[Treatment] Flow Limitations, a problem or not?

[storywizard]

OK, now I have the right place..oh boy....

For the last few months my therapy has not been working well, at least I think its the therapy...
I was reading about flow limitation and how they can cause issues, wondering if that is what is happening to me...
Below is a typical night: Min EPAP 5, Max 6, PS 1-6 and then a night with no events...





I changed my settings a bit last night: Min EPAP 5, Max 6, PS 2-9 just to see if it made any difference:




Is this something I need to change, could these limitations be the cause of my fogginess, and fatigue??

Storywizard

[Walla Walla]

I believe if you have a lot of flow limitations it does disrupt your sleep. After looking at your past threads and having no clue about ASV settings I'm sorry to say I have no answers. The good news is there are others here that do.

[Sleeprider]

StoryWiz, can you grab a closeup of the flow rate during flow limitation? Are those respirations flat-topped or downward sloping? I see the flow limit graph is pegged.

[storywizard]

Here you go:

[storywizard]

a nasty one:

[storywizard]

sorry about the full size images, here is one more...

[CTcentrals]

Sleeprider: did you mean to say the Pressure graph was pegged?  I seem to remember someone (maybe you) mentioning that Resmed flow limits over .4 might warrant be looked at.  If so, flow limits might not be as messy as they look, y/n?

ct

[Sleeprider]

In the graphs you posted, there are flow limited breaths in each of the charts. Nothing very severe in any case, and they don't align well with the FL event flag. The machine is flagging breaths that hesitate, as shown by a double peak, or more truely flat-topped and downward sloping inhales. In all cases, the flow rate is relatively low, but I think that has been typical for you. Generally flow limited breaths occur when IPAP has dropped back.

You seem to be getting pretty good results, but your machine is extremely active offsetting centrals, hypopnea and flow limited breaths. Have you tried increased EPAP? Using ASVauto? Since you did not include the left column I can't see machine settings, but the machine is raising EPAP pressure through this sequence, and maybe a higher EPAP minimum might help.

[storywizard]

Here you go...:-)



I will increase EPAP maybe 1cm tonight??
S
[url=https://imgur.com/2iPmigI][/url]

[Sleeprider]

Sounds good, and give the max IPAP another 1 cm to move.