11-08-2023, 02:39 PM
RE: My first report here
(11-08-2023, 02:00 PM)Frankiboy Wrote: Yes, I have changed it. Epr is now 3.
I'm here to learn and find the right setting and take your advice, but I've come a long way from my titration with 7 and EPR 1, and nothing has really improved since then, so I wanted to sleep with the settings for a few days in the hope that I'll get used to them.
But that doesn't seem to be working and I will now really increase and thank you. Sorry, I really didn't want you to think I didn't respect your knowledge.Y
Look, CPAP is complicated but you have a couple opportunities to improve your therapy should you choose to do so.
Here's the order I'd try to solve your poor sleep:
1. obstructive events
2. hypopneas
3. central apneas
In order to solve your obstructive events, you'll want to increase your minimum pressure by one and sleep with the settings for 2-3 nights.
I'm a big fan of simplifying therapy so I'd actually recommend turning EPR off while you search for your minimum therapeutic pressure. Another reason to turn EPR off temporarily is the pressure difference EPR causes can contribute to increasing central apnea via c02 wash-out. With remaining obstructive events indicating your pressure is too low, adding more EPR is lowering the pressure further and likely making your therapy worse as evidenced by your latest screenshots.
As you find your minimum pressure you'll likely start seeing less hypopneas (dark blue) as well. Once you find your optimal pressure that solves all obstructive events, if there are remaining hypopneas then you can consider adding EPR slowly to see if the pressure differential helps.
You may find that once you find your minimum pressure + optimal EPR that switching to constant pressure mode (CPAP) may benefit you as well because pressure fluctuation can also cause central apneas.
There is a hint of evidence you may have some positional apnea as well considering clustered obstructive events so watch out for that. This is due to your sleeping position.