09-16-2023, 06:55 AM
managing flow limit issues for a newish user?
Hello all, first post here
Some background for context...
I'm relatively new to CPAP. I was diagnosed with severe obstructive sleep apnoea (AHI 120.3) 10 months ago. I started CPAP therapy immediately and noticed my AHI went straight down to less than 3 from the very first night on the trial machine (Resmed Autoset 10), on the very first night using my personal machine (F&P Sleepstyle Auto) I scored 11, initially I attributed that to the sensawake feature being too aggressive, so that I turned off after that night and haven't had such a high score since then.
Throughout the day I noticed a big improvement almost straight away in staying alert, and not being chronically fatigued and lethargic like I was before my diagnosis. However the first thing in the morning I often feel like crap, like my quality of sleep hasn't improved as much as I would have liked. and I often find it difficult getting out of bed. However once I'm up I feel much better.
I had a bad experience with the clinic that I was referred to and did my sleep study. Initially things were going well. I noticed that the machine they sold were priced a considerably higher than what I could get elsewhere for the same machine (like over A$1000 more). I called the clinic and was advised over the phone I could buy a machine from a third party and advise them the serial number, however on my next appointment after I had already bought my machine I was told this was not the case and I could only buy or rent a machine through them. They cut me off after that with an email saying I had requested to terminate care, and they were handing me back to my GP. I called both my GP and the clinic and tell them I hadn't voluntarily terminate care to cover myself as it looked like I was abandoning CPAP therapy, which wasn't the case at all. The clinic said they should be able to monitor my third party machine and wasn't sure why I was told overwise on my appointment I gave them the serial number and they said they will reinstate care, but haven't heard back since so I have to assume no one apart from myself is monitoring my CPAP therapy. Initially my pressure settings were 4-20 cmH2O, but after month I increased the minimum to 8 cmH2O which yielded better results.
Now my question...
Initially I was focused on my AHI, and assumed my low numbers meant I was getting a good night sleep, however the initial morning poor sleep feeling has persisted. After lurking here a few days I've learnt that flow limits impact sleep quality, after taking another look at my stats I noticed every night I had quite a few FL events spread out throughout the night, averaging just under 5 p/h. In the previous few days I have changed the pressure settings to 8-14 cmH2O and increased EPR from 2 to 3 cmH2O. but last night I still had FL events throughout the night, lower than average, but a higher AHI than average also. Any tips on how to manage my FL events.
Attachment 1: Overall stats last night
Attachment 2: Zoom in of apnoea and flow limit events
Attachment 3: Overall summary of statistics
Some background for context...
I'm relatively new to CPAP. I was diagnosed with severe obstructive sleep apnoea (AHI 120.3) 10 months ago. I started CPAP therapy immediately and noticed my AHI went straight down to less than 3 from the very first night on the trial machine (Resmed Autoset 10), on the very first night using my personal machine (F&P Sleepstyle Auto) I scored 11, initially I attributed that to the sensawake feature being too aggressive, so that I turned off after that night and haven't had such a high score since then.
Throughout the day I noticed a big improvement almost straight away in staying alert, and not being chronically fatigued and lethargic like I was before my diagnosis. However the first thing in the morning I often feel like crap, like my quality of sleep hasn't improved as much as I would have liked. and I often find it difficult getting out of bed. However once I'm up I feel much better.
I had a bad experience with the clinic that I was referred to and did my sleep study. Initially things were going well. I noticed that the machine they sold were priced a considerably higher than what I could get elsewhere for the same machine (like over A$1000 more). I called the clinic and was advised over the phone I could buy a machine from a third party and advise them the serial number, however on my next appointment after I had already bought my machine I was told this was not the case and I could only buy or rent a machine through them. They cut me off after that with an email saying I had requested to terminate care, and they were handing me back to my GP. I called both my GP and the clinic and tell them I hadn't voluntarily terminate care to cover myself as it looked like I was abandoning CPAP therapy, which wasn't the case at all. The clinic said they should be able to monitor my third party machine and wasn't sure why I was told overwise on my appointment I gave them the serial number and they said they will reinstate care, but haven't heard back since so I have to assume no one apart from myself is monitoring my CPAP therapy. Initially my pressure settings were 4-20 cmH2O, but after month I increased the minimum to 8 cmH2O which yielded better results.
Now my question...
Initially I was focused on my AHI, and assumed my low numbers meant I was getting a good night sleep, however the initial morning poor sleep feeling has persisted. After lurking here a few days I've learnt that flow limits impact sleep quality, after taking another look at my stats I noticed every night I had quite a few FL events spread out throughout the night, averaging just under 5 p/h. In the previous few days I have changed the pressure settings to 8-14 cmH2O and increased EPR from 2 to 3 cmH2O. but last night I still had FL events throughout the night, lower than average, but a higher AHI than average also. Any tips on how to manage my FL events.
Attachment 1: Overall stats last night
Attachment 2: Zoom in of apnoea and flow limit events
Attachment 3: Overall summary of statistics
