Do I need to limit flow limitation further?

[snorenomore123]

Hello all,

I have been waking up with my body hot, headache and and slightly raised HR (which I associated with apnea) some days recently, but when I check my graphs I have very low to non-existent AHI. So I started digging around in the archives for information about flow limitation and saw that some like Puglover seem to aim for a very significant reduction in flow limitation if possible. I was wondering if someone could help me look at my chart and tell me if these flow limits look problematic or would something else be the cause? I had to lower my min pressure about a month back due to significant aerophagia. TIA! (resmed airsense 10 for her, n20 resmed headgear)

[Pugsy]

Are you having any nasal congestion at all? If you are some of your nasal congestion can show up as FL graph activity.
When that happens tweaking with the settings is unlikely to help much and people have to deal with nasal congestion the traditional ways we deal with a stuffy nose.

Sometimes increasing the difference between inhale and exhale helps reduce FLs....in your situation that would be increasing EPR to 3. I have no idea if it will help or not because we have no idea if your symptoms are from the FLs or not...but wouldn't hurt to give it a try.

If no joy I strongly suggest a discussion with your doctor about your unwanted symptoms.
Not everything that bugs us is airway related or apnea related and not everything is fixable with the machine.
It is entirely possible something else is going on and we wouldn't want to ignore some other problem that might be going on.


Your FL graph isn't really all that exciting. Not horrible by any means. Yours is only very lightly more active than mine.

Here's a really bad FL graph that I stole a while back from someone because it was so darn ugly. Good example of ugly.

[snorenomore123]

Are you having any nasal congestion at all? If you are some of your nasal congestion can show up as FL graph activity.
When that happens tweaking with the settings is unlikely to help much and people have to deal with nasal congestion the traditional ways we deal with a stuffy nose.

Sometimes increasing the difference between inhale and exhale helps reduce FLs....in your situation that would be increasing EPR to 3. I have no idea if it will help or not because we have no idea if your symptoms are from the FLs or not...but wouldn't hurt to give it a try.

If no joy I strongly suggest a discussion with your doctor about your unwanted symptoms.
Not everything that bugs us is airway related or apnea related and not everything is fixable with the machine.
It is entirely possible something else is going on and we wouldn't want to ignore some other problem that might be going on.


Your FL graph isn't really all that exciting. Not horrible by any means. Yours is only very lightly more active than mine.

Here's a really bad FL graph that I stole a while back from someone because it was so darn ugly. Good example of ugly.

Hi Pugsy, thanks for the quick reply. I keep my nose pretty open using nasal strips, so usually I don't wake up feeling congested or anything like that. I will think about setting the EPR to 3. Based on the chart, it doesn't look like it would be necessary to raise lower limit though? It's so weird to me, because the numbers are all good, the pressure curve is quite flat and now, as you say, the flow limit doesn't look that bad. Thanks.

[Pugsy]

I don't know for sure that it would be necessary to increase the minimum to compensate for the little bit more exhale.
Especially cautious of doing that increase in view of your aerophagia issues.
Your number of events are extremely low and I think there is a lot of wiggle room there for a little more EPR and not have it cause too many OAs or hyponeas. Might not change it at all.

So a lot of "I don't knows" here....don't know if the FLs are the cause of your unwanted symptoms...don't know if increasing EPR will even help with the FLs because it sure isn't very bad now...don't know if you will need a little more minimum to compensate for the extra drop. While some people do...some people don't. It's not always a given that we have to increase the minimum when we increase EPR.

It is a rather simple, easy and benign experiment to try though. Your choice of course.

[snorenomore123]

I don't know for sure that it would be necessary to increase the minimum to compensate for the little bit more exhale.
Especially cautious of doing that increase in view of your aerophagia issues.
Your number of events are extremely low and I think there is a lot of wiggle room there for a little more EPR and not have it cause too many OAs or hyponeas. Might not change it at all.

So a lot of "I don't knows" here....don't know if the FLs are the cause of your unwanted symptoms...don't know if increasing EPR will even help with the FLs because it sure isn't very bad now...don't know if you will need a little more minimum to compensate for the extra drop. While some people do...some people don't. It's not always a given that we have to increase the minimum when we increase EPR.

It is a rather simple, easy and benign experiment to try though. Your choice of course.

Thanks for the advice! It's at least reassuring to know that the number of events and fls don't seem to be posing a big problem in and of themselves.