Flow limitation

[DanEm]

This is a link pointing to a ZIP file of all my Resmed data https://we.tl/t-xnMyaYfqJ8

It is a copy of all the files Oscar uses and you could use them to choose whatever view and zoom you need.

Included here my last night results with zoomed views

[Crimson Nape]

Here is the routing to delete your attachments: UserCP ⇾ Miscellaneous ⇾ Manage Attachments

Here is a direct link to this option: http://www.apneaboard.com/forums/usercp....ttachments

[DanEm]

[Sleeprider]

Your charts show your pressure totally maxed out at 20 cm with very high residual flow limitations leading to arousals indicated by the inspiration spikes. The events are obstructive in spite the CA flag on some of them. We can only do so much with CPAP pressure, but it is the pressure support of bilevel that helps to overcome resistance in the airway. We use EPAP pressure to stent the airway open and IPAP to assist in getting a normal breath volume in a normal period of time. For now, I don't see any benefit to pressure over 15 cm. Let's try cutting back the maximum pressure setting.

[DanEm]

Let's try cutting back the maximum pressure setting.

Any suggestion for the numbers ?

[DanEm]

Sleeprider,

I believe I misread your last comments.

I will set my CPAP to 6/15 for minimum and maximum pressure.

Will let you know of the results.

[DanEm]

Sleeprider,

I have set the pressure to 6/15 and had one night sleep.

I am submitting the images of the results so you can assess how I am doing.

I had the MAD but not the collar.

I hope you will find more info about what I should be doing next.

[Sleeprider]

You are be best judge of whether this is better for your sleep. As expected, the Autoset went to maximum set pressure and stayed there, however I don't see where that resulted in any increase of events. The OA cluster (3) was positional and is preceeded by some pretty gnarly flow limits typical of chin-tuck. The flagged RERA (1) actually looks like pretty good sleep pattern for you and while there are a couple larger breaths, I don't see a significant arousal of the magnitude you usually display. The CA shows diminished breathing volume without flow limitation into the CA event and recovery breathing out the other side, so the event seems to be properly flagged.

Overall, this looks better on the graphs to me compared to before. How did it feel?

[DanEm]

I feel much the same after just one night. Still tired during daytime.
But this might take a while to correct ?

For your info, the included screenshot shows the evolution of different indices since I started using the MAD

I will wear the collar for my next night and see if it improves the flow limits.
That collar really prevents my head tilting forward (chin-tuck).

I will post those results tomorrow. 

[DanEm]

As said yesterday, I have posted a screenshot of my last results.

Although I am happy the AHI is perfect, I don't see a very good flow limit.

The RERA is showing numerous events, is this something to be concerned?

Can something be done to improve?

What would be the long-term effect of that kind of result?

To describe how I feel, I think I would need some time going like this to see if my daytime sleepiness improves.

I hope you have enough information to guide me.