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Is This Flow Limitation Cause for Concern?
#1
Is This Flow Limitation Cause for Concern?
Recently I bought an SD card to view my dad's CPAP data and noticed there is a fair bit of flow limitation throughout the whole night, for at least the past three nights. He says his sleep isn't the best at the moment and I was wondering if any of you could take a look at some of the OSCAR data. I'll post screenshots of all the data as well as a two minute snippet of some of his breathing.

Is this level of flow limitation something to be concerned about? Are there any setting changed that could possibly help? Also, his EPR is set to 2 already, should that possibly be raised?

Thank you!


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#2
RE: Is This Flow Limitation Cause for Concern?
Yes, the charts you uploaded do show a good amount of flow limitations. Since he is already at 2 EPR, you can try 3 and that may help a bit. Not sure about the pressure. It is possible that ResMed is raising your dad's pressure to the max setting of 16cm in response to the flow limitations and by bumping up the EPR to 3 it may reduce the FL and thus bring down the max pressure.

That max EPR (Pressure Support) on his machine is 3. If it turns out he needs more, a bi-level machine like the AirCurve 10 might be needed, but for now, try EPR set to 3 and repost OSCAR screen captures so we can see how much of a change it made.
"the quieter you become, the more you are able to hear"
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#3
RE: Is This Flow Limitation Cause for Concern?
Since he has been at this for a few months, you might consider dropping the ramp altogether.  He isn't getting any real therapy during that time and might well feel a little air-starved.
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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#4
RE: Is This Flow Limitation Cause for Concern?
Those times he maxed out IPAP at 16cmH2O he had a cluster of different events flagged, it is possible that he is having some Positional Apnea, possibly Chin Tuck. It is possible a Soft Cervical Collar (SCC) could minimize these events or prevent them all together. Thus minimizing any corrective pressure increase. Otherwise he may need to increase Minimum Pressure to assist in opening the airway.
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#5
RE: Is This Flow Limitation Cause for Concern?
Here are some screenshots with the new settings on two different days, the third picture is a zoom in on a cluster of apneas in which may be caused by sleeping on his back rather than side. Also seems raising the EPR to 3 has helped with the flow limitation a bit.

Is there any other settings that could possibly be changed? How is his data looking overall?

All responses and advice are welcome.


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