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Checked my OSCAR from last night, everything was cruising along decent enough and then the pressure went up my flow rate went to crap. Stayed crap for about an hour and then the pressure dropped back to smooth sailing again. The thing is, I'm not really seeing anything that caused the pressure to jump up in the first place and I'm not sure why my flow rate went to crap. My flow limitations were the highest I've ever seen them. I have been having some nasal congestion for the last few days but it hasn't caused this before.
I added a little more zoomed in shot during what looks to be the worst of it right after this post.
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.
05-26-2023, 08:49 PM (This post was last modified: 05-26-2023, 08:51 PM by David Clark.)
RE: What caused this?
I saw that. I just don't know what caused the flow limits to get out of hand like that. It's not a normal occurrence. Moved the "flow limit" graph into the picture.
It's most likely positional, but could be anything that increased breathing resistance and partial obstruction. The flattening of the inspiratory wave was pretty clear in your previous graphs, and the Resmed Autoset responds aggressively to flow limitation with pressure increases. When it doesn't respond it's often positional. The recovery breathing at the end of the flow limitation really says a lot on how much you probably desaturated. This was like a very long hypopnea, but over 11 minutes.
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.
(05-26-2023, 10:04 PM)Sleeprider Wrote: The recovery breathing at the end of the flow limitation really says a lot on how much you probably desaturated. This was like a very long hypopnea, but over 11 minutes.
That is what concerned me most about the whole thing. I haven't ever had that happen before...and hopefully it won't again. I just wasn't sure what might have caused it this time. I guess I'll just keep an eye on my nights and make sure it doesn't become a normal thing.
The Minute Ventilation looks to be very low during the low flow period here - I doubt you could maintain that for so long without arousal. Could it be that your nasal congestion was higher in this period/position that you switched to mostly mouth breathing and we only see some of the total ventilation on the PAP graph. We do have an increase in leak during the low flow periods which could be through the mouth which would align with that theory.
What Kappa said. Might be worth getting something like a Wellue O2 ring to appease any concerns. I often have periods like this where my leak rate is around 15 l/min - I've woken a few times to the sound of air going out my partially opened mouth. My O2 monitor shows no drops despite very low tidal volume/minute vent during such periods. Most likely the increase in pressure triggered the mouth breathing.
I think you said in the first post that this was an unusual event for you. That is why I'm not going to suggest chasing this down or trying to manage or avoid it. The large breathing at the end is a natural reaction to an arousal with a buildup of CO2 and likely desaturation. What it shows is that everything is working well, and you were aroused from sleep and probably given a shot of adrenaline and a lot of motivation to BREATHE! This event is not at all unusual except for duration and I would guess you were in a pretty deep state of sleep or would have had multiple arousals. If an event like this becomes common, then it may be worth doing something more. You were at maximum pressure and that did not clear the obstruction, so there is not much to be done with the CPAP.
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.
