect themselves from danger. I begin to understand your IDK and NFI's.


3. Trying to analyze tidal volume from that flow curve is completely worthless anyway because of the inaccuracy of the extrapolated data as previously mentioned. If I wanted to look at tidal volume data I'd be looking at RIP belts.

My response to #1 suffices.

4. Don't even try to infer that I denied a relationship between tidal volume exists. Also previously noted as obstruction increases FL > hypopnea > apnea and if we WERE using RIP belts at apnea VT = 0.

No, I'm an honest man who makes honest, sometimes stupid mistakes but am not stupid--pardon this eruption of what you taught me is "humblebrag" you hate. I knew you know better, but its hard in this precinct not to weaken and return some fire. I think and maintain you either came to shoo this pest off your expert turf or to aid CT's terse gunslinging TX sheriff. Where's the rest of PR's long-time posse, anyway--have seen only one rider, maybe two in this thread? More seriously, when you first asked what I had for clinicians I hoped it was not what has turned out--the all too frequent CT silliness I think pugsy tries to redirect or suppress. It's unlikely a clinician would pose your question IMO. My intuition has borne out, sad to say.

I had hope you, with obvious sleep care knowledge--if spottty as it turns out (coruscating fools gold?)--would be one to consider pitching in, trying to find ways to help low AHI sufferers of flow limitation pinpoint it and arm themselves to convince and persuade their care providers of unmet, possibly remediable needs. No not work with me, but work separately to help me and others understand what you have learned, know and could share.


5. You clearly have NFI what you're talking about and I'd really appreciate it if you'd just stop.

"NFI", again,sigh. Squid ink.

Trash (alas) picked up for now, back to work.


The upper part of the image below is an old charting from last year--June? The sleep segment is in the 7-hour view I posted above. The bottom section with notes, arrows and bottom snippet from OSCAR were added today.

My additions to the graphic today update and correct it. It corrects my earlier wrong attribution of FL flagging and flow limitations mainly to wave shape deformities. Some TV/ventilation loss and/or flow limitation likely did contributed some to those deformities and FL flags. The big ignorant blunder/error at that time was failure to check inspiration time--didn't even know anything about its importance back then, but soon began to learn about it from sleep forum posts of experts helping UARS sufferers.

The upper right orange graphic relates to and illustrates my droning-on-and-on explanations above about deficiency of my (expediently simple) constant tidal volume baseline TV, usually 0.50 L. TVd will be over- or under-stated the same as actual local TV varies from
my depicted values when local area measured breath by breath TV rises and falls. If you have been looking at earlier TVd drop graphics here, note that TVd drops in orange are indicated more logically as bars dropping from the axis. I reversed the over and under graphic presentation to make bars rise like FL flags do from their axis. That way it is easier to see differences of TVd graphs from FL graphs.

Revisit-Previous-FLvsTV.gif (375.14 KiB) Viewed 642 times

[dataq1]

Your investigation has been enlightening and informative and exactly what I intended to provoke - a deeper look into that potential relationship.

Please share what you now think you understand.

What I have learned: At least one poster is attempting to apply a degree of analytic rigor to the discussion.

[Morbius]

ASB wrote and I respond in red:

Morbius wrote and I respond in italics:
1. There is nothing in that abstract about tidal volume reductions. If you want to pursue this buy the article, send it to me and I'll review it.

Wow, what a word usage quibble and lack of understanding. So what would you call the abstract's "%NED% drops in flow (25, 25-50 and 50%) which caused,of course, (obvious unstated) commensurate drops in tidal volume?Yeah, you totally missed that one, huh? Simple integration of the FR curve (0.04 sec time slices x flow rate) produces, as it must a volume curve shape with areas identical in form to that of the FR curve. Yeah, you have to filter cardio to find I-time starts, just as Resmed shows in a patent. Are you here as elsewhere indicating the FR curve we rely on and try to decipher for better sleep is meaningless? Maybe so in high leaks, but not elsewhere.


