My APAP doesn't record Flow Limitations

I have an Apex ICH Auto. The software it uses is called "Easy Compliance." This is the only available software for it. It records: Pressure, leaks per minute, compliance, Apneas, Hypoapneas and Snoring. But it doesn't report flow limitations. And that is a problem for me because, I am not sleeping well at all on treatment. It's been 2 months since I was diagnosed with an AHI of 80 (mostly all hypoapneas, I don't snore) and started PAP treatment. And as a result, I am sleeping worse. Waking up more, etc. The PAP treatment doesn't seem to be doing enough, because when I use apps like "Sleep as Android" it records me still moving all night, tossing and turning (somewhat abruptly/violently) while I'm sleeping. So it appears I still have many respiratory arousals. I never did a titration study, the doctor never gave me a an RX for pressure. The DME just told me to set it from 5-20 since it's an Auto... I know, bad. So I have been using 7-20 for 2 months. And at first there was a lot of run-away pressure. But that was only for the first 2 weeks. Since then, it stays at about 7 all night, with a reported AHI from 1-1.5. However, my sleep is still very disturbed, I am noticeably fatigued and spaced out in meetings. I simply couldn't continue on during a dialogue in a reasonably intelligent and interactive manner because it wore me out so much. Lastly, I bought an oximeter from amazon. Wore it for 2-3 nights and no problems. My Oxygen rarely is below 95 and it does occasionally dip/drop to 91 at various times while I'm sleeping. It does seem that during REM sleep, my heart rate is changing a lot and so is my SpO2 (ranging from 96-91%, very jagged, going up and down a lot).


What should I do?? I suspect flow limitations (perhaps during REM) are what are making me wake up. And my APAP never increases its pressure except by a mere .5 cmO2 for 5-10 minutes each night. And I don't have any way of knowing if my flow limitations are being handled or not. Should I increase pressure until I feel/sleep better, since I don't have flow limitation data?

Chart from my Apex ICH Auto:

https:// i. imgur .com/ oycM1gW .png

I'm specifically concerned about the article at the bottom of this post, which mentions that many APAP machines do not detect and respond to prolonged flow limitations. I think other than buying a new APAP, my only other solution is to run the min pressure up high all the time.


article: https:// www. ncbi. nlm. nih .gov/pmc/articles/PMC5005142/

ImOnTheInternet2 wrote:other than buying a new APAP, my only other solution is to run the min pressure up high all the time.

You pretty much know your options.
You could try a higher minimum but it doesn't necessarily need to be "up high" all the time...just maybe a little bit higher than what you are using.
That's what we advise for people who are seeing more flow limitations than we would like.
Usually flow limitations will respond fairly easily to just 1 or 2 cm more minimum pressure.

You can also use apap mode in a tight range so lessen any chance that the wide changes (if you are having any) disturb sleep. Some people say they sleep better in a fixed mode or extremely tight apap mode.

Other than that...getting a different machine that actually flags and responds to FLs is your only option if you want to see for sure or not if you are having FLs.

My machine doesn't measure FL either, for 12 years. One less thing to obsess over, my treatment works fine. I can put my worry into other things. Jim