Eliminated flow limit with EPR or PS?

[CPAPfriend]

Hey! I'de like to do a video on how to eliminate / reduce flow limit, and I was hoping that some community members might have actual OSCAR data that demonstrates that by increasing EPR or PS or even pressure. I'de love to include a couple solid examples in the video so as to encourage patients. I'm aware of the apneaboard flow limit article that includes an example, which I intend to include (referenced of course), but it would be nice to have some more.

Hope to hear back from some of you

[paulag1955]

I scrolled back through my data and found some that show how my flow limits went UP when I turned EPR off, if that would be at all useful.

[CPAPfriend]

Yes, that would! Could you post the images here or send them to me in a DM?

[paulag1955]

Do you want just one of each? Or a couple of each?

[paulag1955]

This is interesting. I exported my data to an Excel spreadsheet. I have just over one month's worth of data. I have 23 days of data with EPR set at 3 and 11 days of fixed pressure. Do you want to see this data as well as the charts?

[paulag1955]

These charts are as close to my averages as I could find.

With EPR enabled

   

With EPR disabled

   

[Sleeprider]

Pauag1955, the examples you posted are fair and show a 95% flow limit moving from 0.16 to 0.13. We often see more significant improvements and you might be someone that benefits from the additional PS of bilevel. The zoomed images of the flow rate chart at a 3 to 4 minute resolution are the most interesting part of this to look at. Examples are in the Flow Limitation Wiki. https://www.apneaboard.com/wiki/index.ph...limitation That wiki is probably due for a refresh, so I'll be watching for useful material too.

[paulag1955]

They actually moved up from .13 to .16 when I turned EPR off. But doing so cut my apneas in half. I'm not sure where to go with this balancing act, but I don't want to hijack this thread with it.

[Sleeprider]

Without EPR your 95% results are 0.16 with pressure 8.4/8.4 (inhale/exhale) on fixed CPAP.  AHI 1.84, with OA 0.57, CAI  0.85, HI 0.42

With EPR your 95% results are 0.13 with pressure 7.0/4.0 to 9.0/6.0 on Auto CPAP with EPR, AHI 2.5 with OA 0.28, CAI 1.53, HI 0.69. In Autoset mode, your pressure was at or near the maximum set pressure most of the night due to continued flow limitation.  You can conclude that EPR reduced obstructive events and increased centrals, and your pressure would have been better optimized with exhale pressure (minimum pressure) above 9.0 and maximum pressure closer to 12.0

[paulag1955]

But it didn't reduce obstructive events. My average OAs went from 6.3 to 3.2 when I went from EPR to fixed and my CAs went from 11.4 to 5.5. My hypopneas did go up from 2.2 to 3.2. I expected my CAs to go down when I turned off EPR, but the reduction in OAs was a complete surprise. I know it makes no sense at all, but it's there in the data. So my dilemma is trying to figure out how to get my flow limits down without increasing apneas.

Honestly, I'm surprised that the machine helps with my CAs at all, but it does.