Raise or Lower Pressure for Flow Limitations?

[CPAPUserDave]

After reading various threads on reducing/controlling Flow Limitations, I got myself all confused. Help!

Thought raising inhale pressure and reducing exhale pressure was the way to go but...

In my case, switched my ResMed Airsense 10 Autoset from CPAP mode (9.0 pressure) to APAP mode (Minimum at 9.0, Maximum at 20.0 with 95% at 10.0-11.0). EPR changed to 3.0 (Maximum this machine will go). Did this about 3 months ago

Now after further reading/researching, maybe best to switch back to CPAP mode and lower pressure as low as can go before Apnea events occur and leave EPR at 3.0 might be the way to go?

Both theories feasible?

I am asking because still not fully rested during day (I say operating at about 80%) and thinking my flow limitations may be the issue. getting some deep sleep but just not enough during the night.

Anyhow, thoughts?

Dave

[SarcasticDave94]

Might be a wise idea to start with an OSCAR chart. I'm thinking reduction in flow limits is to raise EPAP typically. Flow Limits don't last long enough to be classified as apnea, but they're cousins.

[Gideon]

The best solution for flow limits is PS (pressure support) or EPR. Secondary is EPAP.

[CPAPUserDave]

so if i am thinking clearly, since my EPR is maxed out at 3.0, i would need to raise inhale pressure which would also increase exhale pressure since i can not go higher than a 3.0 difference in pressure? at least with the current machine i have.

also, in sleepyhead (oscar?) charts, under statistics box, there is a category called flow limit with numbers after that. what do those numbers mean/correspond to?  is there a 'gold standard' that one tries to achieve like AHI below 5.0?

[Gideon]

With Flow Limits I like to see lower than .25 - .3 (ResMed). At that point a decision has to be made on attempting to lower them further. For that I like to hear the users complaints/symptoms. For many that is a good place to stop, for others, not so much.

[CPAPUserDave]

       

In OSCAR screens, where does one find the value for Flow Limits? (Bonjour replied like to see lower than .25 to .3 - where does this value display?)

posting OSCAR screenshots for review. would like feedback mainly concerning Flow Limits and if any improvements can be made. still not feeling 100% (i'd say running at 80% efficiency) but not sure if flow limitations are affecting me or something else (and those things have been/are being explored)

the close up screenshot shows my breathing pattern that is pretty much typical for the whole night (just smoother before sleep onset)

let me know if any other info needed...

Thanks,

Dave

[jaswilliams]

Dave if you look in the statistics section on the left of the screen your max for flow limitations is 0.14 which is pretty insignificant

[CPAPUserDave]

Dave if you look in the statistics section on the left of the screen your max for flow limitations is 0.14 which is pretty insignificant

there it is. looking back at last three months, the 95% value has never been above 1.0 so that is looking good for me (as far as concerning flow limitations)

[jaswilliams]

Dave if you look in the statistics section on the left of the screen your max for flow limitations is 0.14 which is pretty insignificant

there it is. looking back at last three months, the 95% value has never been above 1.0 so that is looking good for me (as far as concerning flow limitations)

Not quite...

1 is the max value possible for flow limitations, anything over 0.3 needs looking at if it occurs for a large period of time based on the flow limitation graph


unless it’s an ASV and the flow limitations are less significant

[CPAPUserDave]

looked at numbers again, last 3 months my flow limitations values at 95% are mostly in the 0.03 to 0.05 range so....

that sounds acceptable... i think... maybe ??