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Oscar Data. No events flagged but weird flow rate pattern during REM - Printable Version

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RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Dormeo - 07-10-2024

You are using S-mode, which doesn't allow you to see data on flow limitations. I recommend that you switch to VPAP-Auto mode. You can keep you EPAP and IPAP fixed at their present levels by using these settings:

EPAP min = 3
IPAP max = 7.6
PS = 4.6.

Try that tonight then post your chart tomorrow. When you do, please remove the calendar from the left panel, and please include all and only these graphs:

Events
Flow rate
Pressure
Leaks
Flow limitations
Snores.


RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Ynot - 07-10-2024

Hi dormeo.

I used the vauto for a while, and since I started using bilevel, the flow limitation chart does not really spike up that much, even though there is clearly flow limitation sometimes, (Which is not seen with high ps) like in the images I posted. I do not think snores and leaks are an issue in my data. With cpap, it did spike up in a rem like pattern but the flow limitation was terrible. 

It is not the same settings, but here I did: 
epap min: 4
ipap max: 10.4
ps: 6

Tell me what you think, thanks


RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Ynot - 07-10-2024

I messed up, this is cpap data. Wait a bit lol. sorry


RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Ynot - 07-10-2024

vauto...


RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Ynot - 07-10-2024

As a sidenote, it looks here like I'm mouthbreathing throughout the night, which can be seen in the flows with higher amplitude. I started mouthtaping, since I thought it would make my breathing more consistent, and thus maybe solve the problem. I think it might help with the centrals potentially. I also wear a collar.


RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Dormeo - 07-10-2024

'm not sure at this point what you're asking for. I'm afraid I don't know the answer to the question you raised earlier about raising your trigger. And I don't think the number of CAs you're having is enough to be a cause for concern. Could you clarify what kind of advice would be helpful to you at this point?


RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Sleeprider - 07-10-2024

Ynot, if you have not already done so, set Trigger Sensitivity to Very-High. Centrals should be reduced.


RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Ynot - 07-10-2024

(07-10-2024, 07:20 PM)Dormeo Wrote: 'm not sure at this point what you're asking for.  I'm afraid I don't know the answer to the question you raised earlier about raising your trigger.  And I don't think the number of CAs you're having is enough to be a cause for concern.  Could you clarify what kind of advice would be helpful to you at this point?

I just do not know the optimal settings. 

To put it simply, the lower ps is, the more flow limitations I have, and the higher ps is, the more centrals I have. Prior to bilevel, I never had legit CAs. 5 centrals might not be enough to cause concern in your opinion, but those centrals are 100% caused by the ps (ps of like 7 gives me an ahi of around 20), and there is still flow limitation at rem during those nights. I have not had a night with no flow limitation and without many back to back centrals. Most important of all, I feel quite tired regardless of the settings - and the tiredness is 100% because of anatomically induced sleep disordered breathing (I am young, healthy otherwise, good bmi, SA/UARS runs in family). I thought I could find a sweet spot where I did not have flow limitation nor centrals, and I felt rested, but I'm realizing that I cannot find it. I realize that that perfect sweetspot may not be acheivable, but I wonder if there is someone that can determine the settings with the most healthy looking flow waves. It is so difficult to find the perfect settings since there seems to be no perfect settings, I have to choose between having a lot of flow limitation, no centrals/a lot of centrals, no flow limitation/some significant flow lim, a little CA/some sig CA, a little FL.... etc....

It seems like apnea treatment does not work optimally for UARS strangely enough - my doctors and sleep specialists did not even want to consider a bilevel, and it certainly helped.


RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Dormeo - 07-10-2024

Please follow Sleeprider's advice and let us know how it goes. Also be aware that it is quite unrealistic to expect to see no CAs and no FLs. Some of each are part of normal sleep.

When you post your next chart, it would be very helpful if you would include all and only the following in a single screenshot:

Left panel, minus the calendar.
Graphs for events, flow rate, pressure, leaks, snores, flow limitations.

To fit those six graphs into your screenshot, grab the gray bars separating the graphs and push them up a little.

I'll be curious how you do with very high trigger.


RE: Oscar Data. No events flagged but weird flow rate pattern during REM - Ynot - 07-10-2024

(07-10-2024, 07:51 PM)Sleeprider Wrote: Ynot, if you have not already done so, set Trigger Sensitivity to Very-High. Centrals should be reduced.

Hi sleeprider. 

I came across this idea while reading the optimizing therapy thread in apneawiki which offered a lot of valuable information. I'm just wondering, if TECSA is provoked by decreased serum CO2, would forcing a breath with ASV or increased trigger sensitivity further decrease CO2 levels. Is that problematic, or are the CA simply oversensitivity to the ps?