Channel Sponsor: cpapsupplies.com/lefty Use my CPAPSupplies.com (affiliate link): bit.ly/38yPlXk Don't forget discount code: LEFTY20 if all else fails! Have a PAP Analysis with me at: axgsleepdiagnostics.com. Thank you for watching!
I’d having 250 or more FL each night something I need to get looked into? I only came across this today after downloading Oscar as I’m really struggling with tiredness but my AHI are under 5 😞
As a very satisfied customer I highly recommend Jason’s PAP analysis to anyone. Extremely educational, informative and helped me tremendously. You rock Jason!
My flow limitation was constantly at 95% 0.22 in OSCAR. Woke up feeling exhausted every morning. Turned on EPR to 3 and they went down to 0.04 and waking up feeling rested. To add: I'm a tiny, very active lady and I don't even snore. OSCAR showed flattened breaths like in the video but worse. Thought they were cardiogenic oscillations at first.
When you say 95% does that mean you were registering flow limits at 0.22 for 95% of the night?? Or ?? Sorry I’m new & trying to learn about flow limitations
Do you have UARS or OSAS? Are you making progress with it? Some suggest for UARS BIPAP with higher pressure support to eliminate these flow limitations. Just my 2 cents. hope the best for you!
Nice short video. I've still been using the flow limits graph to narrow in on interesting areas of the night, but I can see how looking only at flow rate is more useful to understand the breathing patterns and if there is an arousal. Jason's CPAP analysis zooms are great!
Menopausal women and post menopausal women are now recognised ( in academic papers) as having more flow limitation issues as opposed to hypopneas and apnoeas - so there is something about knowing the total time you are in a ‘flow limitation’ state and how severe they are.
That dude was on CPAP but on APAP on my Airsense 10 flow limitations drive pressure up and down even when an AHI event hasn't been flagged. After using a camera to record my sleeping position, jaw position, and combining that with sleep data from my galaxy watch. I found out I needed the travel pillow you recommended in another video and it's definitely reduced my overall pressure swings on APAP. I even consider switching to CPAP mode based on my testing
Thanks Jason for bringing this up. ResMed APAP uses flow limitation as a criteria to increase pressure (along with the variety of apneas, and snore). For me, FL is the primary driver of pressure increases throughout every night, whether a RERA (or unflagged arousal) is present or not. So, Resmed considers FL important, right or wrong, maybe as just a signal to the machine that worse may occur - so, it keeps the pressure up just in case. Maybe it is helping me, but I still find it annoying. FL could also be a sign of Upper Airway Resistance Syndrome (UARS), so maybe for some it is distinctly important.
ResMed doing this is a commendable effort, but it relies on the assumption that FL can be resolved with static pressure (CPAP). In my experience with UARS that isn't always adequate. I rely on pressure support (breathing assist) to "cheat the physics" of a restricted airway and prevent RERAs from occurring. I used to be on BiPAP (fixed PS) while I now use ASV with PS on a range between 5 cmH2O and 10 cmH2O. I do need 10 cmH2O of PS during brief moments to breathe freely.
good info. i really need to follow more pertinent info like this regarding my pap data. FL are indeed the data du jour regarding oscar data in the forums. the flow FR is--by far--the best indicator of issues. oh, and as an aside. maybe all the folks (myself included) who enjoy jason's vidyas can throw down a couple bucks each to get him a better tripod for his videos. it always looks like he's hunching over a bit to get in frame. it looks uncomfortable. he may ne a natural "huncher", but it appears like he's doing it because his camera/phone isn't high enough up.
I'm glad I saw this video because before respironics came out with a dreamstation 2 I would look at my oscar data from dreamstation 1 and I would see a ton of flattening of my flow waves and I could not get any of my doctors to take it seriously even though I am completely exhausted all the time even with consistent CPAP usage. I'm positive it was causing a ton of arousals. I've tried higher pressures to no avail. My ENT was trying to get me scheduled for a septoplasty for my deviated septum and a soft palate advancement but insurance won't cover the soft palate.
I really need a good breakdown explaining how to troubleshoot your gain, sensitivity and filters. Can you recommend a good source if it’s not something you like to cover? I can find the definitions but I need to see how to make changes and why.
Helpful info as always! Just curious if sometime you might chat about Cheyne Stokes Respiration: what are causes, what machines (if any) can help with it.....
I did a PAP Therapy Analysis with a guy that had REALLY bad Cheyenne Stokes. I'll see if I can screen record our next session so I can speak about it a little and go over our plan in his particular case. Pretty interesting stuff.
@@SkwrHdz An arousal is something that happens in the brain, and it can be identified on the EEG (brainwave recording). It's basically the brain saying "breathing is compromised, I need to wake up and fix that" except you don't fully wake up and you don't consciously remember it. What happens most of the time is that there is some jaw thrusting and tongue thrusting (bruxism) and people can flail with their arms. It also messes up the sleep architecture and causes most symptoms associated with SDB that are most often ascribed to desaturation by laymen and doctors alike. Desaturation is bad, but scientific experiments (doi: 10.1016/j.smrv.2014.07.003) have refuted that. You can infer an arousal by looking at the waveform and seeing an abrupt resolution of the flow limitation, as Lanky shows in this video.
