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3 pages....be sure to follow the links and read all 3
https://sleep.tnet.com/resources/sleepyhead/shorganize

How to use imgur
https://sleep.tnet.com/reference/tips/imgur

Examples in a thread
viewtopic/t103468/Need-help-with-screen-shots.html

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Not sure what you are talking about but the only thing I can think of is the SH full screen view thing....that bug seems to affect only Windows users.
Full view is really unnecessary though. Using the browser full screen thing (up by the X to close out things in upper right corner) is plenty big enough if you full screen it there.

Full screen view from within SH for Windows users will often make it so that there is no easily apparent way of getting out of full screen. Been there and done that and it's really annoying. Since there really isn't any urgent need to do the SH full screen view...I tell people to just not go there and do it or they might not like what happens.

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Can you get me a snapshot of the Flow Limitation graph?

Whistling of the nasal pillows...I have had that happen and it had to do with the way the pillows were fitting the nostrils. Hard to describe and even harder to describe how to fix it. It's not so much a plain leak as it is a little less than optimal seal causing the whistling. Probably not enough to show up on the leak graph but enough to be annoying for sure. If it happens again fiddle with the nasal pillow fit a bit..pull away from the nose and let the pillows inflate again and gently place against the nostrils again.

Which nasal pillow mask are you using?

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I expected the Flow Limitation to look like that...it's a bit what I call "active" for lack of a better word. They don't make it easy to evaluate the flow limitations but in general the more stuff you see the worse it is. Yours is ugly but I have seen worse.
Flow limitations are part of what the auto algorithm will try to "fix" with more pressure. Your pressure pretty much pegged out at the max of 11 that you elected to use last night. I figured it must be the flow limitations driving it because it sure wasn't OAs or hyponeas.

Can we by any chance blame the FLs on nasal congestion by any chance?

If we can't blame nasal congestion then we have to assume the flow limitations are in the airway where the OAs and hyponeas come from. FLs can cause arousals and poor sleep quality and in general make us feel like crap even if they don't grow up to earn an OA or hyponea flag.
Flow limitations are reduction in air flow that don't meet the criteria for an OA or hyponea flag.
Now are these FLs you are having a problem? Dunno yet. Maybe. If we can't blame them on the nose then we maybe talk about what you want to try to do about the FLs in conjunction with how you feel and how you are sleeping in general.
UARS comes to my mind when I see AHI's this low and FLs this high and the pressure pegged out.

To give you an idea of what a boring no flow limitation graph looks like see mine below. I had to hunt to find one with this many of FLs. Most of mine had essentially no FLs.

mask pressure OR pressure graph, but not both.... like the example pugsy gave you.

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desiderata wrote:What led you to expect an 'active' flow limitation graph?

The FL numbers in the statistics column and the fact that your pressure line pegged out at 11 and there really wasn't much OA or hyponea stuff going on. About the only time I see that sort of reaction from the pressure when the AHI is really low is when FLs are driving the pressure up.

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.

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.

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.
Or you can stick with these settings for a few nights but I don't see the sense in it. But the choice is yours. I am good with whatever you want to do. This isn't going to be a sprint...I think it's going to be a marathon...figuring out what might be the best way to address your issues.

If you are getting some condensation in the hose..it makes an awful racket....you may need to switch over to manual humidity so you can increase the hose temp a little. Sometimes it just takes a degree or two to prevent the condensation.

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desiderata wrote:I will probably raise the max. pressure some. 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.

With a fixed pressure of 11 cm. and an EPR setting of "1", your "effective" pressure at the end of your exhale will still be 10 cm. For some people, they experience apneas at the end of their exhale cycle and as they are about to start to inhale.

But, you can try it and see how it goes.


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