SH chart - what is happening here?

[Spot123]

Hi
I was wondering what is happening with this shape curve (first screenshot)-- persisted about 40 minutes last night. The second screenshot is "normal".

Thanks

screenshot-20190313-215438.png (152.18 KiB) Viewed 1502 times

screenshot-20190313-215428.png (158.01 KiB) Viewed 1501 times

[palerider]

Hi
I was wondering what is happening with this shape curve (first screenshot)-- persisted about 40 minutes last night. The second screenshot is "normal".

Beat's me, I can't see squat with those Y ranges. (stupid auto ranging).

Right click the 'flow rate', choose 'y axis', then 'override' and put in something sane, like -60 to 60. then pick 'dotted lines' and turn on the zero line, and repost the pics.

[Spot123]

OK, reposting with better Y-axis range.
first one is normal. second is funny-looking

screenshot-20190314-182731.png (154.6 KiB) Viewed 1451 times

screenshot-20190314-182738.png (151.11 KiB) Viewed 1451 times

Thanks for any ideas.

[katestyles]

It looks like flow limitation to me - but I am not the expert.

[Jas_williams]

OK, reposting with better Y-axis range.
first one is normal. second is funny-looking

screenshot-20190314-182731.png
screenshot-20190314-182738.png

Thanks for any ideas.

Second one looks like mouth breathing to me


Breath in through the nose and out through the mouth arround your mask somehow as you have little to no expiratory flow

[palerider]

OK, reposting with better Y-axis range.
first one is normal. second is funny-looking.

Now, those, I can see... thanks.

I'm with Jas, it looks like some of it is mouth exhaling, you're inhaling through the mask, but most of the air seems to be just 'disappearing'... probably out your mouth, instead of back into the mask.

[palerider]

It looks like flow limitation to me - but I am not the expert.

While expiratory flow limitation is possible, it's not often seen... usually it's inspiratory flow limitation (and that's what causes the machine to react.

for inspiratory FL, you have to look at the shape of the curves above the dotted line, are they flattened, or chair shaped? (or, basically, not very rounded), of that's the case, then they're FL breaths, and the FL chart should be kicking up.

Those weird breaths are pretty rounded, and the FL chart is flat.

Like I said above, I think it's mouth leaking on exhale. (but not certain).

[Jay Aitchsee]

Yes, exhalation through the mouth rather than through the nose.

[katestyles]

It looks like flow limitation to me - but I am not the expert.

While expiratory flow limitation is possible, it's not often seen... usually it's inspiratory flow limitation (and that's what causes the machine to react.

for inspiratory FL, you have to look at the shape of the curves above the dotted line, are they flattened, or chair shaped? (or, basically, not very rounded), of that's the case, then they're FL breaths, and the FL chart should be kicking up.

Those weird breaths are pretty rounded, and the FL chart is flat.

Like I said above, I think it's mouth leaking on exhale. (but not certain).

Wouldn't that show up as a leak on the leak chart? Her is some of my flow. Is it the same? or different? I seek to be educated here. This flow had no flow restrict or leak show up with it either.

educateme.png (18.88 KiB) Viewed 1412 times

[Pugsy]

Wouldn't that show up as a leak on the leak chart?

Not necessarily. There's breathing out the mouth gently and calmly and then there's a mass exodus of air out the mouth with the tornado sounds.

Here's an example of known mouth breathing and how it looks on the leak graph. I happened to wake up one morning and I was mouth breathing. Nice gentle even calm mouth breathing with no mass exodus of air out my mouth. I decided to lay there and continue breathing like that so I could see for sure what it looks like on the leak graph. I circled the known awake and mouth breathing time at the end of the night.
This is why I tell people who think they are mouth breathing that they need to actually look at the leak reports/graphs before they run out and buy a full face mask that they don't want. The little bit of mouth breathing I did...well within the machine's ability to compensate. Now don't ask me what happened earlier in the night...I was asleep, didn't wake me up and I don't know and don't really care. I suspect mask movement. Since my time with the Bleep I have come to realize that I wasn't mouth breathing nearly as much as I thought I was.

[palerider]

It looks like flow limitation to me - but I am not the expert.

While expiratory flow limitation is possible, it's not often seen... usually it's inspiratory flow limitation (and that's what causes the machine to react.

for inspiratory FL, you have to look at the shape of the curves above the dotted line, are they flattened, or chair shaped? (or, basically, not very rounded), of that's the case, then they're FL breaths, and the FL chart should be kicking up.

Those weird breaths are pretty rounded, and the FL chart is flat.

Like I said above, I think it's mouth leaking on exhale. (but not certain).

Wouldn't that show up as a leak on the leak chart? Her is some of my flow. Is it the same? or different? I seek to be educated here. This flow had no flow restrict or leak show up with it either.

Like Pugsy says, 'not necessarily'... all depends on what you're doing with your nasopharynx.

I can put on my nasal mask, open my mouth, stick out my tongue, and no air comes out. I can breathe that way through the cpap, or I can do whatever to make things move around in the back of my mouth, block off my nasal cavity, and breathe through my mouth, and have the cpap think I'm having an obstructive apnea... or, i can hit the middle position, and air goes in my nose, around the corner, and right back out my mouth. It all depends on how you 'flip the valve(s)'.

So, you can breathe in, block that off, and exhale out your mouth... it doesn't show up as a leak at that point... since there's no air actually flowing (except out the vent). If it stays that way too long, you'll see an obstructive get flagged.

Make sense?

[katestyles]

Make sense?

errrr......no.

Don't give up on me though - I'm trying.

[palerider]

Make sense?

errrr......no.

Don't give up on me though - I'm trying.

What part didn't make sense, ask questions... that way I can just try rewording that bit

[katestyles]

Make sense?

errrr......no.

Don't give up on me though - I'm trying.

What part didn't make sense, ask questions... that way I can just try rewording that bit

I can't ask questions - I have to go put on my mask, stick out my tongue and do all those experiments......

[Pugsy]

I can't ask questions - I have to go put on my mask, stick out my tongue and do all those experiments......

I can open my mouth...stick out my tongue...blow raspberries....cough....talk plainly...and breathe nice and evenly with my mask and machine on and zero air goes out through my open mouth.
It wasn't always that way....took months and months and then one night I tried to talk and I could without air tornadoing out my mouth.
I can't tell you how I do it but I am not the only one who can do it....lots of people can do it.
Open mouth doesn't necessarily mean massive leaks...sometimes doesn't mean any leaks at all.