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[Pressure] Pressure change results
#11
RE: Pressure change results
Paula,
Flow Limits can either be very important or not very important.  They are not even considered by most in the medical field.
In your case they are not very important and your numbers are excellent.

Here is a simple definition of Flow Limitations
Event Definition Apnea, Hypopnea, Flow Limitation

  • Apnea: 80% to 100% reduction in airflow for >= 10 seconds

  • Hypopnea: 50% to 80% reduction in airflow for >= 10 seconds

  • Flow Limitation: <50% reduction in airflow for >= 10 seconds

When is Flow Limitation an issue.
1. When RERAs are present
2. When pressure is driven to the Max Pressure setpoint.
3. When the FL graph is at least .25 to .33 consistently.  BUT I don't chase all of these, I'll address them in addition to chasing Obstructive events.  I MAY come back to them is cases with CA AFTER the CA has been managed as best as is possible IF it is a problem.
4. When the user complains about something that I feel FLs are involved with.

The only one of these criteria that may apply to you is #4 so please let me know if it does
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

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#12
RE: Pressure change results
a couple observations on human nature: we tend to filter our responses through the context of our own experiences and we tend to be reluctant to embrace change.

in my mind the jury is still out but mper's exploring observations raise legitimate questions stemming from the historically relative lack of attention to flow limitations, rera and uars. I'm not sure what mper's criteria are, but I suspect it's more than this: it's my sense that any entry in the 95%tile column for flow limitation is worth attending to, especially if the person has complaints.

IDK if this is too far off topic... I have nothing to contribute with respect to your original questions PaulaO2.

re flow limitations however, it looks like apnea is well controlled but flow limitations are driving pressure up and you can see how the flow rate tends to compress at the same time flow limitations show up and pressure rises.

obviously, it's up to you to explore or ignore!
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#13
RE: Pressure change results
(10-13-2019, 10:43 AM)PaulaO2 Wrote: I've had it at 13-17 for about 5 nights now. The AHI is well below 1 which is a rarity.

However, I'm waking each morning with a headache and my dreaming, especially my lucid dreaming, is becoming a problem. I've had odd dreams but last night I woke my wife up twice talking and yelling. I don't remember the dreams exactly but they were weird weird weird. And they were indeed lucid: i backed one up to get a closer look at some old cars sunk into resin. Told you the dreams were weird.

I've not been snoring.
The HI is zero (last night's though was .2 big woop)

Any advice?
Raise it again?
Let it ride and settle?
Put another layer of alien-proof barrier?

Hi, Paula, and folks

Sorry folks, I had inferred based on this above that something important would be bothering Paula’s sleep. Based on my own experience and medical literature, what immediately came to my mind was drawbacks associated with Flow Limitation. Then, in following up post, previous to see any Paula’s chart, I hypothesized on the existence of problems with Flow Limitations. Then, her charts came in and confirmed my suspicion: Flow Limitation could explain her complains in general and should be handled. With proper approach on EPAPmin and PS her sleep drawbacks could be worked out, by lowering FL to at least flagged P95=zero, and Max < 0,10, not to say on the unflagged events (still to be investigate on chart 10min-windows), which could be even more important than the flagged ones.
And, I am afraid you might already know my opinion: for flow limitation (flagged or not) there would be no satisfactory solution, other than BPAP. Only luckily, APAP could work out flow limitation, unless a I have been missing too much on so many cases of lingering folks in this Forum, as I have been a long while scrutinizing here, as I mentioned in my single thread.
 
Good luck
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#14
RE: Pressure change results
This thread started because I realized my 95% pressure was much lower than my max (15/20). I decided to slowly lower the range and went to 14/18.6. After a few weeks, I lowered it again, this time to 13/17. That's when the weird dreams and headaches started.

I took the advice here and raised the minimum to 14. The headaches are decreasing and the dreaming has stopped. The Elbow Alarm has not woken me since that night.

I've looked back over my data (lovin' OSCAR) and note that other than a few .18s and a lot of .22s, my FL ranges from .25 - .38.

I look at the Event Graph, the Flow Rate, and the Pressure Graph and compare them. Sometimes I'll scroll down to see the respiratory rate if the situation calls for it. Other than that, I only glance at the others.

What I *DO* look at religiously is the data box to the left (in OSCAR and in SH). I am more familiar with that than I am the squiggly lines. Big Grin
PaulaO

Take a deep breath and count to zen.




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#15
RE: Pressure change results
For gits and shiggles, I pulled up data from July (random month and because it was warm and I'm a little chilly right now) then selected a date where the data didn't have me laying awake for several hours. Thought I would post it here for comparison.

   

Refer to this post for the other screenshots.
http://www.apneaboard.com/forums/Thread-...#pid315280
PaulaO

Take a deep breath and count to zen.




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#16
RE: Pressure change results
I'm going to put my pressure range back where it was.

- The dreams are continuing--I thought they were gone until my girl started telling me of things I had said or done. One night I woke her up by poking her in the side. When she rolled over, I said "Nine" and went back to sleep.
- not waking feeling rested at all.
- The AHI is great! But not worth the price.
- 95% pressure is hitting the max (set at 14-17 currently)
PaulaO

Take a deep breath and count to zen.




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#17
RE: Pressure change results
Hi, Paula
just speculating: why not a try with BPAP, to tackle your FL/RERA... those flagged ones looks too high for me, not to say on unflagged ones....maybe it would bring more conphort?

good luck
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#18
RE: Pressure change results
As a follow-up, I put my pressure back at 15-20. I continued to have weird dreams for a while but they've settled down finally. In one, I was arguing with my brother and told him if he didn't stop (he was doing typical little brother annoying things) that I would hit him. I woke up when my fist hit the headboard. In real life, he thought it was hilarious.

My AHI remains below 5, typically below 3.
CA is typically the same or higher than the OA but that's normal for me.
I have a lot of CA events the first 2-3hrs of sleep.
Headaches stopped.
Min/Max/95% pressures vary but usually I'm not going much higher than 17 for the 95%.

Attached is the night of the fist dream. I got up to use the little girls room and to make sure my hand wasn't bleeding. I hit that wooden headboard hard!

   
PaulaO

Take a deep breath and count to zen.




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#19
RE: Pressure change results
(10-25-2019, 05:13 AM)mper6794 Wrote: Hi, Paula
just speculating: why not a try with BPAP, to tackle your FL/RERA... those flagged ones looks too high for me, not to say on unflagged ones....maybe it would bring more conphort?

good luck

I can't try BPAP because I'd have to either buy one out of pocket or go through the hoops for Medicare. Since I'm not into hoop jumping, if I decide to try that route, I'll have to pay out of pocket.
PaulaO

Take a deep breath and count to zen.




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