Can I see your Flow limit range? Still tired despite good AHI numbers.

[modest811]

Been using a Cpap (Resmed For her) since september with some trial and error. It seems like some weeks I'm doing okay, others not so much. I've been going through a bout of pure exhaustion lately and my AHI numbers are the best they've been so i've been fairly distressed. I started doing some research and looked into Flow Limit and possible UARS. In my initial sleep study, I scored 0 RERA's and my RDI was the same as my ahi (5.3, VERY mild). But I don't think they scored RERA's at all if I had 0. It seems I had 99% of my apnea's were hypopneas and I had 98! spontaneous awakenings in the night. My Arousal index was 19.5/h, so something is definitely up.

I've noticed on my Oscar chart that while it says my flow limits on the side bar are low, I look at the chart and they're pretty consistent through the night. I'm going to start experimenting with EPR (last time I used it I had a but loud of clear air apenas, but i'm hoping my body has gotten used to the CPAP so they won't come again).



Trying to figure out if I'm just dealing with insomnia, or if this is something that can be treated. I've read BiPAP is better for UARS, but it's a lot of money that I can't spend right now on Vauto machine and I'm hoping i can solve this, or at least confirm if I do or do not have UARS from Oscar data alone (probably wishful thinking).

Sorry for the rambling. I'm pretty tired today. I've attached a typical night for me below. I'd like to know how this looks compared to someone you seems to helped with CPAP and I want to know if the amount of FLs I'm getting are normal or not. Thank you.

[Pugsy]

Here's what my FL graph looks like. Now bear in mind that I have plain jane vanilla OSA and never had a real problems with FLs.



Your FL graph is a bit active but I have seen much worse.

Quit worrying about getting a bilevel machine for UARS for the time being. If you can't tolerate EPR due to centrals popping up then you won't be able to use a bilevel machine anyway. The main difference with bilevel is the ability to use more than what is essentially EPR pressure support than what you can use on the AutoSet. EPR is limited to 3 on the AutoSet and the main feature about the bilevel is the ability to use greater than 3 pressure support/EPR. If you can't use 3 then you sure can't use 4 cm.

[Miss Emerita]

If you're wiped during the day, it's worth experimenting with EPR. Flow limitations don't bother some people at all, but they can keep other people from getting restful sleep.

So try an EPR of 1, raising your minimum by 1. Let us know what happens.

[Julie]

Is it possible you might need to be tested for something that hasn't otherwise been symptomatic?

[modest811]

Hey guys,

Figured I'd post on this thread before making a whole new one.

It's been a few months and I've been very good about using my cpap everyday. Been trying different settings. I now sleep with EPR of 3. I've gotten my leaks down to almost non existent. My numbers look great, the machine saysI have almost no flow limitations (though when I zoom in I still see them pretty frequently, but maybe I'm reading it wrong?). Despite all this. I'm still very very tired.

I was diagnosed with mild sleep apnea. Mostly when I'm on my back. I bought a shirt that you can put tennis balls in the back that stops you from going on your back for long. I don't know if it works well, but I mostly sleep on my side so that's good.

I've been doing research into a BIPAP, apparently these are better for flow limited breathing. Something isn't right. Despite this low AHI, I feel like I haven't slept. I just feel awful all the time. I tried increasing my pressure but i get really bad Aerophagia. I've posted my last two nights, also a zoomed in look at my flow rate during REM, looks a little flow limited to me? Would this cause fatigue? Could I BIPAP help with this? . Really at a loss what to do here. Tired of feeling so awful

[Miss Emerita]

The first zoomed view shows some likely flow limitation (the stunted breaths). The second shows some FL too (points and dents), though the resolution makes it hard to say how much.

It's impossible to know whether you're extremely sensitive to FLs or whether your sleep is unrefreshing for some other reason. You mentioned that your sleep study showed a lot of spontaneous arousals. That's rough, because the "spontaneous" means the cause is not known. Do you have any reason to suspect restless leg syndrome or period leg movements?

And can you try getting 8-9 hours of sleep per night and see whether that is of some help? For some people, less than 8 just doesn't do the trick.

Finally, if you can comfortably afford a ResMed Vauto and can lay your hands on one, there's no reason not to get one and see whether greater pressure support (EPR) helps you. But it's impossible to say in advance whether that will make a difference.

[modest811]

Hey!

Thank you so much for the reply, I really appreciate it.

So, on my sleep study it said I do not have restless legs. Plus I've asked my girlfriend when we're in bed do I kick around and she said no. I do wake up every now and then and I dream a lot, and remember my dreams. I've been told this is a sign of light sleep.

Those flow limitations that you seen happend in a time where my breathing is 'faster' and I think just by looking at the graph it's when I'm in REM sleep.

I'm in the process of looking into getting a Vauto at the moment, but i'd have to drop 1100 dollars Canadian on even a discounted one which is a lot of money for me right now. For something I'm not sure will even work. I think i'm sensitive to these flow limitations but who knows.

I do get normal breaths as can be seen here, but they're mostly near the beginning of the night



Then as the night progresses it becomes a little more chaotic and I can see the awakenings.




Maybe though it's unrelated, like you said. Or maybe i'm just sensitive. I'll just have to save up I guess for a VAuto and hope it'll help.