Need help understanding my Nov. 23 charts, pls.

[kingskid]

kingskid,
You might try playing with the EPR to reduce the Flow Limits. My Flow Limits resembled yours, if not worse, until I tried using the EPR feature. Now my Flow Limit graph looks like peach fuzz on a bad day and blank on a good one. The worst thing that can happen is it doesn't work for you. I use to operate under the assumption that the EPR was for comfort only and didn't serve a purpose until you got into the Bilevel models with higher pressures. . . Boy, Did I destroy my belief in that! . . .I guess next I'll find that there's no Easter bunny too.

Thanks Crimson Nape (ha, Red Neck! love it). Well, you just explained something to me: low or no flow limitations can be achieved. My EPR is at 1, which must be the default setting since I never touched it. By "playing with EPR", did you mean lowering or raising it?? If flow limits pertain to the volume of air able to pass through the P10 pillows, my chronic stuffiness could be the primary culprit. Xlear hasn't seemed any different than other sprays. It could be a physical septum problem since it is deviated and the left side is narrowed more than the right side, but get congested on both sides at different times, so don't know.

[robysue]

If flow limits pertain to the volume of air able to pass through the P10 pillows, my chronic stuffiness could be the primary culprit.

A flow limitation is a distortion in the shape of the inhalation part of the flow rate curve. Certain kinds of distortions are known to have a high probability of being associated with an airway that is in danger of collapsing.

Typically the amount of air moving into and out of the lungs during a flow limitation is not much different from the amount of air moving into and out of the lungs during normal sleep breathing. But because the airway is partially compromised, the effort to move that air is greater than when there is no flow limitation.

Xlear hasn't seemed any different than other sprays. It could be a physical septum problem since it is deviated and the left side is narrowed more than the right side, but get congested on both sides at different times, so don't know.

Deviated septums and congestion can sometimes "fool" the machine into scoring some flow limitations. Usually it's not a huge issue however.

If you really want to understand what a flow limitation is, zoom in on the flow rate curve for a part of the night with a lot of activity or high values in the flow limitation curve. Instead of nice round inhalations you will probably see clear distortions---usually a flattening of the top of the inhalation or extra "peaks" at either the beginning or end of the inhalation. The higher the value in the flow limitation graph, the more distortion you are likely to see in the inhalations.

[Crimson Nape]

kingskid,
1. What robysue said.
2. I went from an EPR of "Off", trying each setting, until I got to 3. My Flow Limits got better with each increase.

[kingskid]

kingskid,

If you are worried about the O2 levels while using CPAP, you could invest in a recording oxymeter that is compatible with Sleepy Head. They're not that expense.

Yes, I need to go back to researching the recording oximeters. Had done some research awhile back, but need to narrow the search to just recording devices, otherwise, I can't capture the data.

---

kingskid,
1. What robysue said.
2. I went from an EPR of "Off", trying each setting, until I got to 3. My Flow Limits got better with each increase.

I'll try that, thanks!

[kingskid]

kingskid,
1. What robysue said.
2. I went from an EPR of "Off", trying each setting, until I got to 3. My Flow Limits got better with each increase.

Well, I checked the machine last night and even though the EPR was set at 1, it was in the off position. Although I've been getting good AHI numbers (under 1 for a good while now), decided to turn the EPR setting on and left it at 1. Well, the AHI jumped to 1.52. Probably will just turn the EPR back off since that has been working for me. I expected that I would see an immediate effect but didn't think the AHI would go up and so significantly. I could only tell a small difference, physically, with the EPR on. Made my lips puff out a little more around my mouth splint.

[Napmeister]

One night is not a good test, 1.5 is still a very good result. Most recommend testing sessions to be 7+ days. Let your brain get used to the rhythm and maybe by the end of the week progress is possible .... just maybe.

Your AHI is low enough that experiments won't affect your health. We can't expect immediate positive results. Be patient it's a journey, G'luck with yours.

[vsheline]

One night is not a good test, 1.5 is still a very good result. Most recommend testing sessions to be 7+ days. Let your brain get used to the rhythm and maybe by the end of the week progress is possible .... just maybe.

Right.

Hi kingskid,

Your pressure quickly goes to max (probably because of the severe Flow Limitations) and stays at max pretty much all night.

I think your Tidal Volume (average volume of air in each breath) does look fairly low, unless you are a fairly short person. Buying one of the recording Pulse Oximeters which are compatible with SH is great idea. The ones like a watch with separate finger sensor cup are less uncomfortable to wear all night or more than one night. I think it is extremely important that the Pulse Ox not press harder than minimum necessary on the finger.

EPR helps us to breathe with less effort.

Turning on EPR for a week at 1 and then gradually increasing EPR by 1 each week may help.

Hang in there.

Take care,
--- Vaughn

[kingskid]

One night is not a good test, 1.5 is still a very good result. Most recommend testing sessions to be 7+ days. Let your brain get used to the rhythm and maybe by the end of the week progress is possible .... just maybe.

Your AHI is low enough that experiments won't affect your health. We can't expect immediate positive results. Be patient it's a journey, G'luck with yours.

Yes. I had thought about not giving it more time with the EPR. But, really don't know if there a benefit for me to use it...need to research this issue more.

[kingskid]

One night is not a good test, 1.5 is still a very good result. Most recommend testing sessions to be 7+ days. Let your brain get used to the rhythm and maybe by the end of the week progress is possible .... just maybe.

Right.

Hi kingskid,

Your pressure quickly goes to max (probably because of the severe Flow Limitations) and stays at max pretty much all night.

I think your Tidal Volume (average volume of air in each breath) does look fairly low, unless you are a fairly short person. Buying one of the recording Pulse Oximeters which are compatible with SH is great idea. The ones like a watch with separate finger sensor cup are less uncomfortable to wear all night or more than one night. I think it is extremely important that the Pulse Ox not press harder than minimum necessary on the finger.

EPR helps us to breathe with less effort.

Turning on EPR for a week at 1 and then gradually increasing EPR by 1 each week may help.

Hang in there.

Take care,
--- Vaughn

Thanks, Vaugh! Am glad you addressed the tidal volume issue. You hit the nail on the head...yes, I am short, 4'11". I didn't know that a person's size affects their tidal volume. Kind of makes me feel better since I cannot do anything about my height...Will have to check out that type of oximeter. Thanks again.

[kingskid]

Vaughn, re: "Your pressure quickly goes to max (probably because of the severe Flow Limitations) and stays at max pretty much all night."

I forgot to ask about my max pressure. I frequently check my SH info on how long the pressure stays at max, and it is pretty consistent every night. Am wondering, therefore, if I should increase the max? I had started out with straight 7, then went to 7-9 and now am at 7-9.6. Had used APAP one night with moderate settings (can't remember what) and I fought the machine and got something like a 2.5 AHI and not a good night's sleeep. Just don't take to "control" very easily! I'm thinking if I set the max to maybe 10 and check it after a week or so to see the if percentage of time I'm maxing 10 out, well, maybe I need to try APAP again. It may sound silly, but because of the "control" issue, I'm a little leary of letting APAP take over..... Thoughts?