question on resp rate and tidal volume, racing heart rate

[palerider]

Could you please right click on my brain and turn on better breathing?

if I could, you can bet I would... and wouldn't even charge anywhere near what sleep docs do!!!

[Morbius]

Should I try increasing pressure or how do I work on removing the flow limit?

Get a ResMed Auto. They hate FLs!

[Morbius]

OK, seriously....

I do not participate in dial wingin' but I'm sure there will be plenty of volunteers who will.

Meanwhile, have you tried side-sleeping?

[HanzT]

The sad thing is I already sleep on my side. What other tips do you have? I wake up tired and with a slight headache, ears ringing some days. Thanks.

[Morbius]

The sad thing is I already sleep on my side.

But do you stay on your side? Do you find yourself on your back on the wake ups?

[Morbius]

In re: the FL, you don't necessarily have to hammer them all if they aren't causing a problem.

However, these are causing a problem. They are creating sleep disruption:

[Morbius]

These are a little more subtle, but a problem:

[Morbius]

This entire area looks pretty gnarly (all of these are still from the 9th):

[HanzT]

I usually do stay on my side, but have switched to my back after waking up. I'll stop that.
What does a flow limit actually do/mean? Limit the amount of air flowing in and out, or limit the size of my breath?
I'm also seeing a lot of flow where my negative number is much larger than my positive flow number. What does that mean?
Am I correct that something that would limit my flow is a restricted airway, like my jaw moving back too far during sleep, shrinking the airway? I am thinking of wearing my dental device and using the CPAP.
Thanks again.

[robysue]

This entire area looks pretty gnarly (all of these are still from the 9th):

Is the reason they look gnarly the fact that there is a slightly larger breath right after where you place the red boxes? Or is the gnarliness something else we're supposed to notice about these particular breath sequences?

And a related question: How significant is it that some of these sequences you're describing as gnarly are not scored by the machine as official flow limitations?

[Morbius]

What does a flow limit actually do/mean? Limit the amount of air flowing in and out, or limit the size of my breath?

It restricts the amount of air flowing in. However, that alone is not necessarily a problem. If they go on to cause an arousal (RERA), which creates sleep disruption, then it's definitely a problem.

I'm also seeing a lot of flow where my negative number is much larger than my positive flow number. What does that mean?

Expiratory flow > inspiratory flow.

Am I correct that something that would limit my flow is a restricted airway, like my jaw moving back too far during sleep, shrinking the airway?

Yeah, and probably the base of the tongue.

[Morbius]

Is the reason they look gnarly the fact that there is a slightly larger breath right after where you place the red boxes?

Zactly.

How significant is it that some of these sequences you're describing as gnarly are not scored by the machine as official flow limitations?

Hanz is having twice as many events as the machine has scored. Indeed, it even did a Pcrit search in the middle of a salvo. Hysteresis was lost, resulting in two obstructive events and an awakening despite the pressure increase:



Significant.

[HanzT]

Thanks for the work on this. So now that I'm concerned, what should I focus on. How big of an issue is the Expiratory flow > inspiratory flow? That seems odd, along with the shape of my flow pattern during those times. I realize I need to get the events down, but all I know how to do is change pressure. Can my machine deal with these issues or do I need a more complex machine? Any suggestions on how to approach this would be appreciated.

[guest1]

Thanks for the work on this. So now that I'm concerned, what should I focus on. How big of an issue is the Expiratory flow > inspiratory flow? That seems odd, along with the shape of my flow pattern during those times. I realize I need to get the events down, but all I know how to do is change pressure. Can my machine deal with these issues or do I need a more complex machine? Any suggestions on how to approach this would be appreciated.

You should raise your minimum pressure by 0.5cm and evaluate for 7 days. The waveform that morbius illustrated is showing your airway collapsing incrementally. Your body has a RERA event which corrected the breathing pattern before it had a chance to become a full obstructive event. RERAs are as destructive to sleep architecture as OAs are. A modest increase in EPAP may be all you need to correct this. An alternate way to achieve a similar result is to switch off aflex on ur machine.

[HanzT]

Is the fact that my overall flow is so small and out is so much higher than the inflow an issue?