Raise or Lower Pressure for Flow Limitations?

[CPAPUserDave]

My thought is your down to fine tuning. Don't go by how you feel night to night give the settings a week between each change, otherwise you get into knob twiddling.

I here what you're saying, just not sure if my flow limitations are at a point where i should let the setting alone and let my body 'heal' from days/weeks/months/years of unrefreshing sleep or do a little more tweaking beforehand.

[CPAPUserDave]

   

last night data above  (by the way, getting screenshots posted from OSCAR to forum much easier than from old Sleepyhead program. maybe i had it set up different on my end, but this is much better)

seems like my flow limit is getting better day to day as I decrease EPAP min and increase PS, but still unfreshing sleep and too much daytime tiredness. maybe time will help or more setting changes? I know i need to settle on some numbers and let them ride for a while, but am I there yet? Doesn't look like more Respiratory Rate looks any better from previous charts

Question: can you turn pressure support up too high? what would be the consequences?

Never talked about chin tucking. I'm assuming that it can affect flow limitations like OA? seems like I read elsewhere that it would present as spikes and clusters more than a steady flow. I don't think that is my issue but ....

Dave

[CPAPUserDave]

My thought is your down to fine tuning. Don't go by how you feel night to night give the settings a week between each change, otherwise you get into knob twiddling.

I here what you're saying, just not sure if my flow limitations are at a point where i should let the setting alone and let my body 'heal' from days/weeks/months/years of unrefreshing sleep or do a little more tweaking beforehand.

i HEAR (not here) what you're saying....

And I even proofread before I posted.

[JoeyWallaby]

Why would you lower Min EPAP when you're still having OAs?

From what i am learning using VAuto machine (new to me), with pressure support at 5.0, add that to min EPAP of 6.0, that gives me a minimum pressure of 11.0? That was more than enough pressure when using my old AirSense 10 machine to control O.A. (mostly used 9.0 fixed pressure during AirSense 10 machine use)
Am I correct in this thinking?

anyhow, at EPAP min of 6.0 last night, AHI still below 1.0 with only 4 O.A. flagged. only one night so far, but was a typically night for me.

(Also a suggestion by Sleep Rider to try and see where it moves)

Somebody correct me if I'm wrong... but Min EPAP is what takes care of OAs, not PS.

[yankees123]

Yes it is the minimum pressure that will control OA.

[CPAPUserDave]

last night data:


   


pressure support up to 5.4 now

results are better, feeling more rested. hard to tell what today will bring, woke up just a bit ago

respiratory rate look erratic and little high yet to me. thoughts?

i think i am on the right track. maybe small raises in pressure support over next days/weeks and see were that takes me?

[JoeyWallaby]

The FL chart isn't 100% accurate, the best way to tell if you're still having FL is to post some close ups of the flow rate where you can see individual breaths.

[CPAPUserDave]

The FL chart isn't 100% accurate, the best way to tell if you're still having FL is to post some close ups of the flow rate where you can see individual breaths.




close ups. all from last night: (looks like some limitations still going on...)


   

   

   

[Osiris357]

[attachment=18265]


This here is a perfect example of flow limited breathing without a flow limitation in sight. I need higher pressure support and hopefully I can convince my doc of that on the 3rd of next month.

This was a minute before I woke up and took my mask off

[JoeyWallaby]

Plateauing on the inspiratory curve on a few breaths, you had only two CAs and barely any leakage, so I don't see why you shouldn't slowly inch up your PS some more.

Your FL chart has also, unsurprisingly, gone down as you've increased PS
PS 4.6

PS 5.0

Ps 5.4