Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Lingering fatigue: trust Resmed sleep report?
#41
RE: Lingering fatigue: trust Resmed sleep report?
(08-14-2019, 01:58 PM)mper6794 Wrote: Hi,
looking at these your three general views of your graphs, I strongly suspect you are in serious  trouble with Flow Limitation, causing great sleep disruptions and awekenings. Could you plot some 2-min details during increased pressures, just to make sure is that?

OK - here's three 2 minute-ish zoom in's on flow limitations during high pressure. How do they look? If problematic, what's the remedy?

Could this be caused by nasal blockage, or the nasal mask changing position and blocking my nasal passages? I mouth tape, so i can't mouth breathe or leak - and nasal masks are the only ones that won't leak for me and wake me up - i've tried 8+ masks to find this one.

thanks!!
Post Reply Post Reply






Donate to Apnea Board  
#42
RE: Lingering fatigue: trust Resmed sleep report?
Yes, things start to clear up.... indeed, it appears is going to be the case..... just plot 10min-windows, and tidal volume, instead of snore.....
Post Reply Post Reply
#43
RE: Lingering fatigue: trust Resmed sleep report?
(08-14-2019, 02:39 PM)mper6794 Wrote: Yes, things start to clear up.... indeed, it appears is going to be the case..... just plot 10min-windows, and tidal volume, instead of snore.....

here are 4 random days with some slight changes in pressure and the stats you requested.. Thank you.
Post Reply Post Reply
#44
RE: Lingering fatigue: trust Resmed sleep report?
gcritchley,
sorry delay...based on my own experience on killing my FL's, and learnings from the gurus here, it appears to me your FL/RERA's are very significant and would be disrupting your sleep a lot (you may be very sensitized to such flow restrictions). FL/RERA's are also associated with the highest pressures at  your 7.0 roof.
Hope counting on other opinions here I could start suggesting Pmin: 8.0 and Pmax: 12.0, and EPR: 3.0 (maximum you can get with your Autoset machine; turned off on your graphs). However, as far as I have been studying and seen so many times in this Forum, best parameter to work out FL/RERA's would be Pressure Suport (PS) of 4.0 or above. It's amazing what may happens overnight when you move from EPR:3.0 to PS:4.0 (allowed only with BiLevel such as VAUTO); it happened with me and others in this Forum. I started my therapy with basic Resmed CPAP, 1.5 year, then changed to Autoset (stay just 1 month), and changed again to VAUTO to get that single 1cm-water pressure. After trying PS as higher as 7.0, I realized there would be no additional gain compared to 4.0 (I ended up with 4.2 these days).

Good luck
Post Reply Post Reply






Donate to Apnea Board  
#45
RE: Lingering fatigue: trust Resmed sleep report?
(08-14-2019, 12:24 PM)gcritchley Wrote:
(08-14-2019, 11:53 AM)alexp Wrote: The 500 ml normal value is for a 5'10'' man. You need to adjust the value for your height. The normal value per kg (ideal weight) is 6 or 7 ml/kg. There are charts on the internet to find the value fitting your height.

For instance, I'm 5'8'' and my expected tidal value is 410 ml which match the value I'm getting on Oscar.

I'm 5'10" - my tidal volume is often (max) in the 700/800's - what can be done about that? wondering if this is the issue.

I don't have a sleep doc I'm working with - The one that did the sleep study said I don't even need to treat...but i bought my machine used, and tweaked it myself.

The mean value is the one you should look at from what I understand not the max one.
Post Reply Post Reply
#46
RE: Lingering fatigue: trust Resmed sleep report?
(08-14-2019, 09:04 PM)mper6794 Wrote: gcritchley,
sorry delay...based on my own experience on killing my FL's, and learnings from the gurus here, it appears to me your FL/RERA's are very significant and would be disrupting your sleep a lot (you may be very sensitized to such flow restrictions). FL/RERA's are also associated with the highest pressures at  your 7.0 roof.
Hope counting on other opinions here I could start suggesting Pmin: 8.0 and Pmax: 12.0, and EPR: 3.0 (maximum you can get with your Autoset machine; turned off on your graphs). However, as far as I have been studying and seen so many times in this Forum, best parameter to work out FL/RERA's would be Pressure Suport (PS) of 4.0 or above. It's amazing what may happens overnight when you move from EPR:3.0 to PS:4.0 (allowed only with BiLevel such as VAUTO); it happened with me and others in this Forum. I started my therapy with basic Resmed CPAP, 1.5 year, then changed to Autoset (stay just 1 month), and changed again to VAUTO to get that single 1cm-water pressure. After trying PS as higher as 7.0, I realized there would be no additional gain compared to 4.0 (I ended up with 4.2 these days).

