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+--- Thread: Can someone help me with these flow rates? (/Thread-Can-someone-help-me-with-these-flow-rates)
RE: Can someone help me with these flow rates? - Sleeprider - 05-09-2018
(05-09-2018, 02:38 PM)yrnkrn Wrote:(02-19-2018, 05:10 PM)Sleeprider Wrote: but the best solution for flow limitation like yours is BiPAP.
My personal experience with insistent flow limitation is exactly as you suggest, pressure support works much better than higher cpap pressure.
For example constant pressure of 13/10 produces much better flow than straight 13.
Intuitively it is correct because some of the work overcoming the flow limitation is done by the ventilator.
I looked for academic/theory reference to using Bi-Level this way combatting flow limitations but found none.
Have you seen such reference?
It would be so much easier if I didn't have to write the book for the pros to use.
RE: Can someone help me with these flow rates? - yrnkrn - 05-10-2018
RE: Can someone help me with these flow rates? - emos12 - 05-17-2018
Hi All,
So as most of you know I have been self-titrating so far with my bipap. Last week I "officially" received a cpap from my pulmonologist, he doesnt know I was self treating. I receive the philips dreamstation, with resmed nasal mask. the pressure was set at 6 and he is monitoring me for a month. I feel good that my doctor is guiding me beceause he is very well known sleep doctor in the Netherlands and also diagnosed me with UARS. I will just see how far he will go with the pressure and other wise I have to turn back to the BIPAP
These are the results. What about the leak rates? I am using a nose masker now.
Also added some zoomed in flow rate, seems a bit distorted. I hope the doctor will see it.
RE: Can someone help me with these flow rates? - yrnkrn - 05-17-2018
I would first fix the big leaks in the graphs. At 6cm of pressure mask leaks should be easy to fix.
You may be mouth-leaking too.
RE: Can someone help me with these flow rates? - emos12 - 05-17-2018
yrnkrn,
Yes I am mouth leaking what should I do? I bought a chinstrap today hopefuly it will stop the leaking
RE: Can someone help me with these flow rates? - Sleeprider - 05-17-2018
These results are very good for you considering the history. The flow rate has smoothed out, but is still somewhat flow-limited, but functional. I'm guessing you will need a higher pressure, and eventually you may want to try C-Flex at a setting of 1. If you change pressure, I would increase it slowly in increments of .5 cm so you can gradually find that place where comfort and results are optimum. It would be a good idea to get several nights of therapy at this baseline before making any changes.
RE: Can someone help me with these flow rates? - emos12 - 05-17-2018
Thanks Sleeprider
I dont think I am allowed to adjust the pressure yet as the doctor is monitoring, but I think it will need to be upped. Also a pic of the night with flow rates, does it look like limitation to you? I can see the small inspiratory curves compared to when I am awake.
RE: Can someone help me with these flow rates? - Sleeprider - 05-17-2018
Flow limitation is a restriction in the upper airway that limits the flow rate during inspiration. It is characterized by those flattened and downward sloping wave-forms which show that as inhale progresses, the flow rate never achieves its potential but is like sucking air through a straw. Compare the inspiratory peaks of your chart to this normal flow rate. Usually, inspiratory flow rises to a peak rate then falls off rapidly ahead of exhale.
RE: Can someone help me with these flow rates? - Sleeprider - 06-02-2018
Emos12, haven't heard from you in a while. You had some seriously disturbed flow-limitations when you joined, and eventually showed some amazing improvement using a ST bilevel. How is this going for you?
RE: Can someone help me with these flow rates? - emos12 - 06-27-2018
Hi Guys,
I havent posted in a little while but I am still stuck with finding the right pressure and it is making me loose faith in therapy. I want it to work out so badly but even with higher pressure my flow limitations are pretty evident. My Pulmonologist will call me next week to review the sleep data. Furthermore, I am waiting for a respond from my GP for a referral to a ENT, as I think there may be a possibility that my anatomy is so that it prevents me from successfully treating with BIPAP.
I can really feel a lump in my throat, that is how all my symptoms even started. Until now there is no clarification for that so i am hoping an ENT will do a sleep endoscopy. So far an ENT only looked with a normal endoscopy and concluded that I have an enlarged tongue and narrow upper airway passage due to soft palate. He suggested surgery, but did not operate on me because they did not diagnose me with apnea in the first place. But now the situation is different. I know surgery is not the most feasible option, however I want to know if its not due to something obvious, wether it is a floppy epiglottis or tonguebase.
Here is a part of my sleepyhead data, you just see my inspiratory flow flattening and then I wake up. Should I use a higher pressure? Pressure is already at 19 and it kinda blows my mask off
