[CPAP] Trouble with flow limits, doctor won't help

[ChickenTenders]

I've been on CPAP for some time now and have a very low RDI score however it doesn't seem to be improving my sleep too much. My doctor believes it's fine but looking at the data it seems I'm getting a lot of flow limits which are disrupting my sleep. From my research the general recommendation is to increase EPR, however I already have it set to 3. Any ideas on what I can do?

[Deborah K.]

I was having that same problem, and when I asked for help I was told that I needed to switch to a Bilevel machine instead of an Apap.  I did so, and the problem was solved.  I sleep much better now with my ResMed AirCurve 10 Vauto machine.

Here's a link to how I went about it in the thread I made asking for help with the flow limits in case you are interested:

https://www.apneaboard.com/forums/Thread...ht=bilevel

Best of luck with getting this solved!

[Old Steve]

In your pressure statistics the Med, 95% and 99.5% your EPR appears to be 2 not 3.

[ManWithOranges]

huh, your right. I guess I'll bump it up tonight.

[quiescence at last]

Man,
I was going to point that out as well. Hope you see a decrease in flow limitations and disrupted sleep. How do you know you are being disrupted by those? are you waking up or being startled?

Feeling rested is one of those things that is elusive for many that have settled their breathing and pressure issues. In that case, there may be reasons other than apnea.

Good luck.

QAL

[ChickenTenders]

I sort of just assumed so since there seems to be a correlation between flow limitations and elevated heart rate when I look at my pulse oximeter. I also tend to wake up during periods of flow limitation, and sometimes I notice that it's difficult to breath unless I shift around a bit. I've tried bumping up the minimum pressure over the past few days just to see, although I'm not sure if it's very successful.

I'm looking into getting a different doctor and possibly a bi-level machine, although it looks like I'm stuck with what I have for the near future. Is there anything I should be looking for as I change my settings?

[Old Steve]

In your last chart you are having some major leaks that may also be causing some arousals.  I am sure that you know that flow limit problems can be caused by nasal congestion.  I use nasal strips and a nasal rinse nightly to help control mine.  I don't think that your flow limitations are really that bad though.   You can check them by enlarging a two minute section of your flow rate wave in the location that your flow limits are occurring.  If the wave is just getting flatter, but you are not having an actual arousal, the flow limits may not be the problem.    Have you ever tried running your machine in CPAP only mode and see how you feel?  This is how I run mine.  If you want to try it in CPAP mode only I would start with a 10cm minimum pressure with the EPR at 3 for a few nights and see if you feel better.

[ChickenTenders]

Thanks for the suggestion, I'll try CPAP only mode at 10 tonight to see what happens. I'll also try getting some nasal strips. When I look at my data from last night and zoom in on the flow limits the flow rate graph ends up looking kinda jagged. I'm not sure if I'm panicking over nothing as while it seems like I tend to get flow limits before I wake up, it could also be for other reasons. It's just that it's the only thing I can point to as my events are very low.

As a side note, I do think cranking up the pressure has improved my sleep a little bit compared to when I had it at 8, and I seem to get less flow limits.