They're like less severe hypopneas. Hypopneas start at 30% reduction of amplitude. But there is no law of nature that says that you can sleep undisturbed as long as the reduction is under 30%. It's just an arbitrary threshold. So people with exclusively FL can suffer just as much as people with diagnosed OSA, it's just very hard to get a diagnosis. This is also called UARS.
@@cebruthius Flow limits (as determined by xPAP machines) are more about the shape of inhalation and don't necessarily involve a reduction in tidal volume and/or minute ventilation. Hence Jason's stipulation that flow limits without arousal aren't really relevant. I'd think with UARS that you'd still expect to see arousals (RERA, whether flagged by the machine or not).
@@kappa7 The problem is that not everything presents as an arousal, there can be Cyclical Alternating Pattern or other indirect manifestations of decreased sleep quality or fragmented architecture but getting a sleep study with CAP analysis is extremely rare. I had 2 full PSGs with almost zero scored arousals.
@@cebruthius Not disputing that there are instances where arousals (or at least poor sleep quality) are not evident in flow, but for many people chasing flow limitations is of minimal value. CAP analysis doesn't seem to be part of the AASM scoring rule book but is more commonly done in some other parts of the world...
@@semiephemeral9 😂. For “flow limitations”? Forums have some good people, but they tend to leave while the toxic ones tend to stay. Unlike us RUclipsrs!!! We just STAY TOXIC!!!! 😂
Some linux distros are directly supported - Ubuntu, Debian. For the 0.00001% of Oscar users - like myself - that have Archlinux it supported in the AUR...
Channel Sponsor: cpapsupplies.com/lefty
Use my CPAPSupplies.com (affiliate link): bit.ly/38yPlXk
Don't forget discount code: LEFTY20 if all else fails!
Have a PAP Analysis with me at: axgsleepdiagnostics.com. Thank you for watching!
I’d having 250 or more FL each night something I need to get looked into? I only came across this today after downloading Oscar as I’m really struggling with tiredness but my AHI are under 5 😞
As a very satisfied customer I highly recommend Jason’s PAP analysis to anyone. Extremely educational, informative and helped me tremendously. You rock Jason!
My flow limitation was constantly at 95% 0.22 in OSCAR. Woke up feeling exhausted every morning. Turned on EPR to 3 and they went down to 0.04 and waking up feeling rested.
To add: I'm a tiny, very active lady and I don't even snore.
OSCAR showed flattened breaths like in the video but worse. Thought they were cardiogenic oscillations at first.
When you say 95% does that mean you were registering flow limits at 0.22 for 95% of the night?? Or ?? Sorry I’m new & trying to learn about flow limitations
@@andresreyna4260 I think it means that 95% of the numbers were lower than 0.22. Could be wrong though.
Do you have UARS or OSAS? Are you making progress with it? Some suggest for UARS BIPAP with higher pressure support to eliminate these flow limitations. Just my 2 cents. hope the best for you!
This video was well done and had no flow limitations of knowledge.
Lmao
That was flownny
Nice short video. I've still been using the flow limits graph to narrow in on interesting areas of the night, but I can see how looking only at flow rate is more useful to understand the breathing patterns and if there is an arousal. Jason's CPAP analysis zooms are great!
Menopausal women and post menopausal women are now recognised ( in academic papers) as having more flow limitation issues as opposed to hypopneas and apnoeas - so there is something about knowing the total time you are in a ‘flow limitation’ state and how severe they are.
That dude was on CPAP but on APAP on my Airsense 10 flow limitations drive pressure up and down even when an AHI event hasn't been flagged. After using a camera to record my sleeping position, jaw position, and combining that with sleep data from my galaxy watch. I found out I needed the travel pillow you recommended in another video and it's definitely reduced my overall pressure swings on APAP. I even consider switching to CPAP mode based on my testing
Thanks Jason for bringing this up. ResMed APAP uses flow limitation as a criteria to increase pressure (along with the variety of apneas, and snore). For me, FL is the primary driver of pressure increases throughout every night, whether a RERA (or unflagged arousal) is present or not. So, Resmed considers FL important, right or wrong, maybe as just a signal to the machine that worse may occur - so, it keeps the pressure up just in case. Maybe it is helping me, but I still find it annoying.
FL could also be a sign of Upper Airway Resistance Syndrome (UARS), so maybe for some it is distinctly important.
ResMed doing this is a commendable effort, but it relies on the assumption that FL can be resolved with static pressure (CPAP). In my experience with UARS that isn't always adequate. I rely on pressure support (breathing assist) to "cheat the physics" of a restricted airway and prevent RERAs from occurring. I used to be on BiPAP (fixed PS) while I now use ASV with PS on a range between 5 cmH2O and 10 cmH2O. I do need 10 cmH2O of PS during brief moments to breathe freely.
good info. i really need to follow more pertinent info like this regarding my pap data. FL are indeed the data du jour regarding oscar data in the forums. the flow FR is--by far--the best indicator of issues.
oh, and as an aside. maybe all the folks (myself included) who enjoy jason's vidyas can throw down a couple bucks each to get him a better tripod for his videos.
it always looks like he's hunching over a bit to get in frame. it looks uncomfortable.
he may ne a natural "huncher", but it appears like he's doing it because his camera/phone isn't high enough up.
