Flow Limit/Flow Rate Help

[Morgoth]

Hello fellow CPAP users,

I introduced myself two years ago, and your help and this board was of tremendous help to me, but long story short, I am living in a country where I basically can't get any support for my OSA treatment. Therefore, I have to seek advice online.

CPAP has helped me a bit with my sleep, although my work is causing me a lot of stress, my sleeping patterns are all over the place, and I still wake up 2-3 times a night. However, I already mentioned all of this in my introductory post two years ago.

I have learned to read Oscar graphs to some extent, focusing mainly on the AHI data. I have been experimenting with pressure ranges, and 99% of the time my AHI is below 5, usually around values of 1-2. However, lately, I have been feeling a bit nauseous and tired every time I wake up. This prompted me to read about flow limitation and flow rates. Based on what I have seen in "normal" charts, I think I might still have some uncontrolled issues with my therapy.

I am asthmatic and have nasal congestion problems, especially when lying down. I have been a mouth breather my whole life... Also I am a diagnosed insomniac

I have been using the F&P Vitera for over a year now and I've noticed that it somehow contributes to my nasal congestion. Regardless of how loose I set it up, it still tends to make me breathe through my mouth and I do battle with some leaks with it. Prior to using the Vitera, I used the ResMed F30i, which, on the contrary, forced me to breathe through my nose. However, I could never get it to work perfectly as even slight movements would dislodge the mask and cause air to blow into my eyes, waking me up. This happened every hour or two, leaving me restless. However, I didn't experience any issues with leaks, and I think the flow charts were better with the F30i. I'll try to find some to share. I'm considering getting the AirFit F20 and giving it a try instead of the Vitera. But it goes without saying that obtaining masks in my country is a real hassle, and I have to pay for everything out of my own pocket, including the CPAP device and masks. Our insurance doesn't cover CPAP therapy.

While it is true that I am very stressed out and nervous, I have also been diagnosed with insomnia. The stress is contributing significantly to my insomnia. I want to address my respiratory problems during sleep, and deep down, I hope that my symptoms are not a sign of me going crazy, but rather that they are caused by OSA


These are my zoomed-in charts during the episodes of flow limitations. Let me know if you need some more data.



What do you think I should try to do? Should I increase the maximum pressure, maybe in an effort to break through those episodes of flow limitation?

Thanks

[Morgoth]

Another 2 images, I can post more but I don't want to spam:

[palerider]

While your AHI is good (and ignore that '5' number, that's a bad standard, < 1.5 is better) you're still having some breathing events that are causing your pressure to spike up, and those breathing problems cause sleep disturbances.

based on the flattening of the breaths you posted, and the above, I'd suggest raising your min pressure a little, try bumping up to 10.

[Morgoth]

While your AHI is good (and ignore that '5' number, that's a bad standard, < 1.5 is better) you're still having some breathing events that are causing your pressure to spike up, and those breathing problems cause sleep disturbances.

based on the flattening of the breaths you posted, and the above, I'd suggest raising your min pressure a little, try bumping up to 10.

Thank you for your response ! Will try that this night, I kind of enjoy having more pressure, I got used to it.

Also, I want to add that while I was doing the home screening, my SpO2 was falling into the low 70s percentage. I'm thinking of getting a Wellue ring to check what's going on. However, my wife owns a Galaxy watch, so I could maybe see the SpO2 levels there as a starting point. That slight nausea upon waking up was causing me concern that my SpO2 levels are not as they should be, despite the low AHI.

Funny thing is, the way we get therapy here is by doing the home screening at home. The doctor reads the results and evaluates if CPAP therapy is needed. If it is, he/she refers you to a local distributor who sells you the CPAP device. In my case, the individuals taking care of my therapy pressure, etc., are the guys from DME, who aren't doctors at all.

I was referred to the local distributor for Phillips Respironics, and a few days after I bought the Dreamstation, the recall occurred. I battled with them for a month to return the DS and get my money back so I could get the Airsense 10 instead, which was very hard to find in my country.

However, while chatting with the guys from Phillips Respironics distribution when I was returning my DS, they looked into my data and said it was looking good. They kind of confessed that they just left the pressures at stock values, which were 4-12 cmH2o on my DS back then. Obviously, that wouldn't be enough for me now, and without the CPAP internet community I would be kept in the dark.

So, thank you !

[palerider]

hey kind of confessed that they just left the pressures at stock values, which were 4-12 cmH2o on my DS back then.

Yeah, those are dumb settings for almost everyone.

[Morgoth]

And just for the reference, this is a night two years ago when I was using f30i. Looking at it right now I see flow limitations as well here... But no leaking problem, however, I was waking up a lot... And this was one of the better nights...

Does it look somehow different to the recent Vitera ones ?

Thanks

[Morgoth]

And here is the last night, if this can be called sleep.








Unfortunately leaks everywhere... Seems that even despite that I like Vitera for its comfort, it leaks for me... The only when it doesn't leak is when I set it very tight on the bottom straps, and it was like that since day one.

[dataq1]

Please check your Private Messages

[Dog Slobber]

And here is the last night, if this can be called sleep.
..

Please check your Private Messages

Be careful of advice sent to you by PM. Sometimes, people are trying to hide bad advice from peer review.

[ChicagoGranny]

I should also add that dataq1 is on the Official PR List of Misleaders/TimeWasters.

[zonker]

And here is the last night, if this can be called sleep.
..

Please check your Private Messages

Be careful of advice sent to you by PM. Sometimes, people are trying to hide bad advice from peer review.

also, why do people say please check your private messages in the open forum? when a user logs on, they SEE what messages await them.

[Morgoth]

Hello guys,

dataq1 stand of point she/he explained to my PM is valid, and I accept his/her advice and I'm grateful.

For the sake of dataq1's choice to PM me instead of saying it in public I won't disclose our conversation.

However, I still seek help and guidance on my problem

I would gladly seek professional help, but I have yet to meet a doctor here in my country that I would trust, and the exams are terrifying expensive. I would maybe rather seek profesional help online with a known specialist if possible.

Thanks

[Morgoth]

also, why do people say please check your private messages in the open forum? when a user logs on, they SEE what messages await them.

For some reason, I indeed didn't look at that part of the screen. Not that I'm defending dataq1 but I would miss it, at least today.

[zonker]

also, why do people say please check your private messages in the open forum? when a user logs on, they SEE what messages await them.

For some reason, I indeed didn't look at that part of the screen. Not that I'm defending dataq1 but I would miss it, at least today.

thanks for the reply!

[ozij]

Hello guys,

dataq1 stand of point she/he explained to my PM is valid, and I accept his/her advice and I'm grateful.

You have every right to do that.

However you can't expect reasonable reliable advice from the members who believe in open discussion if you don't put all the advice you receive and accept out in the open.

You can carry on any discussion you please in private with any member who does not want to have other people respond to their advice.
But don't expect others to waste their time on half stories, not knowing what you really think and what you understand.