gettingbetter - Therapy Thread

[gettingbetter]

I have a few questions about my flowrate on the attached Oscar graph.  I'm a newbie still trying to understand some of this stuff.  Thanks, in advance, for any help provided!

I noticed my inspiration flowrate usually ranges from 15-20ish, and the expiration flowrate ranges from 15-25.  The inspiration flowrate seems lower than the expiration flowrate.  

Questions:  Is it normal for the inspiration flowrate to be lower than expiration?  Is my low inspiration flowrate concerning in any way?  

Thanks!

[gettingbetter]

Any opinions on my previous post?

[gettingbetter]

Hi everyone!  I really need help on where to go from here.  My AHI stats from last night look decent (graph attached), however, the flow limits are screaming.  Plus, even though I "slept" 7+ hours, I just feel brain foggy and wiped out.  

Several questions:

*This time of year my allergies are bad.  Even with meds I have some nasal congestion (but not nasal blockage) until the first frost.  How much of the flow limitations would logically be from some nasal congestion?  Or would most of the flow limitations I'm having be from needing more pressure?

*I wish SO MUCH I could use a FFM but every time I do, I get a super high AHI.  I suspect the AHI with FFM is positional due to retraction of the lower jaw with the lower straps on a FFM, resulting in reduction of airway patency.  I don't use a cervical collar.  However, when I sleep on my back the AHI goes from upper 20s to lower than 2 when I switch from FFM to nasal mask.  Does somebody have ANY insight on how I could successfully use a FFM during allergy season???

*Given my fatigue, I also question the adequacy of my oxygenation.  What is the best way to maximize oxygenation on CPAP therapy?  

Thanks, in advance, for any help or suggestions.

[Gideon]

Your Flow Limits are out of control with your95% stat at 0.54 and we wlike to see 0.1 or less. This could easily be your issue.
Set pressure=7 to allow EPR room to work and EPR=3 to knock down your flow limits

[gettingbetter]

Thanks Gideon!  Would some nasal congestion contribute much to the flow limitation values?

[gettingbetter]

Here is an updated chart after following Gideon's suggestion of 7 cm with EPR of 3.  I wore a cervical collar last night, as well.  Do these flow limits look within normal range?  

I think the centrals at the beginning are when I was still awake.  I had some aerophagia but not as much as before.  Hopefully my body will adapt to this setting quickly.

My guess is eventually I may benefit from a Bipap for a little more IPAP and pressure support (but not until aerophagia resolves at this current setting).

Has anyone had trouble with the cervical collar hurting your neck when you first start wearing it?

[Gideon]

You don't need a BiLevel and you don't need more PS, at least not now. Your flow limits look fine, the 95% is 0.05 well under the 0,10 we look for.

Critically how do you feel? Especially anything other than the Aerophagia

[gettingbetter]

Thanks Gideon!  I still feel wiped out today.  That may be due to allergies.  Or, it just may take my system some time to adjust to these settings?

Another question on the zoomed-in graph (attached):
*What are the jagged edges at the zero mark on the zoomed-in flowrate graph?
*What are the jagged edges at the height of inspiration (around +10-12) on the zoomed-in flowrate graph?

Thanks for any help and suggestions!  I'm still learning!

[Gideon]

Flow limitations, but very minor ones typically of no consequence. the bumps on the zero line are cardiogenic ociliations, again no issue.

[gettingbetter]

Thanks a bunch, Gideon!

One last question, I noticed my inhalation and exhalation times are fairly equal (reference graph in my most recent post).  I thought inspiration was supposed to about double of exhalation.  

Is it possible my Resmed machine is miscalculating inhalation or exhalation times based on the cardio oscillation (I'm sure I totally misnamed that or spelled it wrong, sorry)?  If not, is it a problem that inhalation and exhalation times are close to equal?