New chart for review

[JBarizona]

the only real difference for the beers was that for the first time ever I had zero obstructive apneas. That seems to be counter-intuitive from what I understand about alcohol consumption... Regardless of the beers these are fairly typical charts for me lately , hence my query regarding the leaking in the flow limitation... With the beers have anything to do with the leak rate?

[Julie]

Never said they did.

[JBarizona]

Okay well let me know if you have any insight on my questions regarding leaks and flow limitation and their potential effect on ahi or whether or not they can disrupt the machines ability to accurately detect events

[Julie]

Maybe when you let me know when your attitude's improved.

[JBarizona]

I think you're projecting.

[JBarizona]

Quote anything I wrote that shows that I'm displaying a poor attitude...I am merely asking questions. If you're not interested in answering my questions feel free to not comment in the section. I don't need your attitude. So when you adjusted you can participate here, until then go away. I come here for support and compassion
..not for people projecting their issues on to me simply because I ask questions

[djams]

.....is there any correlation between good/bad flow limit and good/bad ahi?

Of course. A hypopnea is a 50% reduction in air flow for at least 10 seconds. A flow limitation reduces air flow. Thing is, hypopneas are recorded as 10 seconds no matter how long they last. If I zoom in on my hypos I'll sometimes find that they are minutes in duration. Really need to zoom in to assess your hypopneas. They aren't necessarily "better" than an apnea. Here's an example that shows the direct correlation between flow limitation and hypopnea.

FlowLimitation_Hypo.PNG (27.02 KiB) Viewed 2936 times

...but does all this steady leaking affect AHI? can the leaking have an effect on the cpap machines ability to accurately flag events?

Yes, but when it gets to that point, the events show up as "unclassified apneas". As Pugsy said - you're not even close to this point.

i had 6 beers last night..

Cheers(?)

[JBarizona]

Thanks I appreciate your input. I've noticed myself at all hypopneas are registered as 10 seconds so I do check them out to see just how long they were...

[palerider]

thing is, hypopneas are recorded as 10 seconds no matter how long they last

Looks like glitch in sleepyhead for the airsense 10. on the S9, they have varying lengths recorded.

Here's an example that shows the direct correlation between flow limitation and hypopnea.

No, it doesn't. Flow limitations and hypopneas are separate and distinct things.

You *can* have a hypopnea without a FL, and you can have FLs without hypopneas... or, as in your case, you can have both at once, but that is NOT a given.

[djams]

thing is, hypopneas are recorded as 10 seconds no matter how long they last

Looks like glitch in sleepyhead for the airsense 10. on the S9, they have varying lengths recorded.

This has always seemed wrong to me. I can't tell when a hypopnea passes the "official" threshold, but it's apparent that I'm having trouble for longer (sometimes much longer) than the recorded 10 seconds. Makes the "total time in apnea" number suspect. Better to zoom in and have a look.
I noticed that ResScan doesn't record a time for hypopneas either. Maybe a change in the ResMed software on the machine?

Here's an example that shows the direct correlation between flow limitation and hypopnea.

No, it doesn't. Flow limitations and hypopneas are separate and distinct things.

You *can* have a hypopnea without a FL, and you can have FLs without hypopneas... or, as in your case, you can have both at once, but that is NOT a given.

You're right of course. I need to be more careful with my words. I have plenty of FL's without hypopneas and some vice-versa. Thanks for clarifying.

[palerider]

thing is, hypopneas are recorded as 10 seconds no matter how long they last

Looks like glitch in sleepyhead for the airsense 10. on the S9, they have varying lengths recorded.

This has always seemed wrong to me. I can't tell when a hypopnea passes the "official" threshold, but it's apparent that I'm having trouble for longer (sometimes much longer) than the recorded 10 seconds. Makes the "total time in apnea" number suspect. Better to zoom in and have a look.
I noticed that ResScan doesn't record a time for hypopneas either. Maybe a change in the ResMed software on the machine?

I can't remember if ResScan showed duration with S9 data or not.. (it's been a few years since I looked at ResScan). there's so many little edge bugs in SH, I tend to think that's the issue first. The main bit... the charts and such, works well, but you get out away from that, and .. things get iffy.

Here's an example that shows the direct correlation between flow limitation and hypopnea.

No, it doesn't. Flow limitations and hypopneas are separate and distinct things.

You *can* have a hypopnea without a FL, and you can have FLs without hypopneas... or, as in your case, you can have both at once, but that is NOT a given.

You're right of course. I need to be more careful with my words. I have plenty of FL's without hypopneas and some vice-versa. Thanks for clarifying.
[/quote]

I just dislike people getting misled, and it's easy to do, it happens all the time with doctors, DMEs, RTs, they don't bother to be accurate, but people *expect* them to be accurate, so they take what's told them as gospel.... when it's not, and then they have more problems because of those misunderstandings.

We should try to be better

[JBarizona]

First off, thanks to all of you for your wisdom (even you palerider)......The suggestions you have all given me with regards to pressure and EPR seem to be working...since I raised my pressure to 13 and removed my EPR, I've had 9 straight nights with AHI of 5 or less...yes that's not a large sample, but for me it is as I've only been on CPAP 8 weeks....I'm dumbfounded as to why my sleep doctor and 2 respiratory therapists have given me the exact opposite advice you have all given me...it's baffling how wrong they are and how stuck to there opinion they are....none of them say any benefit to raising up my bottom pressure yet this has been the key to lowering my numbers...none of them saw any benefit to eliminating EPR yet since I have done it, my central apneas have dropped drastically....On a side note, the last two nights I had two glasses of wine in the evening and had my two lowest AHI ever, both around 1.5 I thought alcohol was supposed to increase AHI potentially......I'm glad I decided to join this forum and thanks again for all your help everyone....now on to today's questions.....I'll post a few charts below today...one of them has some kind of brown line laying on top of my green pressure line in the pressure graph, does anyone know what that is? I'll attach that chart to this message.....I'll also post two charts with a hypopnea in the flow rate chart.....do this look like actual hypopneas? It doesn't appear that my breathing has stopped....any insight is appreciated.

[JBarizona]

is this a hypopnea?

[JBarizona]

And is this a hyopopnea? If neither are hypopneas, can someone post a chart that shows what a typical actual hypopnea should appear as?

[Pugsy]

Hyponeas...flow reductions that you may or may not see how much of a flow reduction from the data you can see on the machine reports.
Doesn't always equal an actual stoppage of breathing or flat line.

Your flagged hyponeas...You can't really see the percentage of air flow reduction on these graphs. All it takes is a 40% reduction.
I have seen these flagged myself and I sit there scratching my head as to why it got a flag but all we know is that there is probably something going on that we can't see with the data available to us.
Since we have no way to measure % of reduction ....there's no way to show examples of the percent of reduction in air flow.
The machine does it but doesn't show us anything that we can use to make comparisons to. When I see these I shrug my shoulders and move on because I just have to trust the machine. The first one...might be SWJ flagging by mistake....not sure about the second one.

I have no idea what that short segment of different colored overlay on the pressure graph might mean.