Should I be concerned about Flow limitations and VS?

[Sleeping Ugly]

I started CPAP therapy about 30 days ago. I have had, what Sleepyhead considers "reasonably good" results with AHI's. I have like 0.2, 0.9, 1.1, etc. with just one night of a 3.3 when I first started, when I wanted to throw the CPAP machine, mask and myself off a cliff. So, I have good AHI's but I am wondering about other things--like vibratory snores, flow limitations and hyopneas.

I average 8 hours of therapy a night. I have, on the average, like 23 hypopneas, vibratory snores in the high 20's, low 30's and flow limitations in the high 20's each night. Does that sound like good sleep? I dunno. I feel pretty good. I feel like I sleep fairly well. I have pretty good energy throughout the day. But does this mean that I am constantly struggling to get air?

I realize that everyone is different--age, overall health, medical issues, medicines, etc., but I am wondering if I should work on getting these numbers better? I am wondering if more pressure would be beneficial? My minimum pressure is 7 and I feel comfortable breathing that. My average pressure is in the high 9's and low 10's and my max pressure is set to 20, but my machine has only gone as high as 16 one time. I can see that I have gotten pressures of 13 or 14 to correct some struggle with breathing.

Does vibratory snore mean I am snoring/snoring? Like audible snoring? Is there a way to tell that? I use a nasal pillow mask and I feel like I would know if I opened my mouth because the feeling is so God-awful.

Thanks for reading my novel!

[Pugsy]

For a good explanation of snoring flags on Respironics reports
viewtopic.php?f=1&t=155478&p=1182872#p1182872

Do you need more pressure....maybe...it depends on which type of snore you are seeing and how many over how many hours of sleep. 20 over 2 hours might be a problem...20 over 7 or 8 hours not so much of a problem.
And if it is VS2...more pressure won't fix them.

As to FLs...same thing...depends on how many within a period of time...again over 2 hours is more of a concern than if spread out over 7 or 8 hours.

Usually for snores and FLs...a little bit more pressure in terms of baseline minimum pressure will deal with them easily.
Sometimes as little as 0.5 cm more minimum if using apap/auto adjusting pressures or if using fixed cpap just that much of an increase in the fixed pressure.

Snores don't necessarily mean the mouth is open. The snore flag is from the vibration of the airway tissues trying to flop around a bit and sometimes the vibration of a snoring Pug dog resting on a person's neck/shoulder area (happened to me).

[Pugsy]

Snores and FLs are significant because that's part of the auto adjusting algorithm...if you get very many the machine will increase the pressure in an effort to prevent them better because they are warning signs that the airway is trying to collapse.
I few here or there isn't probably a big deal but a lot of them or in dense clusters can mean sub optimal therapy.

[Julie]

Stop asking people about their 02 sats when they report nightly figs! Just because you're obsessed with them doesn't mean everyone else is and most don't use oximeters routinely.. plus newbies won't even know what you mean, or else will worry they're missing something vital. Just stop already, it's so old.

[Pugsy]

Most people won't have a clue what their oxygen levels are.
These machines don't gather oxygen level data. One needs a recording pulse oximeter for that and most people don't need one and/or have no clue what we are talking about.

And you newbies...don't go running out and buying one just yet. If concerned most DMEs will do an overnight test for free and depending on results you can then decide if you want one of your own.

[MaxINTJ]

Along these lines, what should we be looking for in our data?

I know you've said that leaks aren't really accurate, but what would something significant be? I know there's nothing in my data that jumps out, but if things did, what would they be?

[Pugsy]

I know you've said that leaks aren't really accurate, but what would something significant be? I know there's nothing in my data that jumps out, but if things did, what would they be?

I don't remember saying leaks are inaccurate. Might be something I referred to in context with something else.
In SleepyHead the leak statistics can be inaccurate because of the red line threshold numbers.
In general...look at the leak graph for leaks. The machine makes the ultimate determination for if a big leak happened or not.
Doesn't matter what SH says about the leak over in the statistics column.
With Respironics machines and when in apap mode the red line moves for the edge of large leak territory and it makes for a difficult choice for the threshold number which is what SH uses for leak statistics.
Large leak threshold is different at 10 cm than at 15 and even 20...it varies so which number do we tell SH to use?

When looking at things in general I have a fairly set routine.
First I evaluate the AHI itself and look to see which event category things are showing up in.
Then I will look at the Events graph even if the AHI is fairly low and I would look for clustering. Periods where nothing much happened and periods where there might be dense clustering which means the AHI for that period of time might be a lot more significant but offset because of periods of nothing happening giving an overall lower AHI.
On a Respironics report I will pay attention to FLs (only in apap mode because it is turned off in cpap mode) and snores and RERAs...more from a general big picture type of thing. The FLs, snores and RERAs aren't part of the AHI but they are still important because they can mean sub optimal therapy or crappy sleep.

I stick to the basics though...the other stuff about respiration rate and volume this or volume that...I don't mess with because there is such a wide range of norms. It's mainly stuff that points to lung function and if a person were to have a problem with lung function it wouldn't be diagnosed by the data shown in SH. Those particular data points are more useful when using one of those high end specialty machines where lung function is more critical. I leave all that up to the doctor. That's what he gets the big bucks for.

Your situation is entirely different. None of the usual markers are of much value except maybe RERAs or FLs and even then limited value.

[MaxINTJ]

yes

maxINTJ is VERY SPECIAL

he may be the only person in the world with the problem he has

Have you always had a problem with getting infatuated with certain strangers online, or in person?

Just curious....

[LSAT]

yes

maxINTJ is VERY SPECIAL

he may be the only person in the world with the problem he has

Have you always had a problem with getting infatuated with certain strangers online, or in person?

Just curious....

Come on Max....You love the attention

[Sleeping Ugly]

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[palerider]

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it's something you get used to... sort of like swimming against the tide... with luck and perseverance, you'll eventually succeed

[Sleeping Ugly]

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it's something you get used to... sort of like swimming against the tide... with luck and perseverance, you'll eventually succeed

LOL! I love it! Thanks for my first morning smile.