Interesting information - Flow Limitation & Snoring Study

[mjbearit]

Not to take anything away from our "official" scrounger of cool articles, but I was going over my data this morning and this Flow Limitation number just keeps rising. I also notice a high incidence of snoring. Since I had no real idea what Flow Limitation really is, I started up Google and begin searching. I found a lot of junk (as always) then I started hitting the technical articles and finally found a very interesting study. I know we are not supposed to post links to commercial sites, and I don't believe this is a commercial site, but to be on the safe side I thought I would post it in this forum where it has a more limited readership in case I break the rules on accident. I found a great article regarding a study done here:
http://chestjournal.chestpubs.org/conten...5.full.pdf
and I used that information to look at my numbers again comparing pressures to Flow Restriction, etc. I had originally set my machine up for 10-16.5cmH2O, but after looking at the numbers, with one exception every flow restriction occurred when it dropped under 12cmH2O. My old CPAP was set to 12 cmH2O so I am thinking about bumping up that bottom number to maybe like 11 and see if I get any improvement. My RERA is pretty high and I think if I can get more of these nubers besides just OSA events under tighter control, that RERA number will come down somewhat and my overall sleep will improve.
Thoughts? Ideas? Concerns?

[SuperSleeper]

I moved the thread to the Main Forum, MJ... Chest Journal is primarily a news site and it's directly related to sleep apnea, so I'd say it's okay.

I also added to the thread title to give a bit more descriptive info.

[mjbearit]

Thanks

[Tampabaysailor]

MJ,

The link to chestpubs no longer works. Can you update it?

Thanks

[Terry]

and I used that information to look at my numbers again comparing pressures to Flow Restriction, etc. I had originally set my machine up for 10-16.5cmH2O, but after looking at the numbers, with one exception every flow restriction occurred when it dropped under 12cmH2O. My old CPAP was set to 12 cmH2O so I am thinking about bumping up that bottom number to maybe like 11 and see if I get any improvement. My RERA is pretty high and I think if I can get more of these nubers besides just OSA events under tighter control, that RERA number will come down somewhat and my overall sleep will improve.
Thoughts? Ideas? Concerns?

I have exactly the same thing.

My AHI was very low (below 1) but I still had a ton of snoring and flow limitations and my respironics 560p didn't seem very concerned about either and never did anything to prevent them.

Eventually I decided to start raising the lower pressure limit and when I hit 16, all the flow limitations and nearly all the snoring vanished, I started sleeping through the entire night and all was right with the world.

For an intelligent, fully "auto" machine, it's not especially bright, or they made some bad design decisions.

Terry

[Terry]

The link to chestpubs no longer works. Can you update it?

A little google-fu has brought it back from the dead. 8-)

http://journal.publications.chestnet.org...28/685.pdf

[Ghost1958]

I have the PR series 60 auto aflex set on 6 and 15. The machine is plenty smart but the person who set the pressures at the sleep lab wasnt so much. Every 30 hours the machine will calculate where its running most of the time where no events or snores FLs etc are happening and reset itself to start at that pressure. For me it figured out a 8.5 mean pressure where nothing much happens and it only has to bump up a little to level things if something does.

The trouble is set with a min of 6 if nothing is going on the machine will begin to lower pressure to get back to where it was set by the tech to start at which is 6. Normally around 7 things start to go kaput with a snore here FL there then and OA as the machine works its way back up in response to the events.

On my own I would set the pressure to 8 and that would be the bottom limit with 15 max just in case. But Im still on the 30 60 90 day medicare dance so while ive called to get my sleep doc to tell the DME to reset it, it takes while to get that done Docs being how they are about getting to anything in less than a week. My AHI is good so Im content at the moment to play the game and not tick off the Doc by setting it myself until im past the 90 day mark.

[retired_guy]

I hear ya Ghost guy, and understand your reasoning. However medicare and most Docs only care about how many hours did you use the machine, not what your pressures or ahi or anything else is. So while I understand the tendency to work with the sleep techs, if it comes to a point where your health or your therapy is compromised because of their recalcitrance then it's time to take matters (or cute little machine dials) in your own hands.