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How to squash flow limitations?
#11
RE: How to squash flow limitations?
If you're in a hurry to achieve some improvement then I understand but, in normal circumstances, it is good practice to change only one parameter at a time. That would mean either increase your pressure OR add some EPR. This way, you're more able to see what the effect of each adjustment is and how it changes your CPAP experience in terms of comfort. It also helps to make notes and monitor things like how you feel each morning following each change, whether you got more sleep, whether you needed a daytime nap or not, etc. Your machine, in combination with Oscar/Sleepyhead, will record all the hard numbers for you, but won't know how you actually feel. Of course, you should use your machine for a few nights between changes, not make a change every night, so as to get a more robust correlation between sleep quality etc and machine settings.

That said, I bow to the much greater experience of others on here, who have probably dealt with your scenario before and know how to fix it.
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#12
RE: How to squash flow limitations?
Hello!  I've returned from a 3+ month rv trip with a new complication.  Aerophagia!  Oh my goodness, it's awful. Last night I removed the mask and slept without it.  And this morning I awoke feeling completely beat up.  Reminded me of why I began this journey in the first place.

I checked to be sure the EPR is set on 3.  Pressure is 8.8.  I was slowly raising the pressure as instructed.  I do not remember when this aerophagia began, but at least a week or two if not more.   I'm tempted to turn the pressure way down tonight as the air in me is awful.

I'm posting a recent night's chart, not last night.  Can you help me??? 


   
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#13
RE: How to squash flow limitations?
In your most recent chart, you had no obstructive events at 8.8/5.8 pressure. Flow limits are present as alway, but you have the option to lower pressure and find a balance between obstruction and the aerophagia. Its not that complicated, just find the lowest pressure you tolerate without significant obstruction, and that reduces the potential for aerophagia. The range for pressure is going to be somewhere between 7.0 and your current 8.8.
Sleeprider
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#14
RE: How to squash flow limitations?
(10-06-2019, 04:48 PM)Insopita Wrote: Hello!  I've returned from a 3+ month rv trip with a new complication.  Aerophagia!  .....

Hi, it appears to me you are one case more, in which people end up trapped between Autoset-high pressure-associated aerophagia and no solution for Flow Limitation with EPR maximum of: 3.0. It looks you have been awakening a lot, with very poor sleep efficiency. Particularly, I don't see any solution for you, other than moving to BPAP.
good luck
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#15
RE: How to squash flow limitations?
Thank you, Sleeprider and Mper.  Last night I turned down the pressure to 7.6 and all was well.  No aerophagia.

1)  Are you saying that it is the exhale creating the troubles, not the inhale? 

2)  Is it possible to buy a bpap without a second prescription?  Is there an unknown black market?  Seems like a rotten deal if so-called doctors must be paid for a scrap of paper.

3)  I've attached last night's results.  How bad is it to have all the "flow limitations"?

   
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#16
RE: How to squash flow limitations?
Flow limitations are not considered by the professional sleep apnea community as an issue at all, particularly when there are not other obstructive events like hypopnea. It's far more important that you are comfortable and sleep well. We don't know the source of your flow limitation, but it is probably a restriction in the upper airway (nose, throat) and I'm pretty sure we have discussed UARS. In your case flow limitation would probably respond better to bilevel pressure with low EPAP and more pressure support. For example, if you had an Aircurve 10 S or Vauto, your could set the EPAP at 4 and use anywhere from 4 to 6 cm of pressure support for an IPAP pressure of 8 to 10. This usually works pretty well for people that suffer aerophagia at higher EPAP pressure.

The answer to your question, is this 7.6/4.6 is better than without treatment or the use of EPR. Whether you could tolerate higher pressure support is something we don't know. Let your comfort be your guide and don't sweat the numbers.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files

How To Deal With Equipment Supplier


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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#17
RE: How to squash flow limitations?
(10-07-2019, 12:17 PM)Insopita Wrote: .............3)  I've attached last night's results.  How bad is it to have all the "flow limitations"? "? well, first, it would all depend on how do you feel under such high degree of flow limitation. However, flow limitation would be pretty much a synonymous for a serious problem in the long run, the UARS, which could eventually evolve to apnea in future _ to have a better perspective, I would suggest you google/amazon on everything you can on what Dr. Steven Park (ENT) has been elaborating on UARS).

I, myself, used to be a UARS sufferer for some decades; nowadays, completely worked out with the BPAP (EPAPmin: 7.4, PS: 4.6/5.6). Together with RLS/PLMs, the couple only luckily, by chance, didn’t kill me along the way: chronic “insomnia”, nocturia, tens of awakenings (some with suffocations) at night, daily nightmares, anxiety, panic attacks,….

Good luck
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