RE: Resp. Rate spikes
If you can zoom in on the flow rate in the moments before an acute arousal, we will see if the problem has a respiratory origin or reaction.
RE: Resp. Rate spikes
(09-08-2018, 10:30 PM)Sleeprider Wrote: If you can zoom in on the flow rate in the moments before an acute arousal, we will see if the problem has a respiratory origin or reaction.
Here's a zoom of the last few minutes flow rate.
[attachment=8159]
RE: Resp. Rate spikes
Here's a zoom of the respiratory rate, too. Not sure which is more helpful.
[attachment=8160]
RE: Resp. Rate spikes
In the moments before your arousal, your respiration shows some notable flow limitation. This may be alleviated using EPR. Flow limitation can result in a desaturation of blood oxygen, and trigger a panic reaction with increased heart and respiration rate. It can also trigger release of adrenaline. This may be an over-reaction to a fairly minor problem, but it's not unheard of, and certainly not something you could control. We're speculating a bit on what the graphs are showing us here, but that is a workable hypothesis.
Without making other changes, enter the clinical settings, go to comfort settings and turn EPR ON, Full Time, Setting 3. Let's try this again.
RE: Resp. Rate spikes
(09-09-2018, 10:13 AM)Sleeprider Wrote: In the moments before your arousal, your respiration shows some notable flow limitation. This may be alleviated using EPR. Flow limitation can result in a desaturation of blood oxygen, and trigger a panic reaction with increased heart and respiration rate. It can also trigger release of adrenaline. This may be an over-reaction to a fairly minor problem, but it's not unheard of, and certainly not something you could control. We're speculating a bit on what the graphs are showing us here, but that is a workable hypothesis.
Without making other changes, enter the clinical settings, go to comfort settings and turn EPR ON, Full Time, Setting 3. Let's try this again.
Ahhh, so that's why they're flattening out. I didn't know to look for that. Thanks so much for the analysis. Can you give me some insight into flow limitation? Wouldn't that be caused by some kind of obstruction -- snoring or something else?
I'm going to decrease the minimum pressure down to 8 and then turn on EPR to a setting of 3. I believe I had it set for ramp only because I had read somewhere that EPR could be problematic because of the pressure loss on exhale. Nevertheless ... I'll make those changes and see what happens!
RE: Resp. Rate spikes
Two Wiki articles
Flow Limitation and
Flow Limitation/UARS and BiPAP which is linked to from the first.
SR is using EPR to help with your flow limitations.
09-10-2018, 11:04 PM
(This post was last modified: 09-10-2018, 11:05 PM by chd3143.)
RE: Resp. Rate spikes
(09-09-2018, 10:13 AM)Sleeprider Wrote: In the moments before your arousal, your respiration shows some notable flow limitation. This may be alleviated using EPR. Flow limitation can result in a desaturation of blood oxygen, and trigger a panic reaction with increased heart and respiration rate. It can also trigger release of adrenaline. This may be an over-reaction to a fairly minor problem, but it's not unheard of, and certainly not something you could control. We're speculating a bit on what the graphs are showing us here, but that is a workable hypothesis.
Without making other changes, enter the clinical settings, go to comfort settings and turn EPR ON, Full Time, Setting 3. Let's try this again.
Here's a screen from last night. Would you say that the flow limitation is present here? I have trouble understanding how high the peak should be. The EPR and reduced pressure made it more comfortable for sure. The leak rate went way down as well. I still had an arousal (this screen is at that point), but it wasn't nearly as big of a deal as it typically is.
Again, thanks so much for your help.
[attachment=8201]
09-11-2018, 09:29 AM
(This post was last modified: 09-11-2018, 09:40 AM by Sleeprider.)
RE: Resp. Rate spikes
It is not the height of the peak, but the roundness. I can see some subtle respiratory improvements here, in particular, the inspiratory time is now 1.68 seconds and expiratory is 2.28. That compares to 1.86/1.82. That means respiration is reaching its peak faster and this infers less flow limitation. The graph you posted is pretty far out to see details but looks pretty good. Your pressure with EPR is lower across the board as are respiratory rates (bpm14/18/39 vs 16/21/50). At this point your AHI is near zero and frankly I'd consider myself fortunate to have these kinds of results. If you feel comfortable, you are done for now.
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