Assistance needed for set up

[Gideon]

We are trying to use EPR as a therapeutic value as it would be used on the next machine up, a bi-level such as the Vauto.  For whatever reason Flex on PR machines just will not work that way.  We are limited to 3cmw where a bi-level can go much higher.
Bi-level pressure support (PS) is what we use EPR for and that is used to treat hypopnea and flow limitations.  ResMed says it is just a comfort setting.

Do you know the breakdown of events last night?  
Going to 0 EPR is one of the options that I have considered.  That will likely increase your hypopnea and flow limitations.
It is unlikely that the pressure change from 13  to 12.4 caused an increase in AHI.
Guess: the increase in EPR could have aggravated your CA
Guess: your CA randomly increased for the night. IMHO this is most likely what happened
fact: CA on an Auto-CPAP will be consistently inconsistent.

The best option IMHO is to leave the settings where they are at.  
The rule of thumb would be to increase pressure to 14 because your AHI went up. I don't think this is what we should do in this case.

[Mttnkatt]

BONJOUR...I'll ride it out another night with these same settings to see what's going on 

My problem is when I take the sd card out to transfer the data to my computer, when I put the card back in there's an error message and I have to erase the card.  Is that the norm for this machine?

So the card is clear now and ready to record tonight.

[Gideon]

No the error is not normal.

[jaswilliams]

BONJOUR...I'll ride it out another night with these same settings to see what's going on 

My problem is when I take the sd card out to transfer the data to my computer, when I put the card back in there's an error message and I have to erase the card.  Is that the norm for this machine?

So the card is clear now and ready to record tonight.

As you are using a resmed S9 this is normal. Lock the SD card before putting in your PC just remember to unlock after removal

[Crimson Nape]

. . . My problem is when I take the sd card out to transfer the data to my computer, when I put the card back in there's an error message and I have to erase the card.  Is that the norm for this machine?

Here is a utility to disable the System Volume writing option on your PC:

Windows System Volume Write Disable/Enable Utility

[Mttnkatt]

JASWILLIAMS

As you are using a resmed S9 this is normal. Lock the SD card before putting in your PC just remember to unlock after removal


Exactly right!!  What do you mean by lock the card?

[Mttnkatt]

       


Last nights chart...

Bonjour is on the money!!!!!

[herbm]

The EPR is not likely the primary reason for an increase.

Lowering the pressure when you needed to raise it is more likely.

[jaswilliams]

JASWILLIAMS

As you are using a resmed S9 this is normal. Lock the SD card before putting in your PC just remember to unlock after removal


Exactly right!!  What do you mean by lock the card?

There is a small white tab on the left of the sdcard pull it back to lock it to prevent the pc writing any files to the sd card     

[Gideon]

Great results.  While the OA went up marginally the CA went down a bit too.  While flow limits are a bit higher than I would like to see (try an EPR of 4 --- can't) they are better managed at 3 than 2.  Anything we do will be a balancing act between OA and CA.  In general raising pressure will decrease OA and increase CA but the CA levels will be random and inconsistent. Lowering pressure will do the opposite. The only way to fix this issue would be to use an ASV but I'm not at all sure that you need to.

Adjustments from here should be small and for longer periods of time, 5-7 days because of the issue, which is showing managed in last nights charts of CA being inconsistently managed on any CPAP machine.

Your main drive for setting changes should be based on your symptoms, How do you feel?  Working on improving comfort.

Fred