Are Flow Limitations Actually An Issue?

[patrickbateman]

I'm wondering if my flow limitations are actually an issue that's negatively affecting my sleep and need to be fixed? I was diagnosed with UARS in 2020. I tried BiPAP back then and while the data looked clean (see 2020 - BiPAP screenshot), I just couldn't tolerate the therapy so I stopped. As my fatigue has gotten worse over the years, I tried starting again. This time, I encountered lots of CAs which I believe to be TECSA (see 2025 - BiPAP screenshot) - it feels like the machine is forcing me into an unnatural breathing rhythm / over-breathing / breathing too fast, even with the AirCurve 10 advanced settings (TiMax, TiMin, Trigger Sensitivity, Cycle Sensitivity) set to allow the slowest breathing rate possible. In an attempt to fix this, I tried switching to CPAP (see 2025 - CPAP screenshot), but then I start getting flow limitations. I've tried increasing the CPAP pressure, but I can't really tolerate much higher (I'm a very light breather). My question is - are these flow limitations that you see in the 2025 - CPAP screenshot really something to worry about?

2020 - BiPAP:

c2020.png (217.8 KiB) Viewed 366 times

2025 - BiPAP:

c2025.png (283.22 KiB) Viewed 366 times

2025 - CPAP:

2025-12-01.png (266.02 KiB) Viewed 366 times

[ChicagoGranny]

I'm wondering if my flow limitations are actually an issue that's negatively affecting my sleep and need to be fixed?

Judging near bedtime, how did you feel during the day? Energetic? Any excess sleepiness? Tired at bedtime, but not stressed?

My question is - are these flow limitations that you see in the 2025 - CPAP screenshot really something to worry about?

The ultimate objective is to have the capacity for life, and growth or continued existence. Pretty charts are not among the best objectives.

If it feels good, CPAP it.

[ChicagoGranny]

BTW, have you had your airway examined by an ENT?

[patrickbateman]

I'm always tired! I have ME/CFS, so it's hard to decipher whether it's actually poor sleep or my ME/CFS making me tired - hence why I'm asking about the flow limitations. I'm trying to determine if my sleep is actually an issue and if it's worth trying to "fix."

Yes my sleep ENT who diagnosed me with UARS (based on a sleep study), examined my airway with a video scope and while there were no glaring obstructions, he said I have small anatomy, narrow nasal passages, flat face, tight and recessed jaw, etc. - all things very typical for UARS patients.

[ChicagoGranny]

I've tried increasing the CPAP pressure, but I can't really tolerate much higher (I'm a very light breather).

What are the symptoms of your intolerance of higher CPAP pressures? Aerophagia, awakenings, inability to fall asleep, other?

I tried switching to CPAP (see 2025 - CPAP screenshot), but then I start getting flow limitations

If you would post an analysis of your CPAP data using the free SleepHQ.com app, we could zoom in and maybe get a better idea.

I have ME/CFS

Yes, that certainly complicates diagnosis.