Managing Flow Limits

[TexasDon]

Hi,

Looking for a strategy to manage flow limits.

Dropped Ramp
Changed EPR from 1 to 2
Moved min pressure up to 7 from 4
Started using a soft collar and cervical roll
Started using Flonase and nasal spray to clear sinuses

Pic of last night  ...

   

Last night was restless but I just wanted to open a discussion about how to manage flow limits.  I think limits/flow rate is where I should be focusing to work out Hypo and RERA problems. 

As I understand.  

I want a high enough pressure to smooth the inhalation and overcome resistance.   Thinking I should raise my max and see where it goes.
I want my minimum pressure high enough (close enough to the max pressure setting) so pressure changes up/down are not causing problems
I want EPR sufficient to provide comfort but not too excessive that it allows for those up/down changes in pressure.  Not sure EPR adds anything other than comfort.

Currently working on positional flow limits by adding a soft collar.   Just 1 night so far so no conclusions.  I don't have a clear strategy, other than the above ideas.   My low AHI scores don't match how I feel.  Not sure I am seeing any significant changes to flow limits that make me think I don't have a good strategy for working it lower. 

Hoping for advice.

-Don

[Sleeprider]

Move EPR to setting 3. This example of flow limits may not be typical of your full night because your 95% flow limit is only 0.09, but it's pretty clear you can use the additional EPR to support higher pressure support during inspiration. When posting charts it helps us to see the full night in addition to the zoom of the concern. Good chart, but minimize the monthly calendar.

[TexasDon]

Thanks for the advice.   I couldn't recall how to screen capture, directly from Oscar.   Duh.   It was right in the pull down tabs.   Next time for sure.   I moved EPR to 3 and will give it a few days for effect.

Thanks!  Don

[Sleeprider]

My signature has tutorials linked for organizing and attaching images. On a Windows computer, you can get a screenshot by pressing F12 or using the menu, and the shot is saved in My Documents/Oscar Data/Screenshots.

[TexasDon]

Last night I raised my EPR to 3 and my max pressure too.   I got an interesting Oscar report that shows a strong correlation between: pressure, flow limits and tidal volumes.   Not sure what to make of it.   Do you have any ideas?   Its a pretty neat pic.