Dear Omer

I think bellow papers are useful for you.

Furthermore, You can check with preparing EEG of these patients before and after shunt/sleep.

1- B65 THINGS THAT GO BUMP IN THE NIGHT: SLEEP CASE STUDIES AND NON-OSA SLEEP: Ventricular Peritoneal Shunt Malfunction Presenting As Central Sleep Apnea

2- Sleep-Disordered Breathing and Idiopathic Normal-Pressure Hydrocephalus: Recent Pathophysiological Advances

3-Idiopathic normal-pressure hydrocephalus and obstructive sleep apnea are frequently associated: a prospective cohort study

Thank you too much Seifollah for guiding me to these important articles. I would try to get them.

There are ongoing laboratory research studies on what's called "brain glymphatic system", which correlates with the CSF circulation, sleep pattern and individual's activity.

Thank you too much Professor Osama. Kindly give me the titles.

Dear Omer

You know that the majority of CSF discharges by glymphatic system. Recent studies indicated AQP4 increases after occurring hydrocephalus and ...

Another recent study showed during sleeping the clearance rate of CSF is two times higher than other.

Best

Dear Seifollah,

Thank you too much for above informations. It makes me feel happy to find explanations for returning of dreams after shunting. Some researchers might take my words lightly, but the researchers who take patients symptoms seriously are usually successful to find answers.

I am waiting also to see sleep labs as possible indicators to help to guide the very sensitive valve adjustment. Optimal adjustment would help complete cure of symptoms and as well it prolongs shunt life as it decreases CSF stagnation at ventricular catheter and at valve. This will decrease CSF particles precipitations.

My best regards,

Dear Seifollah,

Valve adjustment includes 2 components; lying position and standing position. Sleep labs if practical and feasible, can help in lying position and possibly at 45 degrees. Obviously sleeping sitting is not possible, so an equation to calculate it from lying and semistting is needed to make a correlation with the standing or sitting position.

Otherwise we need to think of other types of indicators like the advanced MRI techniques we were talking about in another question with Dr Vincenzo Alfano. I hope that I am clear.

I have meant above that most people can sleep in lying down position. Sleeping at 45 degrees is possible for many. Sleeping sitting is possible very rarely, like when going in a long train journey but for testing it is impossible for most. I know this is very clear dear Seifollah, but for talking about a plan of testing a talk of me like this should not be considered as unnecessary repitition.

Hi Omer

This idea is very interesting ans challenging.

Thank you too much Seifollah for your note. My observation is a real experience. Comparing sleep EEG record as well as other observations, I hope it can help valve adjustment in lying position as well as at 45 degrees. Sleeping sitting is difficult, so we have to find an equation which helps to calculate adjustment in sitting and standing position.

You have told me that CSF is triple during sleep and dreams and the other obvous point is zero gravity in lying position.

I hope you can work on this point. I can only tell my own observations.

My best regards,

Thank you very much for your comment Omer