flow limitations acceptable levels

[paulag1955]

Mine don't even look rounded even when my flow limit is supposedly zero.

[CPAPfriend]

hey opus1,

theoretically, yes. If you do decide to increase your EPR, it's also advise to increase your pressure by the same amount, as EPR is not true pressure support and actually will lower your average delivered pressure.

paulag1955,

the flow-limit graph is less sensitive than the flowrate graph. Flowrate tells most of the story.

[paulag1955]

Right. My flow rate graph never has rounded curves, even when the flow rate graph is at zero flow limits. Lots of jagged peaks. Think The Alps.

[yankees123]

Gideon when you mention the level 0.1 should be treated is that the 95% or the 99.5 level?

[Gideon]

95%.
Mostly you can ignore the 99.5% value.

On EPR use I don't initially increase pressure.
Why? Because therapeutically your CPAP is is likely already above the pressure needed to manage the OA because pressure alone is used to manage ALL obstructive events on a CPAP. That said, I do look to see if pressure needs to be adjusted after EPR is applied.

[yankees123]

Thanks everybody for your feedback, it’s an interesting topic

[gainerfull]

I'm sorry, that sounded rude and I didn't intend it to be.

My 99.5% flow limit is 0.25 on a very good day. What's not obvious to me, is the relative seriousness of upper end flow limits >0.30 and those <0.20. I guess what I'm asking is what does each 0.01 increment actually represent.

Paula,

You're in a tough spot because although your therapy is ok you report that subjectively you feel mostly same despite statistically good nights / bad nights. What I don't understand is if you always feel the same then why are you putting effort into optimizing your therapy any further?

My journey to a frequent 0.0 AHI and sub 0.10 99.5% flow limitation included fighting a sleep doctor and respiratory therapist over many months, a cpap titration and a bipap titration that were miserable and finally receiving a Resmed Aircurve 10 VAUTO and then spending the better part of a month titrating myself based upon what I learned here while sticking to strict sleep hygiene parameters.

It's unlikely that you'll be able to consistently investigate very low flow rates w/ out the aid of a bilevel and increased PS beyond 3. Instead of focusing on AHI or flow limitations I took the approach that Dr. Barry Krakow recommended and worked to engineer "normal breathing" and the rest followed suite. I'm currently running IPAP 16 / EPAP 9, TiMax 3.0 ,Trigger: Very High and sleep with a soft cervical collar from Walgreens and a breathe right strip every night. Good luck w/ your therapy.

[paulag1955]

I'm putting the effort in because I believe that optimizing my therapy as best I can with what I have to work with is better for my health regardless of how I feel. 

Am I remembering correctly that somewhere on this site there's a paper by Dr. Barry Krakow? Will that give me more insight as to what "normal breathing" is?

[gainerfull]

I'm putting the effort in because I believe that optimizing my therapy is better for my health regardless of how I feel. 

Am I remembering correctly that somewhere on this site there's a paper by Dr. Barry Krakow? Will that give me more insight as to what "normal breathing" is?

https://www.youtube.com/watch?v=Syv7YcHb...=1&t=1409s

[OpalRose]

Paula,
A couple articles from the Wiki:

https://www.apneaboard.com/wiki/index.ph..._and_BiPAP

https://www.apneaboard.com/wiki/index.ph...Discussion