elyfrank wrote: ↑Tue Sep 17, 2024 12:11 pm
Are all those Flow limitations flags "normal" on the event flags?
Without seeing more data where the flow limitations are actually scored, no-one can tell you if they're "normal" or not.
In general, when a machine scores a flow limitation, the inhalation part of the respiration curve is distorted in some way that Resmed's algorithm have identified as indicating there is a
potential for the upper airway to collapse. Hence, when running in AutoSet mode, the machine will raise the pressure when it detects flow limitations.
The problem is that "flow limitations" can be caused by benign things like nasal congestion. In general, if the flow limitations get better when the pressure increases, the probability that they are
real in the sense of the airway being unstable enough to potentially collapse goes up. If the flow limitations don't get better or get worse as the pressure increases, the probability that the "flow limitation" is an early indication that the airway is threatening to collapse goes down.
Also, do you think all my continuous arousals have to do with soft palette prolapse?
I have no idea what might be causing your arousals.
Sometimes I find myself trying to exhale thru my nose I can't, my soft palette blocks the air and it comes out thru my mouth.
A quick Google search indicates that a breathing pattern of breathing in through the nose and out through the mouth
might be a symptom of a soft palate prolapse. But you really need to talk to about this to a doctor.
elyfrank wrote: ↑Fri Nov 08, 2024 5:14 pm
Anybody thinks it could palatal prolapse?
A quick Google search turns up one academic articles on palatal prolapse, expository flow limitations, and sleep apnea from 2018.
You can access it for free at is at
https://pmc.ncbi.nlm.nih.gov/articles/PMC5915321/
The authors do say that palatal prolapse can cause significant movement in the soft tissues of the soft palate and that palatal prolapse can lead to arousals in patients with sleep apnea. The authors make the claim that their work shows that a particular kind of expiratory flow limitation has a high correlation with palatal prolapse as determined by other equipment, and that the correlation is significant enough to assume that if the particular kind of expiratory flow limitation is present, one can assume that a palatal prolapse has occurred. It's not clear to me if the lab studies were done while patients were using CPAPs or not---I've only skimmed the article, and not read the "Methods" and "Results" sections carefully. To really understand how the authors are determining that a palatal prolapse has occurred and the significance of that event, one should take the time to read the "Methods" and "Results" sections very carefully. The "Discussion" section is another section that I have only skimmed, but it warrants reading it carefully if one wants to understand what the authors did in the study and why they think investigating expiratory flow limitations that are correlated to palatal prolapse may be important in understanding and/or treating OSA.
And it would also be worth reading the "Clinical Significance" section rather closely as well, and I have not yet done that.
The paper includes the following image:
[
with the caption:
My understanding of this dense piece of writing is that the the V graph (the top graph) is probably the closest graph to what one of our Resmed CPAP machines might record for the flow rate during a period of breathing with expiratory flow limitation that is suspected of being caused by a palatal prolapse. But the units are different (L/sec instead of L/min), so the scale of that graph is far different than what we would see in the Flow Rate graph drawn in Oscar.
Finally, for what it's worth, my understanding is that our machines are not currently programmed to flag
expiratory flow limitations nor do they respond to them by increasing the pressure.
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