question about pressure AGAIN

Pugsy wrote:Flow limitations are reductions in air flow that don't meet criteria for hyponea or obstructive apnea...
So either not long enough (10 seconds is needed to get a flag) or not enough reduction in air flow.
Obstructive apnea needs a 75% or more reduction.
Hyponea needs a 50% or more reduction.
I suspect that your flow limitations are likely below the 50% threshold. Sometimes high FLs are seen with UARS Upper Airway Resistance Syndrome and sometimes people can have OSA along with UARS and sometimes pressures needed to address the UARS FLs is greater than is needed to address the OSA events. Typically people complained of a lot of arousals with UARS or their sleep studies might mention a lot of arousals. I have no idea if this is what you might have going on...treatment is still cpap/apap therapy though.

I don't know if there is any great clinical significance in your FLs since your AHI is quite acceptable and you are also feeling quite decent.
If you were waking in the middle of the night often then there might be some clinical significance but your main issues appear to be getting to sleep in the first place. Is that correct? And not so much staying asleep??? yes the main problem now is getting to sleep in the first place. i had many many arousals during my sleep study and prior to cpap i noted many awakenings during the night. not so much now

You aren't having any nasal congestion issues by any chance are you? no not since i quit washing everything with scented soap!

If you were feeling horrible and your sleep (once you get to sleep) was fragmented...then we might want to see if things would improve by using more pressure to see if the FLs reduce but since you aren't complaining of those problems and actually feel like you are improving quite a bit then I don't know how critical it is to zap those FLs. how would i know if my sleep was fragmented now? sorry for the dumb question
As Robysue says...increasing the max could open up a whole new set of possible problems...or it might not.
I run my machine wide open an just the other night I saw it hit 20 cm...I never knew it though...no aerophagia...no waking up with hurricane force winds and the only way I knew it happened was the report the next day.

Since you are new and don't quite understand what you are seeing right now there is no urgent need to do anything at the moment.
At some point you might understand things enough that you are more comfortable with a larger range in pressures and you might try it later if you want to. You don't have to do everything right now...you have lots of time for experimenting.

Pugsy wrote:How would you know if your sleep was fragmented or not?

Most of the time it's fairly obvious...you would remember waking up multiple times during the night
But it isn't always obvious...sometimes we have arousals from sleep but we don't wake up enough to note that we woke up or we just don't remember doing so.
That's why when someone tells me that they woke up a lot and feel like crap I know that if they remember a lot of awakenings there's likely going to be a bunch more that they don't remember.

If you remember a lot of little awakenings or if you have to get up and pee...maybe those flow limitations aren't so benign after all.
This is where clinical correlation comes into the picture. Well I think i will just wait and watch what happens with this. I was having lots of awakenings but now I mostly just seem to wake up when my mask is leaking? If I am waking up now it is for VERY brief time periods
We know that they can disrupt sleep...but how much they might be disrupting sleep is something we don't have a way to measure other than subjective feelings.

When I consistently see Flow limitations on my machine (and sometimes I do) I don't worry about the maximum so much though. I worry about the minimum pressure. I tend to want to prevent something from happening in the first place and not worry so much about trying to fix them after the fact. The idea behind auto adjusting pressures is to have a minimum pressure that gets the bulk of whatever we are wanted to kill and let the auto adjusting pressure get the stragglers or difficult stuff. This is a bit over my head
If the minimum pressure is more optimal then the maximum pressure often doesn't go wildly roaming around...besides that wildly roaming pressure can disturb some people's sleep. That's why you see some people using a right range sometimes. They have discovered that the variations in pressure are a disturbing factor to sleep. I think I will eventually go up on the minimum and max pressures if i keep seeing the wild flow limitations, if nothing else because i want to see where my pressure goes if i increase it
I am lucky in that when I see pressures go from 10 to 20 that I don't ever know it. I don't have any aerophagia issues either.
If I was bothered by either then I would most likely use a tight range also.