interesting well 377 FLs in one night does seem crazy if my AHI is 2/3 and Sp02 is always above 95% all night
Many flow limitations but AHI 2/3 and Sp02 always above 95%.. is this an issue?
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Charlieboy UK
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Re: Very high flow rate but AHI 2/3 and Sp02 always above 95%
Yeah looks like Prisma20A and up got 3. You got 2.Charlieboy UK wrote: ↑Thu Jan 08, 2026 12:46 pmthanks... really helpful.. some people said set it to 3, but it only goes to 2.
Y'know, if you wanna load your data onto SleepHQ we can try to figure out why SoftPAP generates FLs (and its absence does not)(at least that's the working theory).
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Charlieboy UK
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Re: Very high flow rate but AHI 2/3 and Sp02 always above 95%
thanks...ill try going to 1 see how it goes... then off.. be interesting if that's all it is. it could be I guess, especially as I use a nasal mask... thanksNocibur wrote: ↑Thu Jan 08, 2026 1:26 pmYeah looks like Prisma20A and up got 3. You got 2.Charlieboy UK wrote: ↑Thu Jan 08, 2026 12:46 pmthanks... really helpful.. some people said set it to 3, but it only goes to 2.
Y'know, if you wanna load your data onto SleepHQ we can try to figure out why SoftPAP generates FLs (and its absence does not)(at least that's the working theory).
Re: Many flow limitations but AHI 2/3 and Sp02 always above 95%.. is this an issue?
You know when someone first told me about using EPR and it sometimes helping reduce FLs I just rolled my eyes and thought it was a stupid idea. Before that I had always been told that to reduce FLs we needed to raise the base pressure....certainly not reduce it which is what EPR will do.Nocibur wrote: ↑Thu Jan 08, 2026 9:38 amOddly, there is anecdotal evidence that eliminating softPAP significantly reduces FLs.Pugsy wrote: ↑Wed Jan 07, 2026 3:25 pmAdding in a bit more pressure support (difference between inhale and exhale) might help reduce those flow limitations but with your current settings you really don't have much room to add in any pressure support.
Is there a setting that you can adjust that might be called exhale relief??? That's how we get pressure support increases....we increase the exhale relief.
Then I saw the results with just adding in EPR and no increase in the baseline pressure and the reduction was remarkable.
Made a believer out of me and I don't know why it works but it does work for some people. Not all of course but some.
Worth trying though as it is a simple, easy and cheap fix. If it doesn't help there's always increasing the minimum baseline option.
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Charlieboy UK
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Re: Many flow limitations but AHI 2/3 and Sp02 always above 95%.. is this an issue?
I already have SoftPAP (EPR) on the max which is 2 on my Prisma SMART APAP... im going to try it to 1 and see what happens....then maybe off.. be good if its that simple...as I cant work out how to solve it, as nothing else i have tried seems to make it any better. I've even tried mouth tape, and a chin strap... no change...and oddly increasing pressure makes AHI worse.. which is clearly not good. thanksPugsy wrote: ↑Thu Jan 08, 2026 3:27 pmYou know when someone first told me about using EPR and it sometimes helping reduce FLs I just rolled my eyes and thought it was a stupid idea. Before that I had always been told that to reduce FLs we needed to raise the base pressure....certainly not reduce it which is what EPR will do.Nocibur wrote: ↑Thu Jan 08, 2026 9:38 amOddly, there is anecdotal evidence that eliminating softPAP significantly reduces FLs.Pugsy wrote: ↑Wed Jan 07, 2026 3:25 pmAdding in a bit more pressure support (difference between inhale and exhale) might help reduce those flow limitations but with your current settings you really don't have much room to add in any pressure support.
Is there a setting that you can adjust that might be called exhale relief??? That's how we get pressure support increases....we increase the exhale relief.
Then I saw the results with just adding in EPR and no increase in the baseline pressure and the reduction was remarkable.
Made a believer out of me and I don't know why it works but it does work for some people. Not all of course but some.
Worth trying though as it is a simple, easy and cheap fix. If it doesn't help there's always increasing the minimum baseline option.
Re: Many flow limitations but AHI 2/3 and Sp02 always above 95%.. is this an issue?
Agreed but that specifically relates to EPR. The SoftPAP delivery is quite a bit different:
- 1000px-Softpap2_example.png (142.14 KiB) Viewed 906 times
- 1000px-Resmed_epr.png (138.25 KiB) Viewed 906 times
You can see SoftPAP has sustained inspiratory pressure vs the more rounded waveform of EPR.
So I'm looking at the Prisma TS software manual and I'm not finding any mention of flow limitation. So is FL analysis an exclusive Oscar operation, but from the Prisma point of view completely irrelevant? IOWs, Oscar is (inappropriately) analyzing engineered breaths.
Re: Many flow limitations but AHI 2/3 and Sp02 always above 95%.. is this an issue?
That said, our analysis will be limited in a SleepHQ file because they don't include the pressure waveform. We'd have to get a copy of the Oscar file and view it in Oscar.
