[CPAP] Trouble with leaks and pressure

[Sleeprider]

You will not likely increase OA events with lower pressure, but whether flow limitation is improved or worsened with lower pressure is a trial and error experiment. Maintain EPR and try lower pressures, and observe the effects and whether you feel better or worse. You can try minimum pressure as low as 7.0, maintain EPR, and try lower maximum pressures. You are currently at 11.6, so experiment with lower pressures. The objective is to maintain tidal volume at current levels or higher, and not increase flow limits. Most of all do what is comfortable. My impression is your comfort level would be better with pressure support of 4 to 6 cm in bilevel, but your excellent AHI suggests to me that getting bilevel therapy will not be deemed a medical necessity, and you will only obtain bilevel if you buy it out of pocket. In other words yoy are ding great, and better than most apnea patients, but there is room for improvement that insurance or health care will not pay for.

[Kadenz]

First of all: I have had Cpap for a few months, and have been so Grateful for this forum, and everybody who is sharing tips and information here. I am still struggeling With leaks and pressure. I startet With pressure 6-11. The max pressure was later set to 13, then 15, and finally 17 because the Controls showed that the pressure just wasnt high enough. In my last visit to the hospital, the nurse suggested that I could turn of the EPR. Later I read that the EPR makes the pressure lower than the actual max pressure. My EPR was set to 3, and I turned it off and felt that it was much easier to breath without it. Then I read that it might be better having a Shorter range between min/max pressure. In the beginning of april I changed the min to 7, which went well. I few days later I went to 7.6. It became a bit uncomfertable, so I reduced it to 7 again. At the same time I set the max pressure from 17 to 16 because it seemed that without the EPR, my Maximum pressure went Down to 13-14 at night. I have before and after these changes have trouble With leaks most Nights. I can see that I have manage to make them smaller after I made these changes, but they come more often. I Wonder why? I have tried to tighten the mask better, but I still get leaks. Does the encreased pressure make it harder to avoid leaks? I also have clusterapnea, some of them over 60 second long. Sometimes it happens when the leak is on a minimum and the flowlimitation is zero. Why? What would be the best min/max pressure for me? I can see that in 95% of the time over a long periode the pressure was lower than 15. But on Nights With large leaks it seems like it isn't high enough max pressure 16.

I would be very greatful for tips on how to do better. Usually I am at 2-3 AHI now. But I am still so tired. I Wake up several times during the night, somtimes I feel exhausted when I Wake up in the middel of the night. That happens when I have had a night With 10-15 OSAS in a row.
Thank you!

Are you using your machine on autoset (ie, adjusting pressure) mode? If not, my advice is to turn that on. If you have the minimum pressure on at the default of 4 is best as it adjusts upwards to the level you need from that starting point. Also, in my experience, having the humidifier on auto works better than adjusting it manually.