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Well, it's all about how you feel because a 0.00 event rate is not something I see very often at all. We can try titrating in more pressure support in increments of 0.2 cm per trial and see where you feel best. I'm almost tempted to ask you to stop looking at the data, or at least writing down your thoughts and observations before looking at data, because at this point it can mislead you more than help you.
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My numbers have always looked good, 0.0 is unusual for me but it's typically < 2. Do those flow limitations look abnormal to you? I'll try bumping up PS by .2 tonight.
sheepless, I have a had a few sleep tests and no one has mentioned restless leg syndrome to me. Attached the requested screen shots, 10 min and 5 minute view
your flow rate pattern looks very much like my periodic limb movement pattern. no way you'd know if you're experiencing it other than someone watching you or audio/video yourself. some sleep tests report plm, many don't. plus it occurs intermittently so even if it was checked during your sleep test, it might not have occurred that night. doctors, including my (ex) neurologist sleep doc, don't seem to want to acknowledge or treat it. in my experience, plm is just about as exhausting as apnea. if you feel like your sleep isn't what you think it should be, especially with your low ahi, I encourage you to look into periodic limb movement. also, be aware that resmed machines respond to plm breathing ineffectively and disturbingly.
What about the charts look like your PLM? Going to get a video camera and record myself, will keep this thread posted. How could I tell the difference between PLM and regular tossing and turning?
04-04-2021, 04:42 PM (This post was last modified: 04-04-2021, 04:43 PM by sheepless.)
RE: ASV for flow limitations in mild OSA
search my username for screenshots of plm flowrate. if you have trouble I'll post another here.
tossing and turning is random and typically once and done in a matter of moments. in contrast, plm in the flowrate looks like a fairly uniform repetitive pattern (periodicity), typically an inhale spike (our response to the kick) followed by some lesser, often flow limited breaths, followed by another inhale spike. sometimes I see a 'softer' version that looks more sinusoidal than box ended, like the waxing and waning typical of periodic breathing. often, for me at least, you'll see darker areas under the zero line (exhale) that look like snores but are moans/groans/grunts in response to the insult. need at least 2 or 3 to establish periodicity. an episode for me lasts from a few kicks to an hour or more. they often end a sleep session, waking me, like your screenshot above. in any given episode, the duration/number of breaths between spikes is roughly the same, usually about 10 to 40 seconds apart (if 10, usually almost all 10 in that episode, if 40, usually almost all 40 in that episode), sometimes longer.
even the plm that doesn't wake me to the point of masking off is tiring. plus (my theory is that) the resmed machines tend to ineffectively raise pressure against non-passive plm induced flow limitations which can be very disturbing in itself and can lead to leaks and aerophagia.
