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Can someone help with these 2 charts
#1
Can someone help with these 2 charts
Hello All,

I recently changed to my mask to the Phillips DreamWear FFM because I was getting major problems with the Anti Asphyixia valve on the Resmed AirFit and not sleeping more than an hour or so. My first night I slept 8 hours and had a low AHI but very high the second night, can anyone see if there is a reason?

Thank you in advance,
Brad


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#2
RE: Can someone help with these 2 charts
OK, a few things to change and then a new item to consider adding in after you read up on positional apnea.

  1. First, let's cut off the Ramp. You're running a static 7 with 45 minutes of Ramp at 4. Ramp is delaying therapy and may at some point let events sneak in during the 45 minutes it's active.
  2. Second, consider adding EPR 3 and going to Auto mode with a 7-11 pressure to see how that helps in feel and in therapy results.
  3. Third, those clusters of events are probably positional apnea where your head and neck bend in such a way to restrict the airway. Read about the positional apnea and the remedy, a soft cervical collar. I have a Wiki link in my signature about soft collars where you may learn about this. If it's positional apnea, no pressure your PAP can create can blow this open.

Let's see what results you get after the edits. But I think a collar will help make a drastic difference.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Can someone help with these 2 charts
It appears that your events are positional and are from either chin tucking or sleeping on your back. Your flow limit is excessive. You might do better by setting the EPR to 3 and full time. Increase your pressure to 10 cm. This will provide you an exhale pressure of your current setting of 7 cm. If you can, turn off the ramp. It is just delaying your therapy.

Good luck!
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Beginner's Guide to Sleepyhead and OSCAR
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Can someone help with these 2 charts
OK thanks for the recommendations, I will do as asked for tonight to see if there are changes.

Brad
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#5
RE: Can someone help with these 2 charts
Here is the results of last night, I woke a few times and didn't really like the feel of the increased pressure. Having no ramp was also a little harder to get to sleep, any suggestions?

Thank you very much.

Brad


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#6
RE: Can someone help with these 2 charts
You will need to give it a few nights for your body to adjust. Your flow limit is still high. This will cause the Resmed to go to its highest set pressure, so don't increase the upper limit for now. In my opinion, the only thing that can reduce the flow limit any further is a bi-level machine, like the Resmed Aircurve VAuto.

Thoughts?
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Beginner's Guide to Sleepyhead and OSCAR
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Can someone help with these 2 charts
Thanks for the reply, can you maybe explain what you mean by Flow Limit is high?

Brad
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#8
RE: Can someone help with these 2 charts
Flow limits chart shows your flow limits. A flow limit is an apnea - see the bottom in my signature. They can cause you not to be able to get to a deep sleep or wake you up.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
Cervical Collar     Dealing w DME     Chart Organizing
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#9
RE: Can someone help with these 2 charts
Second night's chart is much improved with the exception of the cluster of events about 23:45 or so. FL/flow limit is a weaker version of an apnea as Stacey has explained. If the FL "grow" then Hypopnea and OA will event counts will be higher, and that means your therapy is less effective and you will not get the rest you need.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Can someone help with these 2 charts
Yes the cluster of events at 23:45 was my son ordering pizza at midnight!! I will keep at it and thank you for all the information.

Brad
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