Bad at Breathing

[Sleeprider]

As you have observed, in Autoset mode, your pressure will rise to the highest pressure your settings allow. This is in response to the flow limitations. Higher pressure will not generally resolve the flow limits, but pressure support will. It may be useful to look at a zoomed image of your flow rate. Try zooming in on the chart to where you can clearly see the wave-form for your respiration. This will generally be a 2-3 minute period of time in the zoom. What I'd like to do is to give you a more graphic idea of how flow limitation is interrupting your sleep. Ideally the zoom will include both flow rate and mask pressure graphs.

[Haldir]

I've attached last night's data and a zoomed in one.  I can definitely see the flat or double peaked flow rates on the inhale.  I also notice that it seems like the EPR isn't quite in time with my breathing?  Like maybe the pressure needs to come up quicker?  Maybe that's how it's supposed to look? 

[Sleeprider]

Nicely done with the graph. As you can see you have flattned peaks with a jagged top with 2-3 peaks. This shows that during peak flow, your airway obstructs and vibrates, most likely with a snore. The ragged peaks suggest a vibration of upper respiratory tissue that alternately opens and closes. While higher pressure may help this, more pressure support (difference between IPAP and EPAP) will support a normal breath and prevent the peak flow obstruction, without necessarily requiring higher peak pressure. Clearly, this peak flow obstruction or flow limit is very disruptive to your sleep, and we see an arousal after the really nasty FL at 03:14:10. I will stay with my recommendation for bilevel, that will increase pressure support from 3-cm to a level that will mitigate the peak flow limit. It's a really common problem, and Deborah who has active in this thread can offer good personal experience of how bilevel helps, and how to get a bilevel.