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Thinning/Sluggish Flow Rates Followed By Disturbance - Help!!
#1
Thinning/Sluggish Flow Rates Followed By Disturbance - Help!!
I need some advice on settings - for Vauto - for the following. 

I seem to follow a predictable pattern each night. Flow Limit scores of 25ish, then as the night goes on, my limit scores start to “thin” or become sluggish, slowing down to scores of about 12, sometimes even 10. My tidal volume also decreases to around 330-360ish at this time too. 

I then seem to awaken, or toss/turn. Breath becomes batshit, and then my flow limits go back up to 20-25ish along with increased tidal volume of about 450ish. 

First question: is this normal? Or indicative of shallow breathing/chin tucking? Is this indicative of a RERA? 

How do I solve this on my Vauto settings? 

I feel like crap every morning and fight off sleep everyday. But my AHI is always “good”. 

See the attached low breaths, then the recovery/toss turn/ then the increased breaths. 

HELP ME!!

Here are the other flow limits after plus the disturbance


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#2
RE: Thinning/Sluggish Flow Rates Followed By Disturbance - Help!!
EDIT - TIDAL VOLUME ACTUALLY DECREASES TO 250ish sometimes on the Flow Rate slowdowns.
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#3
RE: Thinning/Sluggish Flow Rates Followed By Disturbance - Help!!
Hard to tell from the charts you posted, but things look normal to me in those views. Can you post the entire evenings chart using the standard format?

There are arousals during the night due to a variety of causes. Tossing, turning, dream states, leg movement, etc. Hard to tell from what you posted.
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#4
RE: Thinning/Sluggish Flow Rates Followed By Disturbance - Help!!
Samthesleeper  -  In order to post images of OSCAR, please follow the steps below on how to properly capture the OSCAR image.
  1. Make sure that your display is set to the Standard view and your graphs are in the default order.
    • If not, go to (View > Reset Graphs > Standard)
  2. To take a screenshot of your Daily screen, select one of the following:
    • For Windows or Linux: Use the F12 key
    • For a Mac: While holding down the Fn key, press the F12 key.

- Red
Crimson Nape
Apnea Board Moderator
Project Manager for OSCAR - Open Source CPAP Analysis Reporter
www.ApneaBoard.com
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Thinning/Sluggish Flow Rates Followed By Disturbance - Help!!
See the attached

And attached here


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#6
RE: Thinning/Sluggish Flow Rates Followed By Disturbance - Help!!
Thank you for posting those.  If your CA's start rising a lot, you can turn down the PS from 4.2 which you have it now.  It is kind of a balancing act.  That PS is helping, but might be causing the few CA's you have (and also possibly contributing to some leaks).  Your EPAP stay fairly low from about 6 to 8.  You can also try starting with 8 as your min.  

Here are a few tips for mask leaks.  Leaks can wake a person up at night and make therapy less effective.  Mask Primer

Possibly using a soft cervical collar, if you can tolerate it, could keep your airway a bit straighter and help possibly with some of the disturbances you are having at night.  You don't have clusters of apneas, but just a thought here with all the "tossing and turning" you say you do during sleep.  

That is all I see.  Someone else may see something else in your charts.
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#7
RE: Thinning/Sluggish Flow Rates Followed By Disturbance - Help!!
Samthesleeper,
If the lower PS setting doesn't help, try raising the Trigger setting to High or very high.
That has been known to lower CA's.
OpalRose
Apnea Board Administrator
www.apneaboard.com

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE.  ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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