Unusual flow

[estgad]

Reviewed my data last night and saw this unusual episode and was wondering if it was positional, a chin tuck, or something else.  
I attached 3 screen shots, the first 2 are an overview of the half hour episode, with all the graphs and machine settings.  The 3rd is a close up where the flow rate is easier to make out.

I am not sure what to make of it so that is why I thought about asking here to get some input from those that are much more knowledgeable about it than me.  
Thanks.

[G. Szabo]

You had some recovery breathings flowed by Hs. But these might not be classified as true Hs.
I suggest increasing your maximum pressure because you are close to it or hitting the ceiling sometimes. What about setting the maximum to 10.4 cm?

[estgad]

I suggest increasing your maximum pressure because you are close to it or hitting the ceiling sometimes. What about setting the maximum to 10.4 cm?

Thank you for the reply.  I have been very slowly increasing the pressure, I make a small change and give it time for my body to adapt.  I am at around 35 days at these current settings.  This past month has been the best results so far.  But I know it should be better.

The epap is one roadblock for me, the last time I did an increase it took the epap to above 5 and produced worse results, so I increased the ps so the epap would max out at 5, so that is why there is a 4.4 difference instead of just 4.

So my question is should I also increase the pressure support to cap epap at 5 or will that larger difference create problems or should I keep ps at the 4.4 and just go up by .2 increments for both max ipap and epap?

[G. Szabo]

I apologize for not being clearer.
I suggest setting PS= 4.4 under AUTO; min EPAP=4, max IPAP= 10.4. This will give you a wider pressure window, so the AUTO can increase the pressure when the flow limit occurs, and you might avoid the recovery breathing periods leading to Hs.

[estgad]

That is what I thought you meant.  I just got done changing the iPAP Max to 9.6. 
I am going to have to do this very slowly because with the PS at 4.4 when it reaches the max IPAP this will bring the EPAP up to 5.2. 
The last time I tried increasing EPAP above 5 it was causing problems.
The one graph that I didn't show in my previous screenshots was time at pressure, and the one thing I noticed that yet is it spends very little time at the max pressure so I think by doing a slow and steady change like this I might be able to adapt to it better and slowly work my way up. 

Thanks.