Flow Shape

[InquiringMind2890]

My dad has switched to using a BiPAP machine, and while the AHI's seem really low, he's still waking up exhausted; and of course the sleep technician's don't care, just as long as the # of apneas is low.

On Reddit, someone mentioned that the flow shape wasn't correct, but didn't mentioned how so. How does the flow shape look like? Is that what's still causing the fatigue...
   

[PeterFD]

The thing that struck me most is how mask pressure is mainly at the low end of its range. I am used to seeing the mask pressure at the low end for about 50% of the breathing cycle, but that could be a feature of the BiPAP machine that I am not familiar with.

Yes, there is more to life than AHI. The quality of sleep is important too for wellbeing, and PAP machines don't report on sleep patterns. For that you need to use a polysomnogram.

Also, keep an eye on tidal volume. Your vertical scale range is excessive so you can't see the values well, although you can still read the value at the green cursor displayed at top left of the graph. An oximeter may also help, to keep a watch on blood oxygen saturation. OSCAR is able to import the data from many brands and display it.

[InquiringMind2890]

The thing that struck me most is how mask pressure is mainly at the low end of its range. I am used to seeing the mask pressure at the low end for about 50% of the breathing cycle, but that could be a feature of the BiPAP machine that I am not familiar with.

Yes, there is more to life than AHI. The quality of sleep is important too for wellbeing, and PAP machines don't report on sleep patterns. For that you need to use a polysomnogram.

Also, keep an eye on tidal volume. Your vertical scale range is excessive so you can't see the values well, although you can still read the value at the green cursor displayed at top left of the graph. An oximeter may also help, to keep a watch on blood oxygen saturation. OSCAR is able to import the data from many brands and display it.

That's really good to watch out for, thanks!! How can we reduce the tidal volume?

Would tidal volume be affected by the Backup rate at all? Or the TiMax/TiMin? I was told that TiMax @ 3.5 seconds seems like it's too much, but the sleep technician never mentioned why he set it that way, when by default it should be about 2 seconds...

[jdougc]

Welcome to the forum, 
We would like to see some data first, the following graphs, (in their order of importance) 
1.Events
2.Flow rate
3.Pressure
4.Leak rate
5.Flow limitations
Please exclude the calendar.
The statistics and device settings on the left side should be fully visible. We need to see PS and other device settings.

We need to see an un-zoomed the full night's chart.

Use the F12 key or FnF12 for a mac to take screenshots. You can attach the .png file and insert in in your post.
Those are flow limitations and can lead to arousals and daytime sleepiness.
https://pubmed.ncbi.nlm.nih.gov/38530665/

[InquiringMind2890]

Welcome to the forum, 
We would like to see some data first, the following graphs, (in their order of importance) 
1.Events
2.Flow rate
3.Pressure
4.Leak rate
5.Flow limitations
Please exclude the calendar.
The statistics and device settings on the left side should be fully visible. We need to see PS and other device settings.

We need to see an un-zoomed the full night's chart.

Use the F12 key or FnF12 for a mac to take screenshots. You can attach the .png file and insert in in your post.
Those are flow limitations and can lead to arousals and daytime sleepiness.
https://pubmed.ncbi.nlm.nih.gov/38530665/

Thank you for your reply!! Does it work if I just send you his SleepHQ link?
https://sleephq.com/public/teams/share_links/ae7d0a7e-1390-4d91-800a-5c2f9b563820/dashboard

[jdougc]

Not everyone likes SleepHQ. But is gives more than 1 day and lets us zoom round the breathing chart.

Your dad is not sleeping enough to get appropriate therapy. he needs 7 1/2 to 8 hours.
He did better in the early part of May, almost 7 hours, what change to make him stop the machine?

He has a lot of Hypopneas during REM sleep, during this time we lose control of mot of our muscle controls, except those for essential stuff, the breathing and brain functions.
You can estimate this REM sessions with small peaks in the tidal chart

A soft cervical collar might help as he might be tucking his chin to his chest, restricting his airway, like kinking a garden hose. 

We can't see flow limitations with theses settings, they are not full obstructions, but partial restrictions in his airway that might take more effort to breath and possible causing arousals and daytime sleepiness.

Is there a VAUTO setting available?