2. Dayquill's image does NOT show tidal volume reduction. It's insignificant. It's non-existent. It's absurd. It's IDK how to explain it to you that there's nothing there.

You keep hoisting yourself of your own petards. We have "does Not show tidal volume reduction", "It's insignificant" (Yes, insignificant though present I'm pleased we agree. It's one thing you have correct from a sleeper's point of view, POV, but not from the analytical POV of post #1 or of mine.) and "It's non-existent", and "It's absurd " besides. In war they once used fog machines to hide troops placements just as squids eject ink to protect themselves from danger. I begin to understand your IDK and NFI's.
Got nothin' there either. Don't look now but you're hemorrhaging.

3. Trying to analyze tidal volume from that flow curve is completely worthless anyway because of the inaccuracy of the extrapolated data as previously mentioned. If I wanted to look at tidal volume data I'd be looking at RIP belts.

My response to #1 suffices. There was no response to #1.

4. Don't even try to infer that I denied a relationship between tidal volume exists. Also previously noted as obstruction increases FL > hypopnea > apnea and if we WERE using RIP belts at apnea VT = 0.

No, I'm an honest man who makes honest, sometimes stupid mistakes but am not stupid--pardon this eruption of what you taught me is "humblebrag" you hate. I knew you know better, but its hard in this precinct not to weaken and return some fire. I think and maintain you either came to shoo this pest off your expert turf or to aid CT's terse gunslinging TX sheriff. Where's the rest of PR's long-time posse, anyway--have seen only one rider, maybe two in this thread? More seriously, when you first asked what I had for clinicians I hoped it was not what has turned out--the all too frequent CT silliness I think pugsy tries to redirect or suppress. It's unlikely a clinician would pose your question IMO. My intuition has borne out, sad to say.I hate getting patronized more than I hate humblebrag.

I had hope you, with obvious sleep care knowledge--if spottty as it turns out (coruscating fools gold?)--would be one to consider pitching in, trying to find ways to help low AHI sufferers of flow limitation pinpoint it and arm themselves to convince and persuade their care providers of unmet, possibly remediable needs. No not work with me, but work separately to help me and others understand what you have learned, know and could share.
Read my 6000 other posts.


5. You clearly have NFI what you're talking about and I'd really appreciate it if you'd just stop.

"NFI", again,sigh. Squid ink.

Trash (alas) picked up for now, back to work.
Nope. Trash still there.

The upper part of the image below is an old charting from last year--June? The sleep segment is in the 7-hour view I posted above. The bottom section with notes, arrows and bottom snippet from OSCAR were added today.

My additions to the graphic today update and correct it. It corrects my earlier wrong attribution of FL flagging and flow limitations mainly to wave shape deformities. Some TV/ventilation loss and/or flow limitation likely did contributed some to those deformities and FL flags. The big ignorant blunder/error at that time was failure to check inspiration time--didn't even know anything about its importance back then, but soon began to learn about it from sleep forum posts of experts helping UARS sufferers.

The upper right orange graphic relates to and illustrates my droning-on-and-on explanations above about deficiency of my (expediently simple) constant tidal volume baseline TV, usually 0.50 L. TVd will be over- or under-stated the same as actual local TV varies from
my depicted values when local area measured breath by breath TV rises and falls. If you have been looking at earlier TVd drop graphics here, note that TVd drops in orange are indicated more logically as bars dropping from the axis. I reversed the over and under graphic presentation to make bars rise like FL flags do from their axis. That way it is easier to see differences of TVd graphs from FL graphs.

Revisit-Previous-FLvsTV.gif

[Morbius]

Your investigation has been enlightening and informative and exactly what I intended to provoke - a deeper look into that potential relationship.

Please share what you now think you understand.

What I have learned: At least one poster is attempting to apply a degree of analytic rigor to the discussion.

So IOWs, nothin".