That said2, we can still compare the differences between SoftPAP1, 2 and Off.
That said2, we can still compare the differences between SoftPAP1, 2 and Off.
Re: Many flow limitations but AHI 2/3 and Sp02 always above 95%.. is this an issue?
True and sure worth trying. Cheap and easy experiment. Might get lucky. Stranger things have happened.
I have been really ill the last few months and then hubby had to go and have a heart attack a couple of months ago so between all this crap.....I just haven't had the time or energy or inclination to go digging around the other machines like this Prisma.
Hell for all I know all this may not mean much at all.
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Charlieboy UK
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Re: Many flow limitations but AHI 2/3 and Sp02 always above 95%.. is this an issue?
But SleepHQ also shows many Fls and they work off the raw data (as shown on one of my screen grabs). but you could be right, that it might be best to ignores the Prisma FLs... I wish other people had this machine so we could see... ERP is meant to be similar to SoftPAP... but as you say... not the same.Nocibur wrote: ↑Thu Jan 08, 2026 4:36 pmAgreed but that specifically relates to EPR. The SoftPAP delivery is quite a bit different:
1000px-Softpap2_example.png1000px-Resmed_epr.png
Waveforms from https://www.apneaboard.com/wiki/index.p ... imitations
You can see SoftPAP has sustained inspiratory pressure vs the more rounded waveform of EPR.
So I'm looking at the Prisma TS software manual and I'm not finding any mention of flow limitation. So is FL analysis an exclusive Oscar operation, but from the Prisma point of view completely irrelevant? IOWs, Oscar is (inappropriately) analyzing engineered breaths.
Re: Many flow limitations but AHI 2/3 and Sp02 always above 95%.. is this an issue?
As it would, but as we (I) theorize, it's meaningless.Charlieboy UK wrote: ↑Thu Jan 08, 2026 5:48 pmBut SleepHQ also shows many Fls and they work off the raw data (as shown on one of my screen grabs).
Can you share the SleepHQ link?
Feel like running a Prisma TS report?
https://www.apneaboard.com/forums/Threa ... -5-19-0-12
And/or post some 30 second windows of the "FLs" with Flow Rate and Mask Pressure together using SoftPAP 0ff, 1, and 2.
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Charlieboy UK
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Re: Many flow limitations but AHI 2/3 and Sp02 always above 95%.. is this an issue?
I took my SoftPAP to 1 last night...and i di get less FLs... but also less deep sleep according to my Garmin watch, but that might not be related. https://sleephq.com/public/61091782-196 ... a3cbeb8457Nocibur wrote: ↑Fri Jan 09, 2026 3:24 amAs it would, but as we (I) theorize, it's meaningless.Charlieboy UK wrote: ↑Thu Jan 08, 2026 5:48 pmBut SleepHQ also shows many Fls and they work off the raw data (as shown on one of my screen grabs).
Can you share the SleepHQ link?
Feel like running a Prisma TS report?
https://www.apneaboard.com/forums/Threa ... -5-19-0-12
And/or post some 30 second windows of the "FLs" with Flow Rate and Mask Pressure together using SoftPAP 0ff, 1, and 2.
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Charlieboy UK
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Re: Many flow limitations but AHI 2/3 and Sp02 always above 95%.. is this an issue?
So... as suggested on here... I reduced my SoftPAP (ERP) from max 2...to 1... and it cut my FL rates in half last night... how odd.. RERA was also cut in half...I know you cant tell a lot from one night.
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Re: Many flow limitations but AHI 2/3 and Sp02 always above 95%.. is this an issue?
I asked CoPilot for professional info about the Prisma Smart.
https://www.docdroid.net/LPC2YQl/prisma ... glish-pptx
Do you (plural) know it has (or will have?) two kinds of APAP pressures? (see pages 15-16)
Here's how it describes SoftPap:
softPAP
1 and 2 in CPAP and APAP
With pressure reduction during early phase
of exhalation: especially for patients who
find it unpleasant or difficult to exhale
against positive pressure
With pressure increase in time at the end of
critical end expiration phase to prevent
obstructive events.
respiratory
And page 7 shows SoftPap's pressure reduction varies by pressure!
And look at page 22:
https://www.docdroid.net/LPC2YQl/prisma ... glish-pptx
Do you (plural) know it has (or will have?) two kinds of APAP pressures? (see pages 15-16)
Here's how it describes SoftPap:
softPAP
1 and 2 in CPAP and APAP
With pressure reduction during early phase
of exhalation: especially for patients who
find it unpleasant or difficult to exhale
against positive pressure
With pressure increase in time at the end of
critical end expiration phase to prevent
obstructive events.
respiratory
And page 7 shows SoftPap's pressure reduction varies by pressure!
And look at page 22:
APAP: Algorithm Details
•
Pressure range ( Pmax Pmin ) is
divided into four quartiles
•
Dynamic reactions depend on
pressure range
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Good advice is compromised by missing data
Forum member Dog Slobber Nov. 2023