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koy23 - Flow Rate Analysis
#51
RE: koy23 - Flow Rate Analysis
(12-12-2021, 04:42 PM)sheepless Wrote: 'jerking awake' may have nothing to do with pressure.

with vauto, min pressure support is the setting to address flow limitations. some people are more sensitive to flow limitations than others but yours are so minor I don't think it's your problem. with fixed pressure I don't see how pressure changes can be a factor. if you've experienced arousals after a bump of .2 cmw, my guess is that it's the result, not the cause of your arousal. both screenshots are really good charts but higher pressure produced more mouth leaks so why not leave it lower.

to figure out why you're awakening, make a note of when you wake. stop flow for a minute, spike a huge breath or leak, speak to a voice activated audio recorder, use a video camera... then you can scroll through your flow rate at various view scales (I suggest 10 minutes and 3 minutes) looking for clues, especially in the few minutes leading up to the awakening. you're looking for disordered breathing, events, pauses that are less than 10 seconds, big flow limitations, leaks and repetitive patterns.

can someone explain why the flow limit is so much higher with the higher EPAP ? I increased the EPAP to 12.6 while maintaining the PS to the same 1.8. well, crazy flow limit!
then when I woke up with an air leak after just 2 hours, EVERY TIME i almost drift to sleep, i'm awaken with the gasp (spike).
when reducing the EPAP back to the 6ish, i finally could fall asleep (after 3 hrs or trying witht the higher EPAP) which leads me to start thinking that :

THE SPIKES ARE HAPPENING BECAUSE OF THE MACHINE!
the higher the pressure -> the higher the intensity -> the more violent is the jerk/arousal!

       
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#52
RE: koy23 - Flow Rate Analysis
Your charts indicate that you have a defective VAuto. OSCAR lists a maximum IPAP setting is 10.6 but the VAuto is running up to 14.4 for both 95 and 99.5 percentile. That is 3.8 cm past the set limit. I see in your profile that you have an AS10 Autoset declared. Did you just get this VAuto? Is there any warranty?

- Red
Crimson Nape
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#53
RE: koy23 - Flow Rate Analysis
(02-04-2022, 06:22 PM)Crimson Nape Wrote: Your charts indicate that you have a defective VAuto.  OSCAR lists a maximum IPAP setting is 10.6 but the VAuto is running up to 14.4 for both 95 and 99.5 percentile.  That is 3.8 cm past the set limit.  I see in your profile that you have an AS10 Autoset declared.  Did you just get this VAuto?  Is there any warranty?

- Red

It's Vauto
Bc I changed it through the night it reflects only the latest
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#54
RE: koy23 - Flow Rate Analysis
I don't have time to look closely at your screenshots at the moment. I just wanted to remind you that epap treats obstructive apnea and pressure support is used to ease flow limitations. without taking any other considerations into account, like your history and screenshots, I suggest you raise min ps if you're concerned about flow limitations. I'll try to take a closer look tomorrow but hopefully someone else will before that.
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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#55
RE: koy23 - Flow Rate Analysis
I still think these are just hypnic jerks and not caused by breathing issues. The blip is not indicative of a breathing issue, it is indicative of an arousal/jerk. The reason you get more of them at higher pressure is because you are not used to the higher pressure or comfortable with it. The reason the blip is higher is because the higher pressure expands chest further so blip has more amplitude.

The main breathing/cpap issue present you can fix are leaks which could be the cause of a number of these arousals. Imo the rest is another arousal issue not related to sleep disordered breathing (hypnic jerks most likely) but that is just my opinion.
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#56
RE: koy23 - Flow Rate Analysis
(02-04-2022, 09:28 PM)Geer1 Wrote: I still think these are just hypnic jerks and not caused by breathing issues. The blip is not indicative of a breathing issue, it is indicative of an arousal/jerk. The reason you get more of them at higher pressure is because you are not used to the higher pressure or comfortable with it. The reason the blip is higher is because the higher pressure expands chest further so blip has more amplitude.

The main breathing/cpap issue present you can fix are leaks which could be the cause of a number of these arousals. Imo the rest is another arousal issue not related to sleep disordered breathing (hypnic jerks most likely) but that is just my opinion.
Thanks, and I beleive you, what I found is that there is a "safe range" of settings to minimize the jerks
If the pressure is too low, they happen, if too high they happen now I am at Epap 7.6 with PS 4.4, I just want to tell you that changing the EPAP to 7.8 trigger the jerks!
I can't understand why, I'm trying to "optimize" the machine.
With my current settings I jerk less but not jerk free and I'm working on the leaks.
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