Help wanted on interpreting air flow shape

[PeterFD]

The first image is what I think is an example of air flow when I am awake.

The second image is what think the air flow looks like when I am asleep. The exhale following the peak returns to zero something like an exponential decay.

The third image is what I want advice about. It is also when I am asleep and usually occurs with my second example either side of it.

It is characterized by a very spikey exhale followed by a plateau of exhale before starting the next inhale. Could I be getting a leaky obstruction during the plateau phase to give such a remarkably constant exhale rate?

[PeterFD]

Why didn't my three attached PNG images show?

[PeterFD]

           

[PeterFD]

My images appear in the reverse order to what I intended, If you hover your cursor over an image you will see the file name. It is the file named "spiky" that I am asking about.

[WisNaeMe]

Have a look at this OSCAR wiki page -

https://www.apneaboard.com/wiki/index.ph...imitations

"Spiky" looks like expiratory mouth breathing or possibly palatal prolapse. The charts also suggest you have some unmanaged flow limitations (FL).

I had charts similar to your "spiky", but managed to eliminate the glitchy bit using a Knightsbridge chin strap to firmly clamp my mouth shut. You may be able to achieve similar results with either a soft cervical collar or alternative chinstrap (YMMV).

Further, you might be able to reduce the FLs by increasing EPR (if you've not already done so).

[LaurenceShaw]

... but managed to eliminate the glitchy bit using a Knightsbridge chin strap to firmly clamp my mouth shut.  You may be able to achieve similar results with either a soft cervical collar or alternative chinstrap (YMMV).

Please use the link of Supplier #37 rather than a keyword search if you are interested in the Knightsbridge Dual Band chin strap or you will likely end up with a counterfeit.

Briefly, the Knightsbridge has straps which pass under the jaw and lift vertically to work with the natural rotation of the jaw.  In contrast, traditional neoprene chin straps wrap around the tip of the chin and force the jaw almost directly into the jaw joint.  This is illustrated in the drawing at the top of the More Info page of Supplier #37.

[jdougc]

LaurenceShaw is correct, use only a chin strap which passes under the jaw and lifts vertically. The Knightsbridge chin strap is well designed.

[PeterFD]

I have been using a Resmed chin strap with a nasal mask. Without the strap I blow raspberries when my tongue loses suction with the roof of my mouth. At a pressure greater than 8 even though I may not get a leak through my lips, my cheeks may blow up. I also have a full face mask which covers the mouth and should stop that, but it feels more intrusive and with the larger perimeter I have more trouble maintaining a good seal.

I see Knightsbridge has three models of chin straps. Should all versions be OK?

[WisNaeMe]

The Knightsbridge will certainly offer more jaw ‘clamping force’ than your current ResMed chinstrap and so help prevent your jaw / tongue dropping.  Its wide stout straps cross the cheeks and I find that helps reduce ‘chipmunk cheeks’ too …but that air has to go somewhere!

The three Knightsbridge versions are more about comfort, they all function in the same way, so all will work fine. The mesh ones are lighter and more breathable and the most expensive one doesn’t squash your ears as much as the others.  It is quite a cocooning experience wearing it, particularly if you end up using a FFM …so not for all!

Your experience with the nasal mask might just be down to being new to it - it does require a fair bit of practice to prevent the tongue dropping. Some people just can’t master it and so use a FFM or hybrid mask.

Your experience with a FMM might just be down to incorrect size/poor fit …or even just loose straps.  Most of us have ended up trying a good few masks before we get it right.

Might also be worth looking at hybrid masks such as the ResMed AirFit F30 / F40 or the F&P Evora.  These are less intrusive with less 'perimeter' than the more conventional FFMs, if you end up having to go that route.

[LaurenceShaw]

The Knightsbridge will certainly offer more jaw ‘clamping force’ than your current ResMed chinstrap and so help prevent your jaw / tongue dropping.  Its wide stout straps cross the cheeks and I find that helps reduce ‘chipmunk cheeks’ too …but that air has to go somewhere!

The three Knightsbridge versions are more about comfort, they all function in the same way, so all will work fine. The mesh ones are lighter and more breathable and the most expensive one doesn’t squash your ears as much as the others.  It is quite a cocooning experience wearing it, particularly if you end up using a FFM …so not for all!

Thanks WisNaeMe.

Yes, the three versions of the Knightsbridge chin strap all function in the same manner and differ only in the construction of the cap to address comfort issues.  

To be particular with regards to "clamping force" ... the Dual Band design minimizes the applied force when the jaw is closed and only engages in applying substantial force when the jaw opens.  This is hopefully illustrated by the graph on the More Info page of Supplier #37.


(If you are interested in the Knightsbridge Dual Band, please use that link rather than a keyword search or you'll likely end up with a counterfeit.)