First SleepyHead graphs

[Sleeprider]

This is expiratory flow limitation. I don't know much about it, and don't know of a good solution, other than your airway is becoming occluded during exhale.  The other two graphs show and OA and some flow limitation.  If I was only to judge your therapy on these events, I'd suggest increasing minimum pressure.  However, your AHI is only 0.33/hour an these seem to be isolated events, which is why we usually look at the full night as well as these anomalous details.

[midwestguy]

This is expiratory flow limitation. I don't know much about it, and don't know of a good solution, other than your airway is becoming occluded during exhale.  The other two graphs show and OA and some flow limitation.  If I was only to judge your therapy on these events, I'd suggest increasing minimum pressure.  However, your AHI is only 0.33/hour an these seem to be isolated events, which is why we usually look at the full night as well as these anomalous details.

Thanks, SR. The restriction of three images per post means 
many posts to show the entire night. 

Any suggestions about that?

Best,

Harv

[Sleeprider]

Live within your limits?

[midwestguy]

Live within your limits?

 Philosophy.

[midwestguy]

[attachment=29698]

Looks like you have everything we normally want to see, and you could even vertically expand some, especially flow rate.  We really don't need the mask pressure, resp rate and tidal volume on most charts. The results show that with a minimum pressure of 8.0 and maximum 18 and EPR 1, your median pressure is nearly 10.0 and things don't change much from there with a 95% pressure of less than 11.0.  Flow limit is the main driver of pressure, and is marginally on the high side.  CA events at the end of the night look like arousal and sleep-wake events.  If you were not sleeping soundly in this time, you can probably disregard that.  Tidal volume is pretty low, and I think it may be worth taking a look at some random 3-minute zooms of the flow rate to see why that might be.

My inclination from this one example is to raise minimum pressure to 9.0 and increase EPR to 2. Normally we are not keen to increase EPR where centrals are the predominate event, but the fact they are near the end of the night and clear until then, make me think you are better off addressing the flow limitation.

Thanks, Sleeprider.

Have set min. pressure and EPR as you suggest. Tonight may show changes.

Attached a chart with part of flow rate zoomed. Is this what you wanted?

Harv

Attached 3 minute zoom of flow rate near start of night. Does this help?

[Sleeprider]

Actually, that is a 3 hour zoom of the 8 hour session. You're getting closer but not quite there yet.

[midwestguy]

[attachment=29699]

Actually, that is a 3 hour zoom of the 8 hour session. You're getting closer but not quite there yet.

Okay. Here's  about 3 minutes. I think.

[Sleeprider]

This is exactly what a good detail graph looks like, and extra credit for finding the dotted line at zero.  Through this segment we see mostly normal respiration with an even volume and pace typical of sleep. At 03:37:15 there is a sigh, a longer breath with more flow, and then things settle back and oscillate a bit into lower flow.  The lower flow at the end is probably in response to the sigh earlier which met your respiratory needs. No obstruction or airway resistance is apparent here.

[midwestguy]

Thank you. What else do you need to see?

[midwestguy]

Please tell me if (1) the essential ones are shown and (2) any suggestions for
getting the less important ones removed.

All but one attachment has been deleted to free up space.