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[Wulfman...]

Thank you, all; I appreciate every one who has taken the time to post and share their perspective. This is how we learn and improve best, pooling our resources. This is complex stuff we're dealing with and trying to sort out. Getting a hand on which variables are influencing what is a science and an art it seems to me.

...we see with last nights Flow Limitations that fixed pressure of 10 probably didn't do much to help the FLs.

I'm not sure I'm understanding this... a range was used, not fixed pressure.

I don't have much congestion since I had sinus surgery, but I could use the neti pot and see how that goes.

The hose did collect some water in the low point - no actual rain out in my face - when I noticed I elevated the hose for it to drain back into the tank. I may set the humidity from 4 down to 3. Also, I looked back over my reports and notes from the previous periods of use to refresh myself about the specifics. Have some possible changes I can try.

Some people think that with using a range of pressures, the increasing pressures (pressures primarily rise on Flow Limitations and/or Snores) may "squash" the flow limitations ("gonna need a bigger hammer"). While they might, it will also lead to higher pressures, pressure changes and possibly unwanted effects like mask leakage, mouth leakage, pressure changes disturbing sleep and then there's no guarantee that the increased pressures will actually reduce the flow limitations.

You can surely try a higher maximum pressure to see if it helps, but keep these things in mind in case you experience adverse results.


Den
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[desiderata]

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[palerider]

I'm not sure I'm understanding this... a range was used, not fixed pressure.

At some point in your experiments I would like to see you try the regular apap mode to see if it does a better job fighting the FLs. No rush though. Just something to keep in mind for a later date. I don't anticipate it making any difference though.
It's not like your pressure last night fluctuated much once it got up to 11.

and keep in mind that flow limitations of that magnitude mean there's an increased effort to breath, pretty much all night long, so, basically, working in your sleep... and that's no good for rest.

[palerider]

By 'regular apap' you mean raising the upper number? Why do you suspect it might not make a difference to the FLs? Is there anything that would make a difference in them? If raising the pressure won't likely impact the FLs, why even try it -- just in case it does?

for most people, more pressure = less flow limitations, less snores, less obstructive apneas, less hypopneas, that's why auto machines raise pressure until those things go away.

[Pugsy]

It would be a PITA to try to dig up the specifics, and since it was long enough ago that things could well have changed, it may not be worth the effort.

I see no sense at all in going to all that effort. We deal with the here and now and what we see now anyway.

By 'regular apap' you mean raising the upper number? Why do you suspect it might not make a difference to the FLs? Is there anything that would make a difference in them? If raising the pressure won't likely impact the FLs, why even try it -- just in case it does?

No...I meant the other apap mode...I think you are using the "for Her" mode right now.
I don't think that the other regular mode at these settings (9-11) will really make much difference because your FLs are pretty darn ugly. I was just thinking of comparing modes at the same settings....you are my guinea pig. Only if you want to be though. People ask about the "for Her" mode but other than some fluff that ResMed spouts off we really haven't seen it in action to compare it to the regular mode. I am a "if I see it I believe it" type of girl.

And I do think that increasing the max pressure in the current for her mode is in order.
I don't know if the FLs will respond but I sure don't want to not try to do something with them if at all possible.
I am not about to throw up my hands and give up until it is proven to me that something simply won't work.

Now if you develop a problem with more pressure then we talk about compromises but at this point I am far from being in the "let's compromise" mode.
If the FLs were related to the nose...more pressure never seems to help FLs coming from nasal mucosa congestion but they usually will respond to more pressure when they are in the airway down where those OAs and hyponeas develop.

The thing is...the FLs could be causing arousals that you may or may not be aware of and they could be messing with sleep quality...and for that reason I think it is open hunting season on them until we figure out what it takes to kill them and figure out if the killing them causes more problems than it fixes.

I suspect that your original trial with cpap didn't yield you the results you expected despite the good numbers.
Whatever symptoms you were having didn't improve. I don't remember if you ever said what those symptoms were but I wouldn't be surprised if those same symptoms aren't still present or you wouldn't be willing to try cpap again.

[desiderata]

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[Tballinusa]

When I first started CPAP about 2 years ago, my doctor had set my pressure at 4-15 which is completely ridiculous. Not only did it feel like I was suffocating when I first started the machine, when I get up at night to use the restroom I had to start back at 4 again. I had him up my start pressure to 9 and that is perfect for me. Although I have a max pressure of 15, my follow ups show that I do best at around 11. The doctor at the sleep disorder center said I'm one of the odd Sleep Apnea cases. I'm 40, in great physical shape and cycle 100 miles a week. I wouldn't even thought about a sleep study until my wife said I snored really bad.

[desiderata]

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[Pugsy]

http://www.resmed.com/us/dam/documents/ ... sa_eng.pdf

I thought with "Auto" for both humidity and hose temp you got 85% at 81 degrees. Sounds like you have temp to auto and humidity to manual. Change hose temp to manual and add a couple of degrees and see if that helps or not.
It all depends on how cool your bedroom is as to how warm you need the hose air temp to be.

Question #2: Could the pillows be too small, restricting air flow and causing some of the FL activity?

While the nasal pillow might need to be a little larger for air movement comfort I don't think that the pillows are responsible for the FL activity.

Question #3: Could I just have a small airway and it would cause FL activity no matter what?

I dunno. Here's an experiment to try. Do this while awake with no chance of falling asleep. Put the mask on and use the machine for about 30 minutes. Then see what the flow looks like while you were for sure awake and no chance of sleep apnea soft tissues collapsing. Read a book, watch TV but make sure you are totally awake.
Then look at the FL graph.

[desiderata]

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[Wulfman...]

Here's an experiment to try. Do this while awake with no chance of falling asleep. Put the mask on and use the machine for about 30 minutes. Then see what the flow looks like while you were for sure awake and no chance of sleep apnea soft tissues collapsing. Read a book, watch TV but make sure you are totally awake.
Then look at the FL graph.

I will do that. Do you think it matters if I'm sitting up or lying down?

I would suggest trying it both ways. One period sitting and another period laying down.


Den

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[desiderata]

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[Wulfman...]

Since both positions are apparently on one continuous report, would the time you switched be around 17:00 - 17:05?

If that's the case, the Flow Limitations seem to be a little more lying down, but still present sitting up.


Den

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[Pugsy]

Now take your other FL graph from last night or whenever...and highlight a 40 minute time in the FL graph so you can compare 40 minutes awake vs 40 minutes asleep and get an idea of apples to apples scale.

To get a 40 minute segment just highlight a short segment of time and eyeball the starting and ending times on the graph.
Only interested in the FL graph...don't worry about all the others.
When you click and drag the mouse to highlight things the highlighted area gets zoomed in on.

[desiderata]

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