Good luck

Thanks for this info. myper6794 - anyone else in agreement with the above? I actually only see RERAs in the one example I posted, but I almost never see them on any other days. Yes there are flow limits - I'm reading here about them either being insignificant, or to apply EPR of 3, or to increase the minimum to closer to the maximum, and hope that any leaks don't start a new sleep battle. Thoughts please?
Post Reply Post Reply
#47
Flow limits tweaks/lingering fatigue
Hi helpful friends

It has been suggested to me here that my "severe flow limitations" (FLs) might explain my lingering daytime sleepiness and fatigue despite long nightly treatment for the past 5 months or so. My treated AHI is below 1 and often zero. However I feel brain foggy and need to nap daily - so indeed something's not right. In my recent quest and research in lowering FLs I've been told to raise the lower pressures, and sometimes the high as well. (I'm on Auto - resmed airsense auto). I've attached overviews of the last three nights

As I raise the pressures (the past three nights) to chase down the FLs, I'm not seeing any major change in the flow limitations on my charts - perhaps you'll see differences I don't. What I am noticing, however, is how much the higher pressure affects my sleep for other reasons - I mouth tape, so if my tongue falls away from the roof of my mouth, or something in my breathing causes me to reflexively try to mouth breathe (perhaps the FLs?), the air that was suppressed by my tongue in a resting position comes rushing in to fill my cheeks with air (I tape my mouth close and use a nasal pillow mask after trying about 8 styles and types of masks.) It's not like a super pressurized mouth balloon, but it's enough to wake me...last night at the highest pressures so far, this happened many times I'm aware of, and maybe many more that I'm not. This didn't happen at the pressures before I started raising them. 

So I have an issue - i've been instructed to raise my pressures, however I was awakened by the air, translating to the attempt to cure being a new problem. AND, I don't see much change in what I was trying to remedy.

I know these aren't high pressures for most users, and I'm not sure how people handle this issue if they have it. Chinstraps don't keep my mouth closed, full face masks leak and wake me, so I settled on this mask, and with barely any pressures, was having low AHI scores and accepting therapy, and until my lingering fatigue alerted me that all is not well. I thought my "optional" (according to me sleep doc) therapy was going to help, and it did make a dent in the worst of the fatigue, but not like I had hoped.

Any further suggestions - do I continue raising pressures? Is my FL issue really the issue?  Thanks for any help


Attached Files Thumbnail(s)
           
Post Reply Post Reply






Donate to Apnea Board  
#48
RE: Flow limits tweaks/lingering fatigue
Many people with FLs benefit from using EPR. I would suggest you try the maximum of 3. To get the full benefit of this, your minimum pressure would need to be 7. Maybe that would make the inflation worse, but maybe not. Worth trying, I think. But I hope an expert will be along soon to see whether what I’ve suggested is good advice.

Just curious, what was your AHI in your sleep study?
Post Reply Post Reply
#49
RE: Flow limits tweaks/lingering fatigue
(08-16-2019, 11:06 AM)Dormeo Wrote: Many people with FLs benefit from using EPR. I would suggest you try the maximum of 3.  To get the full benefit of this, your minimum pressure would need to be 7. Maybe that would make the inflation worse, but maybe not. Worth trying, I think. But I hope an expert will be along soon to see whether what I’ve suggested is good advice.

Just curious, what was your AHI in your sleep study?

Thank you - My untreated AHI is 8.
Post Reply Post Reply
#50
RE: Flow limits tweaks/lingering fatigue
(08-16-2019, 11:06 AM)Dormeo Wrote:  But I hope an expert will be along soon to see whether what I’ve suggested is good advice.

Me too!  - how do the flow limits look to you?
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  [Pressure] Can someone take a look at my OSCAR Report flcpap17 0 3 5 minutes ago
Last Post: flcpap17
  Do sleep aids effect sleep study results wking 11 202 7 hours ago
Last Post: wking
  A deep report on sleep treatment racprops 35 1,313 10-21-2020, 07:05 PM
Last Post: racprops
Question First time poster, long time CPAP user with an OSCAR report. Afasterme 8 208 10-13-2020, 09:29 PM
Last Post: Afasterme
  Requesting Sleep Report Analysis & Second Opinions omariumprime 31 689 10-10-2020, 01:32 AM
Last Post: omariumprime
  Leak rate - What does Resmed Airsense 10 report? elliotg 5 219 10-03-2020, 12:32 AM
Last Post: elliotg
  [CPAP] Help understanding OSCAR report Dodgie 7 168 09-24-2020, 09:11 PM
Last Post: Dodgie


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.