I'm glad I saw this video because before respironics came out with a dreamstation 2 I would look at my oscar data from dreamstation 1 and I would see a ton of flattening of my flow waves and I could not get any of my doctors to take it seriously even though I am completely exhausted all the time even with consistent CPAP usage. I'm positive it was causing a ton of arousals. I've tried higher pressures to no avail. My ENT was trying to get me scheduled for a septoplasty for my deviated septum and a soft palate advancement but insurance won't cover the soft palate.
I really need a good breakdown explaining how to troubleshoot your gain, sensitivity and filters. Can you recommend a good source if it’s not something you like to cover? I can find the definitions but I need to see how to make changes and why.
Cpap legend
Where's the cat ?? 🐈
what are the measurement units of flow limit ?
What mystifies me is that my 2nd and 3rd PSGs scored basically no arousals. What about CAP analysis?
Helpful info as always! Just curious if sometime you might chat about Cheyne Stokes Respiration: what are causes, what machines (if any) can help with it.....
I did a PAP Therapy Analysis with a guy that had REALLY bad Cheyenne Stokes. I'll see if I can screen record our next session so I can speak about it a little and go over our plan in his particular case. Pretty interesting stuff.
@@Freecpapadvice thank you!
Jason, can you explain just what is a CPAP arousal?
You mean an EEG arousal? The CPAP doesn't have arousals, it doesn't have a brain :)
Well, I’m still totally in the dark about what Jason is referring to when he talks about arousals in this and other of his CPAP YTube videos.
@@SkwrHdz An arousal is something that happens in the brain, and it can be identified on the EEG (brainwave recording). It's basically the brain saying "breathing is compromised, I need to wake up and fix that" except you don't fully wake up and you don't consciously remember it. What happens most of the time is that there is some jaw thrusting and tongue thrusting (bruxism) and people can flail with their arms. It also messes up the sleep architecture and causes most symptoms associated with SDB that are most often ascribed to desaturation by laymen and doctors alike. Desaturation is bad, but scientific experiments (doi: 10.1016/j.smrv.2014.07.003) have refuted that. You can infer an arousal by looking at the waveform and seeing an abrupt resolution of the flow limitation, as Lanky shows in this video.
@@cebruthius Thanks VERY much for a reply I think I understand. Much appreciated.
Dr Krakow says NO to flat tops. He like da round tops. Da kine dat ASV make.
I've never understood flow limits. It sounds like they're just redundant to what your breathing is, is that right??
They're like less severe hypopneas. Hypopneas start at 30% reduction of amplitude. But there is no law of nature that says that you can sleep undisturbed as long as the reduction is under 30%. It's just an arbitrary threshold. So people with exclusively FL can suffer just as much as people with diagnosed OSA, it's just very hard to get a diagnosis. This is also called UARS.
@@cebruthius Flow limits (as determined by xPAP machines) are more about the shape of inhalation and don't necessarily involve a reduction in tidal volume and/or minute ventilation. Hence Jason's stipulation that flow limits without arousal aren't really relevant. I'd think with UARS that you'd still expect to see arousals (RERA, whether flagged by the machine or not).
@@kappa7 The problem is that not everything presents as an arousal, there can be Cyclical Alternating Pattern or other indirect manifestations of decreased sleep quality or fragmented architecture but getting a sleep study with CAP analysis is extremely rare. I had 2 full PSGs with almost zero scored arousals.
@@cebruthius Not disputing that there are instances where arousals (or at least poor sleep quality) are not evident in flow, but for many people chasing flow limitations is of minimal value. CAP analysis doesn't seem to be part of the AASM scoring rule book but is more commonly done in some other parts of the world...
@@kappa7 Let's just keep it succinct. The AASM is stuck in the stone age.
APAP mode uses flow limit increases to adapt the pressure, doesn't it?
Only on ResMed Autoset devices
There is a certain forum that seems very obsessed with "treating" flow limitations and using EPR.
Or so I've heard.
Yeah. God bless them. Their advice sends me TONS of business.
@@Freecpapadvice I think they mean well but seems like the solution is "turn on EPR"
Might check out the other forum.
@@Freecpapadvice and again today another "turn epr on". From the same crew. It's like a Swiss army knife. Lol
@@semiephemeral9 😂. For “flow limitations”?
Forums have some good people, but they tend to leave while the toxic ones tend to stay.
Unlike us RUclipsrs!!! We just STAY TOXIC!!!! 😂
@@Freecpapadvice appears to be for some odd hyperventilation stuff this time.
I have tried unsuccessfully several times t
O download OSCAR on my IPad, does it need to be downloaded to a pc?
PC or Mac
@@SamsomiteMight pc
@@fjcook or Mac
Some linux distros are directly supported - Ubuntu, Debian. For the 0.00001% of Oscar users - like myself - that have Archlinux it supported in the AUR...
Yep, very handy that it’s in the AUR!