Cpap Newbie - Help with pressure settings

[Dormeo]

Your chart still indicates that your EPR is off. Could you triple check that you've selected and confirmed EPR on at 3? We should be seeing two lines on your pressure graph and a delta of 3 for between your pressure and your EPAP numbers in the left-hand panel.

[Crimson Nape]

One guess about the EPR is you have it set to "Ramp Only" and not "Full Time". Since you aren't using the ramp feature, it is not showing up.

- Red

[georges089867]

Hi guys,

My bad, I uploaded the wrong screenshot.

Here's the latest Oscar graphs from last night when I had the EPR set at 3.

[Dormeo]

Your FLs were better, but just marginally. Keep the EPR for sure, though.

I see that on both nights, you were using the machine for less than 7 hours. That means your actually sleep time was less than that. You may simply need more. I see that you're a night owl. Any chance you can go to bed maybe an hour earlier? It's worth a shot to see whether that would give you a more refreshing night's sleep.

Are there any other aspects of routine sleep advice you might need to follow more diligently? Here's the usual list:

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.
• Establish a relaxing bedtime routine.
• Use your bed only for sleep and sex.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
• Limit exposure to bright light in the evenings.
• Turn off electronic devices at least 30 minutes before bedtime.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
• Exercise regularly and maintain a healthy diet.
• Avoid consuming caffeine in the late afternoon or evening.
• Avoid consuming alcohol before bedtime.
• Reduce your fluid intake before bedtime.

I was sure this was all so vanilla it couldn't possibly help me -- and yet it did. Fingers crossed there will be some help for you too, somewhere on the list.

[georges089867]

Sure. I'll try to go to sleep 1-2 hours earlier tonight to see if that makes a difference.

Is there any other way to help control the flow limitations though? I keep waking up every hour or so throughout the night; sometime with my heart beating fast.

[Gideon]

You can attempt increasing your min pressure, that is the old school method but I doubt you will be successful there. Don't let that stop you from trying, I love being made a liar in these matters.

It is via increase in the differential pressure between inhale and exhale pressures (EPR) that manages flow limitations. The next step is a BiLevel such as the VAuto where PS/Pressure Support above the 3cmw EPR limit may be applied. This is where you are more likely to find success. In this you will most likely be on your own, with no insurance since they will see your AHI of under 5 and thus you are "cured".

[Dormeo]

Just FYI, I bought my lightly used VAuto on my own dime -- very lucky to be able to afford to do that -- and it dramatically reduced my FLs.

The big unknown is whether reducing FLs will help you sleep better and feel more rested. It's cheaper and easier to see whether getting more sleep might do the trick, though if you can afford the VAuto comfortably, you could do both at the same time.

[georges089867]

Thanks guys.

I'll try working on my sleep hygiene more and upping my min pressure a bit to see if that works over the next few weeks.