Constant flow limit on sleepyhead. Should I be worried?

[chefmate]

I was diagnosed with OSA but I believe I might have Upper respiratory restrictive syndrome based on the high flow limit events all night.

[coolbranch]

I can't offer expertise here however I will watch this thread and learn something new.

[Pugsy]

I have seen much worse in terms of the FL graph.

Is this amount something to be worried about? I don't know...this is where clinical correlation needs to be done.
Is the nose often congested and these FLs related to nasal mucosa issues as opposed to airway issues?
How is the sleep quality in general?
Wake up often? I see at least 2 breaks in therapy where the machine was turned off? Why?
How about the daytime symptoms?
Take any meds of any kind for any reason?

[chefmate]

Hi Pugsy,

Is the nose often congested and these FLs related to nasal mucosa issues as opposed to airway issues?

No issues with nasal congestion. I believe it is an airway issue.

Wake up often? I see at least 2 breaks in therapy where the machine was turned off? Why?

I was not able to fall asleep so got up to take Benadryl.

How about the daytime symptoms?

I have not seen Improvement in the daytime symptoms besides body aches. I don't wake up feeling like someone gave me a beating last night but I am still exhausted all day.

Take any meds of any kind for any reason?

Doctor recently prescribed nuvigil for daytime sleepiness. Its only making my anxiety worse.

[Pugsy]

So you have trouble falling asleep? Does this problem predate cpap therapy?
Do you also have trouble staying asleep? Meaning once you get to sleep you wake up often for whatever reason and then have trouble falling back to sleep again? How many wake ups?
Of the 11 hours on the machine on this report...how much would you estimate you were actually asleep?

[Julie]

May sound simple, but it's helped others - have you tried a soft cervical collar to keep your head off your chest and your airway more open? It can make quite a difference, and also helps to keep your mouth closed if there's a chance of mouth leaking.

[Pugsy]

Your diagnostic AHI was in the 50s...is this correct? That part of the OSA is being handled very well.
I see in another thread that you say you have been using cpap 1 week now? Is that correct?
While it wouldn't be impossible for someone to have UARS and OSA...the treatment is the same and one week isn't really long enough to expect a big turn around in how we feel despite what we read about those people who have the overnight miracle and feel like a totally new person....those people are extremely lucky and in a minority.

I am so leery of adding Nuvigil (or similar) to the mix. I don't care what they say that stuff is going to be a factor in the blood stream when a person goes to bed and already probably has trouble getting to sleep and staying asleep.
It's going to be in the blood stream at some level at bedtime because it isn't totally gone due to the half life properties.

And remember what they say....cpap can't fix bad sleep unless the sole cause of the "bad" sleep is only sleep apnea and there's a long list of causes for bad sleep that are totally unrelated to sleep apnea.
And unfortunately often we have more than one cause for our bad sleep. I know I had more than one cause for my bad sleep.

[chefmate]

So you have trouble falling asleep? Does this problem predate cpap therapy?
Do you also have trouble staying asleep? Meaning once you get to sleep you wake up often for whatever reason and then have trouble falling back to sleep again? How many wake ups?
Of the 11 hours on the machine on this report...how much would you estimate you were actually asleep?

I have had trouble falling asleep lately on Cpap therapy with some highly arousals due to APAP pressure variations. I was probably asleep for about 8 hours last night.

[chefmate]

May sound simple, but it's helped others - have you tried a soft cervical collar to keep your head off your chest and your airway more open? It can make quite a difference, and also helps to keep your mouth closed if there's a chance of mouth leaking.

I have never tried a cervical collar. I will definitely look into that and maybe complement it with a pillow designed for sleep apnea patients.

[Pugsy]

I don't see the pressure graph on this report above. Next time you might include it and omit the snore graph as the snore graph isn't particularly useful in this situation.

You know it is very possible that the pressure changes themselves are a factor in your overall sleep quality and at some point you might want to investigate either cpap mode with a fixed pressure or apap at a very, very tight range.
Your machine will try to fix those FLs and they may or may not need fixing but the changing pressures could be more of a problem than the FLs.

Again....how many wake ups do you think you are having? Just the 2 breaks that I see which apparently you weren't even asleep?
Or like me with 30 to 50 wake ups during the night where I remember waking up but don't turn the machine off?
I had a separate issue that caused those wake ups so I had to deal with that issue separately..it's still a factor but at least the wake ups are greatly reduced. That's a battle I will never totally win.

[Wulfman...]

So you have trouble falling asleep? Does this problem predate cpap therapy?
Do you also have trouble staying asleep? Meaning once you get to sleep you wake up often for whatever reason and then have trouble falling back to sleep again? How many wake ups?
Of the 11 hours on the machine on this report...how much would you estimate you were actually asleep?

I have had trouble falling asleep lately on Cpap therapy with some highly arousals due to APAP pressure variations. I was probably asleep for about 8 hours last night.

That's easy enough to remedy. Narrower (tight) pressure range of find the optimal single pressure setting. However, with a tight pressure range, you might as well just go "eenie, meenie, minie, moe" and select one and then adjust if necessary.


Den

.

[chefmate]

I don't see the pressure graph on this report above. Next time you might include it and omit the snore graph as the snore graph isn't particularly useful in this situation.

Or like me with 30 to 50 wake ups during the night where I remember waking up but don't turn the machine off?

I believe 3 to 4 wake ups all night. Most wake ups were due to increase in pressure.

[Pugsy]

Finding a suitable cpap pressure or very, very tight apap range is probably going to mean you have to choose what you want to try to address first...the OSA stuff or the FL stuff and use higher pressure all night instead of part of the night.
Since you know for sure that the pressure changes are a factor in sleep quality then I would want to address that sooner than later.
Are you wanting to do this yourself or use your medical care team? Some people are comfortable doing it themselves and some aren't.

How long have you been taking the Nuvigil? Like how many this week since you have been on cpap therapy?

[musculus]

I don't see the pressure graph on this report above. Next time you might include it and omit the snore graph as the snore graph isn't particularly useful in this situation.

Or like me with 30 to 50 wake ups during the night where I remember waking up but don't turn the machine off?

I believe 3 to 4 wake ups all night. Most wake ups were due to increase in pressure.

You may want to try a fixed pressure at 16 or higher (if you can tolerate) and see if FL get better.

Also can you zoom in on one prominent FL event and share the flow graph here?

[chefmate]

Also can you zoom in on one prominent FL event and share the flow graph here?