Expiratory Flow Limitations

[imposterdroids]

I've got a question maybe someone can answer. Flow limitations as shown on the OSCAR app for my AirCurve 10 seem to be exclusively for flow limitations occurring on the inhale. I assume this is because the machine itself only detects them on the inhale and does not do any calculation for the exhale. Is this the case and is there any method of calculating them for the exhale?

I'm trying to convince my ENT that my sleep disturbances primarily occur on the exhale, and having an expiratory flow limitation (EFL) graph or number to discuss with him would help. I'm fairly certain I have palatal prolapse and want to avoid surgery for an Inspire device if it will not be helpful. (Yes, I've done a DICE, and am apparently a viable candidate, though I have serious doubts.)

Thanks in advance. If this question turns out to be a half-baked idea brought on by sleep deprivation, I trust you'll all forgive me.

[Morbius]

Yup.

Your buddy Ali Azarbarzin invented it:

https://www.ncbi.nlm.nih.gov/pmc/articl ... Suppl.docx

[imposterdroids]

Yup.

Your buddy Ali Azarbarzin invented it:

https://www.ncbi.nlm.nih.gov/pmc/articl ... Suppl.docx

Thank you sir. I apparently overlooked an NIH link.

Guess I'll delve into the OSCAR code and see how difficult it would be to implement.

[zonker]

Guess I'll delve into the OSCAR code and see how difficult it would be to implement.

if you want any help with that, forum member blue dragon is on the oscar dev team.

[SleepyCPAP]

Hi Imposterdroids,

I found the same thing - flow limitations are only inhale. But I did find that sometimes snore will appear in Palatal Prolapse. I didn’t have any motivation to measure it, I just wanted it gone.

I think I conveyed this to you, but in case others are reading this thread I’ll include this here: I didn’t go for surgery or implants. Instead I got the 6” AlaxoStent which completely solved the expiratory Palatal Prolapse.

- SleepyCPAP

[imposterdroids]

Hi Imposterdroids,

I found the same thing - flow limitations are only inhale. But I did find that sometimes snore will appear in Palatal Prolapse. I didn’t have any motivation to measure it, I just wanted it gone.

I think I conveyed this to you, but in case others are reading this thread I’ll include this here: I didn’t go for surgery or implants. Instead I got the 6” AlaxoStent which completely solved the expiratory Palatal Prolapse.

- SleepyCPAP

Thanks for the response SleepyCPAP. I've been looking at the AlaxoStent and have contacted the company - just waiting to hear back and get a referral. I assume it's your review of the 6" stent that they featured on their website? I've been reading your review and daily results for the device and I'm going to give it a try.

[Rubicon]

I've got a question maybe someone can answer. Flow limitations as shown on the OSCAR app for my AirCurve 10 seem to be exclusively for flow limitations occurring on the inhale. I assume this is because the machine itself only detects them on the inhale and does not do any calculation for the exhale. Is this the case and is there any method of calculating them for the exhale?

I'm trying to convince my ENT that my sleep disturbances primarily occur on the exhale, and having an expiratory flow limitation (EFL) graph or number to discuss with him would help. I'm fairly certain I have palatal prolapse and want to avoid surgery for an Inspire device if it will not be helpful. (Yes, I've done a DICE, and am apparently a viable candidate, though I have serious doubts.)

So you posted one small segment



and maybe there's some EFL. Could also just be some mouth exhalation.

But seems to me if an EENT and a DISE isn't making your case--

Do you, in fact have a case?

I mean you're starting to talk some big bucks here (is this covered by your insurance?).

IIWM I might be experimenting with a nasal trumpet for 3 bucks but I'm frugal (cheap).

TTBOMK compliance with stent therapy is horrible.

What's your current AHI? Is there really a problem? Or just an unexplainable occasional squiggle?

[Rubicon]

What's the leak rate look like? Ever try a FFM? Or the aforementioned taping?

[Rubicon]

Whatever happened to yrnkrn?

IMO, a lot of the stuff he posted was NOT palatal prolapse:



If we were to calculate inspiratory volume and expiratory volume with ASB's .04 Waveform Slicer, the expiration looks to have simply disappeared!

OTOH this one could be some EFL perhaps caused by PP:

[Rubicon]

This one, pressure on max, small breath which in turn just disappears:



No leak graph to troubleshoot.

[chunkyfrog]

This is way over my head; and I suspect over too many doctors' heads as well.
If I feel dumb, it's sort of OK; but doctors? . . . Makes me cringe.

[Rubicon]

See on Mask Pressure when exhalation begins and there's those blue lines that drop below set pressure? Seems to me in a sealed system you wouldn't have a pressure drop, especially with a forceful exhale (which would probably be happening @ 20 cmH20). AAMOF, you'd probably have a little +pressure burst. So IMO that looks like inspiration OK but expiration pops mostly out of his mouth.

[Rubicon]

In his "article", baseline -0- is dropping a tiny bit, but that decline looks so precise IMO it seems more like the machine baseline -0- is drifting.

[Rubicon]

I've been looking at the AlaxoStent and have contacted the company - just waiting to hear back and get a referral. I assume it's your review of the 6" stent that they featured on their website? I've been reading your review and daily results for the device and I'm going to give it a try.

OK that sounds like a great idea! After all

Most episodes of epistaxis are not life-threatening, particularly when modern methods of diagnosis and treatment are used.

[Rubicon]

OTOH this one could be some EFL perhaps caused by PP:

Could also be plain ol' flappy lips: