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What causes flow rate to look like this?
#1
I started using a ResMed Dental Appliance in combination with my BIPAP awhile back. I'm starting to see some issues certain nights, where the pressure increases, and the flow rate shows very large spikes which resolve, then spike again It also shows some flow limitation. I'm not sure what is causing this.

Usually my BIPAP has been staying at low pressures all night, but specific nights it does this. I think sometimes I breathe through my mouth, because my mouth is dry. But even wearing a chin strap hasn't helped me from breathing through mouth.

Am I having a hard time breathing? Increased respiratory distress? Or is something else causing these spikes?
I'ld like to get these smoothed out.

Otherwise my dental appliance has helped to reduce my apneas.
   
   

   
ResMed AirCurve 10 vAuto
Pressure EPAP min 5.6, IPAP Max 16, PS 3.

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#2
Looks like flow limitations are causing the trouble. Might try increasing your pressure support from 3cm to 4cm and see if that improves it. If not you may have to increase the pressure support a little more.
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#3
Does flow limitations mean the air is not flowing good? Or there is blockage? 

If I increase pressure support or my maximum, that usually causes more CA in me.

I'm thinking maybe the dental appliance may be blocking my breathing a bit if I mouth breath. And it is causing the machine to increase pressure.
ResMed AirCurve 10 vAuto
Pressure EPAP min 5.6, IPAP Max 16, PS 3.

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#4
Yes flow limitations means something is causing a partial blockage.
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#5
(08-10-2018, 02:58 PM)Walla Walla Wrote: Yes flow limitations means something is causing a partial blockage.

Okay thanks. Well I thought I had my sleep issues 100% fixed with the dental appliance in combination with BIPAP. But apparently not. Some days it looks okay, but I've now had two days where it looks like the above.
ResMed AirCurve 10 vAuto
Pressure EPAP min 5.6, IPAP Max 16, PS 3.

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#6
You might want to just try small increases in the pressure support of .2 at a time and see if you can get it to come down without the CA's. Also you can increase the EPAP.

I used to get CA's above 3cm on the pressure support eventually my body adjusted and I can go higher now.
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#7
(08-10-2018, 04:14 PM)Walla Walla Wrote: You might want to just try small increases in the pressure support of .2 at a time and see if you can get it to come down without the CA's. Also you can increase the EPAP.

I used to get CA's above 3cm on the pressure support eventually my body adjusted and I can go higher now.

ok I'll try that tonight. Because last night I had the same thing happen. Do these charts mean that I'm having a more difficult time breathing and taking larger breaths?

The peaks go high to low. My Insp. Time drops during those peaks. So is my body straining to get air during these times?
I wonder if I should go see my sleep doctor again, to get a new sleep study with my dental appliance.
ResMed AirCurve 10 vAuto
Pressure EPAP min 5.6, IPAP Max 16, PS 3.

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