Can someone help me with these flow rates?

[Crimson Nape]

The I:E Ratio is your inhale time versus your exhale time.  If you also look at your respiration times below the I:E value (lower left, under Statistics), you will see that it is taking you a long time to exhale as opposed to your inhale time.  I am guessing, but have you been diagnosed with any form of COPD?

[emos12]

Ah I see, and what would be normal ? Isn't it possible that due to my lack of sleep my body is totally whacked and short of breath and beceause I am still not improving also in the night I am having this short of breath? No COPD, I have done lung function tests and every looked fine. I am just short of breath all-the-time.

[Crimson Nape]

I just noticed in prior posts that you have changed equipment. I have been using your equipment profile for a basis of my reasoning.  Based on my limited observations, I would expect a ratio to be in the area of 2:1 or 1:2.  Each person is different and I don't know of a rule that covers this.  

You have managed to exhaust my knowledge on this.  At this point, I would recommend that Sleeprider's advice should carry considerably more weight than mine.

Good luck.

[Walla Walla]

You need to turn on your event flags at the bottom left of the charts.

[Sleeprider]

Emos, welcome back.  Let's cover some basics.  You started on CPAP using a Dreamstation auto CPAP and looking back at the first couple pages of this thread, you're results were horrible with a terribly disturbed breathing pattern.  We encouraged you to obtain bilevel therapy, and you are now using a Resmed S9  VPAP ST, however you have not updated your profile. I'm going to be a bit fussy here and ask you to do so now: http://www.apneaboard.com/forums/usercp.php 

Secondly, I authored a wiki on how to organize a sleepyhead chart http://www.apneaboard.com/wiki/index.php...ganization .  Let's re-do these charts, removing the calendar by clicking that triangle in the date line, get rid of the pie chart/smilie face by clicking the menu options File/Preferences/Appearance and unclick the Pie chart option.  Be sure to turn on the remaining events in the event flags by selecting the options at the lower left of the graph.  Now that I've endlessly complained about your formats, let me say "Wow what a difference pressure support has made!"    I will make further comments once you fix this mess. 

[emos12]

Hee Sleeprider,

Yes I totally forget to add my new machine and also adjust my sleepyhead! I hope its good now

[Sleeprider]

Emos your progress is impressive and your breathing has tremendously improved. The UA events are unclassified, and I think I'd like to see some zoomed in screenshots of a couple events before making a judgement. I am inclined to think those may be central events, and that we may want to move to ST mode using the same settings, but setting a backup rate of 10 BPM (breaths per minute). This will result in the machine automatically triggering IPAP when you miss a normally paced breath (14 BPM) and may help stimulate an inhale.

[emos12]

I am glad that it looks fine now Now I just need to feel better and I will be forever grateful for all the help on this forum what about those m waves does that look like something disruptive or not per se? I see, so the possible centrals are due to the higher pressure? I will put it on ST with backup rate of 10BPM and post the results here.

[Sleeprider]

Emos, I still can't see the tidal volume and other statistics that would help. Please be sure to go to the menu file/preferences/appearance and turn off the pie chart. It would also help if you vertically shorten the flow rate graphs so that leaks, snores and flow limitations can show. The mask pressure can be moved down in the order for now.

[yrnkrn]

but the best solution for flow limitation like yours is BiPAP. 

My personal experience with insistent flow limitation is exactly as you suggest, pressure support works much better than higher cpap pressure.
For example constant pressure of 13/10 produces much better flow than straight 13.
Intuitively it is correct because some of the work overcoming the flow limitation is done by the ventilator.

I looked for academic/theory reference to using Bi-Level this way combatting flow limitations but found none.
Have you seen such reference?