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General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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palerider
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Re: Sleepyhead: best display

Post by palerider » Tue Mar 21, 2017 10:22 pm

Pugsy wrote:
desiderata wrote:So they are "aspirational" OAs/Hs? Caused by the same tendency that causes OAs/Hs?
Yeah, pretty much. Think of flow limitations as a reduction in air flow in the airway caused by the airway tissues trying to collapse but they don't quite make it to the point where they earn an OA or hyponea flag. Maybe the reason they don't earn a flag is they only last 9 seconds...and you need 10 second minimum to get an OA or hyponea flag. Maybe the flow reduction isn't quite enough...like maybe it was a 38 % reduction and I think ResMed needs 40% lasting 10 seconds for hyponea flag. Needs 80% or more to get an OA flag.
Flow limitations can trash sleep architecture...cause arousals that you may or may not remember but they can sure mess with our sleep quality. They are important...if they weren't these machines wouldn't have built in to their algorithms to increase the pressure in an effort to kill them.
actually, flow limitations may not have a reduction in total airflow (tidal volume, which is required for a hypopnea) because they may result in longer inspiration time to get the same volume of air. think breathing through a straw vs through your open mouth, you still end up filling your lungs with the straw, but it's more work, and probably tiring after a bit... in essence, the flow of air, on the inspiration, is limited, but not necessarily the volume. and it's the volume that's what's monitored for apneas and hypopneas. maybe this is just nitpicking, but it might help understand the difference.
Pugsy wrote:
desiderata wrote:If they aren't the problem, what else might be? Or would the KISS approach suggest I focus on these first, somehow. But what can I do about them?
If you had told me that you have horrible nasal congestion issues then we probably would chalk some of those FLs to nasal stuff but since you didn't then I think we should consider these FLs a problem.
PR has a good video that explains FLs...I don't have it handy...maybe he can post it.
https://www.youtube.com/watch?v=-gie2dhqP2c
Pugsy wrote:What I would suggest for tonight is increase the max from 11 to 12 and see what the machine does and see if the FLs still stay ugly or not.
of course, I have to stick my "want it NOW!" attitude in here and say "I'd set the machine for min11 max 20 and see what a night's worth of data says". of course, Pugsy knows I'm not patient

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Pugsy
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Re: Sleepyhead: best display

Post by Pugsy » Tue Mar 21, 2017 10:39 pm

That's the video. Thank you so much. I will try to bookmark it for future use assuming I remember where I put it.
palerider wrote: actually, flow limitations may not have a reduction in total airflow (tidal volume, which is required for a hypopnea) because they may result in longer inspiration time to get the same volume of air. think breathing through a straw vs through your open mouth, you still end up filling your lungs with the straw, but it's more work, and probably tiring after a bit... in essence, the flow of air, on the inspiration, is limited, but not necessarily the volume. and it's the volume that's what's monitored for apneas and hypopneas. maybe this is just nitpicking, but it might help understand the difference.
I know...I was trying the KISS principle because I was rambling enough as it was. Trying to avoid confusion with multiple
definitions when the end result is that we want to kill the FLs if we can....or at least reduce their numbers significantly.
palerider wrote:of course, I have to stick my "want it NOW!" attitude in here and say "I'd set the machine for min11 max 20 and see what a night's worth of data says". of course, Pugsy knows I'm not patient
I know..patience and you don't coexist at all. I got the sense with the OP that she was wanting to do things super cautious...the 9 to 11 range was the big neon sign to that fact. For that reason I adapted my thinking to try to be more in line with what I felt she was comfortable doing. It's a marathon...not a sprint..we will eventually get to where we need to go.
desiderata wrote:Breathing out was hard at times with 11 so I'm also considering EPR of 1; not sure of the pros and cons on that.
You gotta be comfortable to get to sleep...use whatever feels good to you...if we need to make a pressure adjustment to offset the drop that EPR does on inhale...then we can do it later. An adjustment may or may not be needed. Cross that bridge if/when you come to it.
Gotta get the sleep first...that's the primary goal. All the best settings in the world are useless if you don't sleep.

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palerider
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Re: Sleepyhead: best display

Post by palerider » Tue Mar 21, 2017 11:06 pm

Pugsy wrote:
That's the video. Thank you so much. I will try to bookmark it for future use assuming I remember where I put it.
you can always text me and I'll remind you

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.