12-13-2019, 02:56 AM
(This post was last modified: 12-13-2019, 08:18 AM by jaswilliams.)
RE: Flow limitations
I don’t see a problem your flow limitations, nothing is jumping out fix me I would reduce the EPR to 1 and you may find your CA’s reduce if they are normally at this level. Other than that how are you feeling and sleeping
RE: Flow limitations
Your charts look good to me but I’m not an expert. If you feel good I would keep it as is. If it was me and I didn’t feel good I would put EPR on 3 and bump up the minimum pressure by 1cm h20 and give it a few nights.
That’s not a recommendation It’s just what I would do
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RE: Flow limitations
I would have to echo jaswilliams recommendation.
Set EPR to 1. (This may clean up a couple Clear Airway events.) They really aren't much, but that’s what I would do.
I don’t see a problem with Flow Limitations. Your FL readings are pretty low.
RE: Flow limitations
Thank all of you. Prior to recently starting APAP I felt exhausted/run down constantly. Been doing a lot of searching here on AB and a little fine tuning on my end, and have been feeling like I am getting a better quality of sleep, morning headaches are gone, and muscle cramps are gone (Dr felt it was hypoxia).
I found that if I set EPR to 3 that I have more CA events along with H and RE and feel generally poorer upon waking.
With EPR at 2, I get the few CA's (as shown) but no H or RE (typically). And generally feel rested upon wake.
With EPR at 1 or 0, there are virtually no events, but I feel horrible in the AM. Like I didn't sleep at all.
So for right now EPR 2 seems to be my happy medium.
The pressures seem to be working well for me. I recently lowered my Max to 14 because anything 15+ would give me a horrible headache.
RE: Flow limitations
Just a guess, but you might see whether the little bursts of FL continue to show the kind of pattern we're seeing here. Especially in light of your respiration-rate changes, this might be a REM-related phenomenon. In any event, nothing to worry about, it seems to me.
RE: Flow limitations
Late to the game, but there is nothing of concern here related to flow limitation. There are a couple periods of low flow limitation that work to increase pressure, at which point the flow limits resolve. This is exactly as designed. I agree with your conclusions that higher EPR would be counter-productive, and this looks effective and comfortable. Well done!