What else causes flow limits?

[StevesSp]

Since the folks in here pointed out that I have an issue with flow limits, I first tried adjusting the EPR in line with suggestions. This didn't seem to help the flow limits but did increase my centrals.

 I then tried a cervical collar with EPR back to 'normal'. A bit of fiddling was required to adjust the fit so that it prevented chin tucking while allowing me to mouth breathe. I eventually got to the point where I could sleep with it all night but alas, flow limits are unchanged once again.

I have attached last night's graphs, one showing the flow limits and one is a zoom in on the breath waveform.

Can anybody tell me if this degree of flow limitation is indeed a problem that needs addressing and, if so, what else I could try please?

[Phaleronic]

You have some flattening of the sine wave during inspiration in that chart. I would raise min pressure to 12.4cm.

[Dormeo]

FLs disturb the sleep of some people and not others, so it's hard to know in advance if it'd help you to reduce them. Also, they can originate in the nose or further down in the airway. If they originate in the nose, there's really nothing the machine can do to fix them. The structures in the nose are too rigid.

So my question to you would be whether you have a stuffy nose or other nose-related problems. Or perhaps you breathe through your mouth during the night? That would rule out a nose-related FL issue.

Also, in your place I would increase the EPR to 3 and leave it there for at least a week to see whether it tends to help with FLs. I wouldn't worry much about the CAs; they may very well decrease on their own as your body adjusts to the EPR.

[Deborah K.]

Folks here can better help you if you change your Oscar charts. Eliminate the calendar and the pie chart. Then we can see useful information below. Also, on your first page, we need to see the following, in the order listed, and nothing more:

Event Flags
Flow Rate
Pressure
Leak Rate
Flow Limits

We need to be able to read to the very bottom of the flow limits.

[ejbpesca]

This reply is to subscribe to this thread concerning flow limitations.  I don't see a button to click for subscribing so reply posted.

[Crimson Nape]

If you click on the thread you wish to subscribe to, look at the very lower left corner of the thread's end, right below the "Possibly Related Threads..." section. There is the option to subscribe to that thread.
- Red

[PeaceLoveAndPizza]

Turning the question around, do you feel the flow limitations are something that needs addressing? You have a 95% of 0.12, which is 2.2x what we like to see (95% FL=0.05). If it is not affecting your sleep, then it is less of a problem.

Having some flattening of inhalation waveforms is not unusual for most. Even those with a “perfect” night will have some flattening. 

Given the limitations of your machine (EPR=3 is the max), you can likely clean up quite a bit by increasing EPR from 2 to 3 as has been pointed out. However, I doubt it will solve it completely. Even with a bilevel and EPR of 4 or more you will have some flattening of inspiration peaks. The question is how much does it affect your sleep?

Have you seen an ENT to get your airway checked? Could be anything from enlarged turbinates to deviated septum to something else.