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Flow limitations 199 detected please help!

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LeoCadeau +0 points · 5 months ago Original Poster

I started the APAP therapy a week ago and just took a look at my data with OSCAR. Well, I doesn't understand a lot, but I find the amount of flow limitations detected quite concerning. Since my research shows that doctors don't care about anything else than AHI I hope someone can tell me if I have to be concerned with there flow limitations and if so what I can do about it. Since I am new here I hope I uploaded the screenshots of OSCAR correctly. Please tell me if anything else is needed. Thank you so much in advance!

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LeoCadeau +0 points · 5 months ago Original Poster

I can't see my original post, so I´ll just post it again as an answer. Sorry if its redundant.

I started the APAP therapy a week ago and just took a look at my data with OSCAR. Well, I doesn't understand a lot, but I find the amount of flow limitations detected quite concerning. Since my research shows that doctors don't care about anything else than AHI I hope someone can tell me if I have to be concerned with there flow limitations and if so what I can do about it. Since I am new here I hope I uploaded the screenshots of OSCAR correctly. Please tell me if anything else is needed. Thank you so much in advance!

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Sierra +0 points · 5 months ago Sleep Patron

Sometimes when a new user posts multiple images the post gets hung up in a purgatory section!

Flow Limitations are a restriction in the flow rate. If you really zoom in on the Flow chart so you can see individual breaths you may see a bit of a flat spot around the peak flow on inhale (above the centerline). That would be a flow limitation. In my experience one can reduce the incidence of flow limitation by increasing the differential between the EPAP (exhale pressure) and IPAP (inhale pressure). On a ResMed this is called EPR, and you can increase the differential to a maximum of 3 cm. I am not sure what your machine calls it, but it looks to me that it is reducing EPAP by 2 cm. If you are able to increase that to 3 cm or more, it may help reduce flow limitations. Also more pressure can reduce flow limitations. I see your minimum pressure is set at 4.5 cm which is quite low. You may want to try increasing that to 7 cm. It would likely be more comfortable and could improve the flow limitation frequency.

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Sierra +0 points · 4 months ago Sleep Patron

This machine flags flow limitations instead of just displaying the flow limitation graph like a ResMed machine does. I think that method makes flow limitations appear worse than they really are.

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ejbpesca +0 points · 4 months ago

Your Flow Limitations graph is not visible on the posted OSCAR reports. It is below the visible graphs. The graphs can be moved up and down the report. I see the 199 Flow Limitation events which is something my APAP machine does not show in Events. My OSCAR has a graph and a number that is like a score to show the flow limitation level. Since I have chronic flow limitations my events would probably be a large number like yours, but I do not know what your APAP machine considers as an EVENT, that is, how limited must the airflow be before it registers it as an event. Your flow limitations graph may give you a better indication of your flow limitations than the events. My flow limitation graph is different each sleep session and is never flat which would be no limitations.

Flow limitations are a hot topic for CPAP users and those who give CPAP advice. If their AHI is decent, the next thing to improve is flow limitations. I have my EPR set to 2. I will take Sierra's advice and increase it to 3 which requires going into the Clinical Menu on my machine. You may have access to EPR settings on your machine but if not, do a net search for instructions on how to access pressure changes and EPR changes for your brand/model of CPAP machine. You will need to get into the Clinical Menu also to set pressure min. and max.

Your air pressure settings are surprisingly low. Do you have the report from your sleep study? It shows the pressure levels used to stop apneas. Did you DME (supplier of the machine) or a technician set the pressures or are those the default settings of a new machine? Your min. 4cm is as low as my machine goes. Ask whoever set your machine if that is the default or a prescribed setting for you. If no one sets the machine is has default pressures.

4 cm min. and 20 cm max. are the lowest and highest pressures of my machine. Your settings look very low and I see your pressure is maxing out to 8 cm, so at least increase the maximum level it can reach. The goal is to have it just high enough that the pressure graph does not show it maxing out. This is never perfect, maxing out may still happen at times. It is suggested pressure changes be done in small increments over several sleep sessions, eg .5 to 1 per adjustment.

Search Flow Limitations OSCAR for articles on how to interpret them on OSCAR. I have high flow limitations for reasons that I think I cannot change. Mine go up and down as does the effects on my airways due to my allergies. What I pay much attention to is the Leak Rate.

I have used an APAP machine for 17 years. I am not an expert in therapy but have been using and studying OSCAR for a few years. OSCAR can be overwhelming to me....so much data!

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