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+--- Thread: Review please (/Thread-Review-please)
Review please - SpinGently - 07-10-2023
So I have been on Apap for over 100 days and it has been a game changer for me.....except for the last few nights. I am having a reduced flow rate and increased flow limitations and I am not sure what is going on.
Pressures are set at 5-11 and my 95% average for the last 3 months is around an 8, but the last few nights I have been maxing out. Flow limitation is generaly a .03 and now I am seeing .10.
Thoughts?
RE: Review please - staceyburke - 07-10-2023
I would raise my min to 7, that will help with your flow limits.
RE: Review please - OpalRose - 07-10-2023
Your flow limitation is high. Using EPR will help, but you are not getting the full benefit of EPR when using a minimum pressure below 7cm.
However, I think you will see much better results with a minimum of 8cm and maximum at 12cm. Keep EPR at 3 (full time). This should help with FL, Hypopnea, Reras and at the same time keep your EPAP from dropping too low and keeping Obstructives from occurring. EPAP helps sprint the airway open.
Try these settings for a couple days and repost.
RE: Review please - SpinGently - 07-10-2023
Will do, Thanks!
RE: Review please - SpinGently - 07-13-2023
Ok here are 2 nights with the new settings, I feel worse. On the first night, I had leaks like crazy and a marginally worse AHI. The second night I ran a new mask test and made adjustments, but had a lot more events and a much worse AHI than I normally do. In the past, I have been having great scores with no leaks, I am not sure what changed. The first photo, July 5 is a shot of a normal night before things changed Thoughts?
RE: Review please - OpalRose - 07-13-2023
(07-13-2023, 04:18 AM)SpinGently Wrote: In the past, I have been having great scores with no leaks, I am not sure what changed. The first photo, July 5 is a shot of a normal night before things changed Thoughts?
The July 5 chart does look the best.... and it was not originally posted.
You came on here concerned with your high flow limitation, which we addressed by moving your pressure from 5 to 8. The EPR of 3 originally had no effect on your therapy due to the low pressure of 5.
Re-reading your first post, you said you were on therapy for over 100 days with no problems, then things changed. So, ask yourself what changed when you noticed the higher FL.
The increase in leaks can cause sleep disruptions. Have you changed the mask cushion lately? Tighten or loosen the straps?
My suggestion is to revisit the pressure range where you felt most rested, but realize that most folk have AHI variations night to night.
RE: Review please - SpinGently - 07-13-2023
(07-13-2023, 05:31 AM)OpalRose Wrote: The July 5 chart does look the best.... and it was not originally posted.Sorry for not posting a baseline photo, hindsight says that would have been helpful. I honest can’t think of anything that has changed. My sleep schedule is constant. I have 3 cushions for my mask that I rotate out weekly when I clean my gear. I actually thought about that and swapped for another last night which resulted in worse performance. My strap feels like it fits the same though I am sure there could be some creep and stretch over time.
You came on here concerned with your high flow limitation, which we addressed by moving your pressure from 5 to 8. The EPR of 3 originally had no effect on your therapy due to the low pressure of 5.
Re-reading your first post, you said you were on therapy for over 100 days with no problems, then things changed. So, ask yourself what changed when you noticed the higher FL.
The increase in leaks can cause sleep disruptions. Have you changed the mask cushion lately? Tighten or loosen the straps?
My suggestion is to revisit the pressure range where you felt most rested, but realize that most folk have AHI variations night to night.
Thank you so much for taking the time to respond. Cpap is an interesting journey.