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Cannot get AHI down
#11
I see a lot of leaks, it looks to me like you may have a lot of leaks causing you to constantly be aroused, and the arousals then look like clean airway events as you move between sleep states. Fix the leaks as a first step.
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#12
Thanks a lot.
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#13
Roy, generally people with abundant CA events do best with EPR off and reducing fixed pressure until OA begins to appear in the results. For you, that may end up being as low as 8-cm You will need to experiment to find that spot where AHI is minimized through no EPR and lower pressure. If acceptable results cannot be achieved on CPAP, then the next step is Bilevel ASV. I think we can get your event rate fairly low. Take pressure to 10 with EPR off and see if CA rate is reduced.
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#14
Thumbsdown 
I also have a lot of CA events and had to turn off the EPR. That seemed to fix my problem with CA events.
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#15
The past 3 nights I have tried sleeping with EPR off and I can report that my CA events were quite reduced as well. I find I don't need EPR as much if my minimum pressure is around 8 as opposed to say 10. Turns out setting my minimum to 8 helped reduce my overall AHI score.

But everyone is different and there is no shame whatsoever in using EPR if that is what makes it more comfortable to ensure one uses the machine. During my first month I found the EPR really helped me get comfortable with the treatment and ease my breathing.

Roy, I think you should follow Sleeprider's advice though and not use EPR. He really knows what he is talking about and I would trust his advice.
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#16
As Marillion said, everyone is different. For me EPR is not just a comfort feature. My statistics page shows that when I reduce EPR to 2, my AHI goes up. After a manometer pressure test, the tech forgot to restore the EPR, and my AHI jumped to more that 8 until I noticed the change.

It's not a matter of shame - it's what works for me. Maybe I should have a bi-level, but I don't.
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#17
(03-29-2017, 03:25 PM)pholynyk Wrote: As Marillion said, everyone is different. For me EPR is not just a comfort feature. My statistics page shows that when I reduce EPR to 2, my AHI goes up. After a manometer pressure test, the tech forgot to restore the EPR, and my AHI jumped to more that 8 until I noticed the change.

It's not a matter of shame - it's what works for me. Maybe I should have a bi-level, but I don't.

I never realized that for some, EPR can actually improve their AHI results.  I thought it was more of a feature to increase comfort on exhalation.  Thanks for that insight pholynyk.  This is good to know.
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