general question about flow limitations

[Rubicon]

If I recall correctly, LeftyLanky at one point said Flow Limits didn't matter. That is when I stopped watching his videos because they clearly do matter.

Oh really?

In what way?

Nothing, huh?

So Lanky Lefty must be right.

[Rubicon]

Nothing, huh?

I mean, you've had all night to Google.

Surely you've found something...

[Rubicon]

EDIT: Leaving this thread. I do not like arguments with snarky comments.

Well that's quite a luxury to be able to be that discerning.

I was just hoping for a general answer to the significance of flow limitations, but there doesn't seem to be a simple answer.

There is, and it's clear that the one offered above, unable to be supported, ain't it.

[MyIdaho]

EDIT: Leaving this thread. I do not like arguments with snarky comments.

Well that's quite a luxury to be able to be that discerning.

I was just hoping for a general answer to the significance of flow limitations, but there doesn't seem to be a simple answer.

There is, and it's clear that the one offered above, unable to be supported, ain't it.

Too bad the thread got derailed. Rubicon, more than one answer was given relative to the importance of flow limitations. Which answer do you agree with and which do you think is unsupportable? It is only fair for you to provide a clarifying answer.

[Rubicon]

It is only fair for you to provide a clarifying answer.

Well, life's not fair now, is it?

The larger issue (as I see it) is that people look at the definition of UARS, see "an RDI <5" and nothing else and think they're going to solve all their problems with a CPAP machine.

After years of xPAP therapy, and in some cases, surgery or multiple surgeries, these people feel no better, or worse.

Insert Georgie Santayana meme here.

[MyIdaho]

It is only fair for you to provide a clarifying answer.

Well, life's not fair now, is it?

The larger issue (as I see it) is that people look at the definition of UARS, see "an RDI <5" and nothing else and think they're going to solve all their problems with a CPAP machine.

After years of xPAP therapy, and in some cases, surgery or multiple surgeries, these people feel no better, or worse.

Thank you for the clarification and my apologies for missing earlier in the thread that you agreed with LL. I rarely look at my data but when I do, I glance at both FR and FL. My therapy is pretty well dialed in, no need drill down into the nitty gritty... Sleep like a baby!

[Rubicon]

...you agreed with LL.

Not necessarily with Jason, but rather the definition of RERA, which comes from Da Rules:

If electing to score respiratory effort-related arousals, score a respiratory event as a respiratory effort-related arousal (RERA) if there is a sequence of breaths lasting ≥ 10 seconds characterized by increasing respiratory effort or by flattening of the inspiratory portion of the nasal pressure (diagnostic study) or PAP device flow (titration study) waveform leading to arousal from sleep when the sequence of breaths does not meet criteria for an apnea or hypopnea.

However, since most users cannot determine when flattening generates an arousal, it seems to me DIYers decided to try to wipe out all FLs to be on the safe side.

Will the CPAP Police arrest you in the middle of the night for a Class B Felony if you try to do that?

Probably not.

So what's the downside of clubbing all the FLs to death?

Higher than necessary pressures and potentially more leaks.

If that's not a problem tho, who cares.

But again, what can be an issue ("IMHO") are those users who claim to have UARS without meeting the definition (the second part, RERAs >5). Without sleep disturbances, daytime sleepiness cannot be blamed on UARS and trying to treat something that isn't there is futile.

Further, if after a few years of DWing w/o improvement, maybe the issue isn't something that is CPAP-able?

[Rubicon]

I would also argue that EDS would be generally related to the severity of the RERA Index (i.e., not possible that @4.9 you're fine, @5.1 you're completely debilitated).

But hey, what do I know? I'm just a retired HCW who only visits Upstate New York.