Old Steve - Therapy Adventure

[Old Steve]

Is this what you need?


   



   

[UnicornRider]

You do not have any resting pause in either of your screenshots. Actually a very tapered exhaust flow rate to zero flow rate then change over to inhalation.

 I took mine down to one minute view to really capture the "shelf" at the tail end of my exhalation. 

   

The Cardioballistic artifacts are clearly seen in my screenshot. My pulse was 58BPM at the start and finish of this screenshot with a low of 56BPM from 22:39:22 to 22:39:30,  and a high of 59 BPM from 22:39"52 to 22:39:54. so fairly steady through this screenshot.

Have you always had a Flow Rate pattern like this, or is it a recent development?

[Old Steve]

From what I can tell the really odd flow rate started happening about a month ago.  I have attached another screen shot from a few days earlier.  This one shows me going from one wave form to the other.  Looks like I may have had an arousal between the two.  Looking thru some of my charts I noticed that when the odd flow wave happens my tidal volume drops and stays below the line.  It stays below the line until my wave changes back to what I consider my normal wave.



   

[UnicornRider]

I've  not forgotten you, I got distracted by activities here. The first two graphs display air-trapping, Not enough cycle time to complete the exhalation process so you do not taper down to the crossover from Exhalation to Inspiration. My first thoughts went to my mother with COPD. There are time where respiratory irritants cause it to be hard to inhale as well as exhale and it can be the bronchioles that feed the alveoli. Then I would recommend you consider a Bronchiole dilatator.

Yet your third screen shot show that it clears with an arousal. To me that would indicate some flappy partial obstruction that limits the flowrate, that cleared maybe with positional change or swallowing. So there you are dealing with physical structure or thick mucus..

    If it results in air trapping your tidal volume would go down. Your SpO2 would also show a drop.

 Either case it would be wise to share this with a respiratory medical personal. A good respiratory therapists would be able to isolate the cause shortly.

[Old Steve]

Thank you.
After reading your excellent explanation of the wave form shape could this also be a possible cause?   I have sinus problems, I use a nasal rinse nightly and Breathe Right nasal strips.  I also use a ResMed N20 AirTouch mask and I tape my mouth.    Is it possible, that during the night for what ever reason my mask is getting pushed down my nose slightly.  Then the foam cushion contacts the nasal strip, pinching my nose slightly and cutting off some of my supply of air.  

[UnicornRider]

I just pinched my nose slightly to simulate the "Imagined Effect" and tried to breath for several minutes with eyes closed while mentally painting a picture of the Flow Rate and Tidal Volume graphs resulting.

  By varying the pressure slightly I could replicate each of the three wave shapes you presented including the third with the arousal in the midpoint with recovery to normal to near normal breathing.

 The air trapping, incomplete exhalation cycle, with the accompanying varying Tidal volume. Yes, I can see that happening.

Normally when I mention cameras in the bedroom,,,,  
people get kind of freaky,

 But if you could get a camera with a time clock sync'd with your Resmed time. It would answer that question. 

[Old Steve]

UnicornRider,

 Thank you so much! 

 That has to be what was causing the strange waves.  I vaguely remember waking one night and having to move my mask up on my nose.  I am going to try using my AirFit mask cushion (silicone) and see what happens. It has a little more space for my nose.  If that doesn't work I may have to go back to my F20 FF mask.  

Having a camera in my bedroom would be six hours of boredom...

[UnicornRider]

That Evora hybrid FFM, sounds like a contender.

Everybody has to promote their favorite mask.



Have you tried FlowNase, or similar product in your nightly nasal routine?