Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

[CPAP] Optimal AHI
#11
Mike, your median pressure is a bit over 12 with settings of 8-16 with EPR at 3.0. I'm thinking your minimum pressure of 8.0 is a bit on the short side, and if you keep EPR at 3, would suggest 10 might work out a bit better.

As an alternative to increasing minimum pressure, I'm going to suggest you reduce EPR instead. Let's stay with 9-16. but put EPR at 1. I think this will result in the lowest AHI.

The organization for graphs that is most useful is described in the first link in my signature line.
Post Reply Post Reply
#12
I see pressure climbing almost immediately to what I think is 11+ with settings of 8-16 and no EPR
I see a fair number of CA events so I'll ask again, (sorry if I missed it) does your wife have any mention of Central Apnea or Complex Apnea from her sleep study? Was the sleep study at home or in lab?

Except for the CA portion I would raise the minimum pressure to 10 but would not expect that to do much because it is below the minimum pressure the machine is holding all night. If these are "real" CA events we need to be cautious, if we don't know we still need to be cautious. ROT Higher pressures tend to make CA worse. whereas higher pressures make obstructive events less.

The intent, without further info would be to slowly (.2cmH2O) every third night or longer and watch closely to see what happens.
Post Reply Post Reply
#13
SleepRider I read EPR was Ramp Only, otherwise cutting the EPR would have been my 1st choice. I don't know, can EPR be set for Only in the Ramp? I think so because of the consistency of the pressure
Post Reply Post Reply


#14
Thank you for the suggestion. I'll change the setting to 1. 

I think the last image I posted followed your instructions. I spent most of the afternoon with a learning curve. Did I miss something? 

Thank you again.

Mike
Post Reply Post Reply
#15
(03-22-2017, 06:30 PM)bonjour Wrote: I see pressure climbing almost immediately to what I think is 11+ with settings of 8-16 and no EPR
I see a fair number of CA events so I'll ask again, (sorry if I missed it) does your wife have any mention of Central Apnea or Complex Apnea from her sleep study?  Was the sleep study at home or in lab?

Except for the CA portion I would raise the minimum pressure to 10 but would not expect that to do much because it is below the minimum pressure the machine is holding all night. If these are "real" CA events we need to be cautious, if we don't know we still need to be cautious.  ROT Higher pressures tend to make CA worse. whereas higher pressures make obstructive events less.

The intent, without further info would be to slowly (.2cmH2O) every third night or longer and watch closely to see what happens.

She had a sleep study in a lab in June 2014 and May 2016. Nothing in the reports that I have mentions either Central or Complex Apnea. Sounds like she needs to touch base with her sleep study doctor?

Thanks
Post Reply Post Reply
#16
Not necessarily, It would be very unusual for a sleep study to miss CA. I'll let SleepRider override me if he disagrees.
Having some CAs is not unusual, We can re-evaluate if the numbers climb.

Set the minimum to 10 as both of us has suggested. Then we look again.
Post Reply Post Reply


#17
As a relative newcomer, I hardly feel qualified to offer a contrarian opinion but looking at the graphs it looks like the EPR is off except for the ramp period. In my personal case, when the EPR is off my events rise in a fashion not dissimilar to what's posted here. I do far better on EPR 3.

Also, it looks like 97% (or so) of the events are happening with a pressure of about 13, so raising the minimum to 10 with no EPR doesn't strike me as the answer.

I'd be tempted to turn the EPR on and see how that goes. It would likely provide better comfort and might drive down the numbers.

Bill
Post Reply Post Reply
#18
SpyCar you are correct. It is a cautious 1st step. I would not be surprised if we ended up near 12+. But
We are seeing fairly good results that could be a bit better.
Just a bit of patience.
Post Reply Post Reply
#19
Just to make sure we're all on the same page, the image I was commenting on is below.  This shows settings at 8-16 and EPR at 3.  My suggestion for starters was to reduce EPR. This was intended to both address the obstructive component and CA component.  What I missed is that EPR was only on during Ramp.

OA appears to be real based on a persistent flow limitation in the graphs. So I agree an increase in minimum pressure is needed to address the OA. The amount of flow limitation has me wondering if perhaps a bilevel approach might help, which in this case means having EPR full time. In theory we cold move the minimum pressure to 10, and use EPR at 3 full time and that would provide the "pressure support" to reduce the hypopnea and flow limitation. The auto function would allow IPAP to rise to 16 max, allowing a maximum pressure of 16/13.

Good catch Fred and Spycar, I missed this.

[Image: attachment.php?aid=3315]
Post Reply Post Reply


#20
OK - EPR on full time @ 3 and see what happens next couple of nights.

Thanks
Post Reply Post Reply


Possibly Related Threads...
Thread Author Replies Views Last Post
  " An optimal minimum IPAP-EPAP differential is 4 cm H2O" Shin Ryoku 9 301 11-12-2017, 07:39 AM
Last Post: Shin Ryoku
  Resmed S9 optimal battery runtime configuration questions Crimson Nape 4 202 09-10-2017, 10:57 AM
Last Post: Crimson Nape
  [Pressure] Help with optimal settings on my ResMed AirCurve 10 VAUTO (using Swift LT Nasal Pilw) TimmyT 39 1,045 08-22-2017, 10:00 PM
Last Post: PaytonA
  [Pressure] ASV optimal settings Jimmy D 12 1,384 06-16-2016, 09:26 PM
Last Post: Jimmy D
  optimal mask purchasing Paptillian 3 1,269 07-23-2013, 03:41 PM
Last Post: PaulaO2
  [CPAP] Optimal Pressure Settings - Range EasyBreather 3 2,791 07-10-2013, 05:30 PM
Last Post: zonk

Forum Jump:

New Posts   Today's Posts




About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.

For any more information, please use our contact form.