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EPR Settings and Flow limits
#21
RE: EPR Settings and Flow limits
If there were more of them yes. I would maintain these settings (EPR=3,fulltime) for a while. The CA events should diminish over time
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#22
RE: EPR Settings and Flow limits
Okay. I will keep going with it for now. Thank you.
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#23
RE: EPR Settings and Flow limits
Hello everyone.
Please be patient with me, because I am still trying to get a good night's rest. 
I recently had a very unrestful night with 7 CAs only. It was a night where I felt like I hardly slept at all. So I took my EPR back down to 2 and changed my pressures. I had one night with maybe 3 apneas and increased flow limits. On the second night at this, my apneas shot up. 
I just switched back to an EPR of 3 and my flow limits went down but had many apneas, hypopneas and RERAs. I am wondering if some of the problem stems from mouth leaks, as I have been using a chin strap that does not quite hold my mouth shut. I tried taping, but feel it is dangerous because I do have nasal congestion. So, I am wondering what to do for tonight. I was going to try a night at 10.40 minimum pressure with EPR 3 and see if I can get a good night's sleep again. I know you said to give it time before, but it had been about a month at EPR 3 and I was having some restless nights. I am looking into a new chin strap or, possibly, even a cervical collar. But aside from that, do you see anything in the tidal volume or insp /exp time that could be problematic in either scenario?
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#24
RE: EPR Settings and Flow limits
and one more
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#25
RE: EPR Settings and Flow limits
I don't see any difference between 2 and 3 EPR in your results except for a slight increase in flow limits with EPR 2 and an increase in pressure with EPR 3. I think the increase in pressure is due to occasional OA events and you apparently need about 8.4 cm EPAP pressure to avoid most obstruction. OA events are occuring in clustered pairs which suggests some of it is positional, but that is too infrequent to advise you pursue positional correction. Your best results appear to be with higher EPR, but I would consider increasing minimum pressure slightly with EPR 3. The pattern of events with EPR 2 is less clearly associated with pressure.
Sleeprider
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#26
RE: EPR Settings and Flow limits
Hi Sleeprider. I sometimes have very few apneas with EPR2 but more flow limits. Do you think I should try increasing pressure to at least 11 with EPR 3? Also, anything unusual with tidal volume, insp time and exp time?
Maybe some of the OA clusters have to do with my mouth opening. I am trying to fix that.
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#27
RE: EPR Settings and Flow limits
DJCpap thanks for your posts. And thanks to all that help you here.
DaveL
compliant for 35 years /// Still learning!

ResMed N20; ResMed P30i modified headgear; F&P Evora Full FFM



I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

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#28
RE: EPR Settings and Flow limits
Hello again! 

I have inched up my minimum pressure slowly to 10.8 (someone suggested getting to 11) and I am finding my AHI has been higher. I am noticing that I seem to be having very vivid and strange dreams, so not sure if the settings are causing me to have more REM sleep (my apnea pre-treatment was severe in REM) or if I am having oxygen desaturations or both. I have nothing against dreaming! I have a history of intense dreams, but I often wondered if many were the result of the apneas I was having in REM. Anyway, after my second to the last arousal, I was trying to get back to sleep and put an oximeter on. My oxygen was fluctuating between 95/96 while I lay awake trying to sleep and my heart rate went as low as 50. I woke up just as I was falling asleep and my oxygen was 94. I know this is normal, but I was asleep for about 5 seconds. So I am wondering if it is going lower. But my real question is still whether or not an EPR of 3 is working. When I had an EPR of 2, my AHIs were under 1 pretty much every night. My flow limits in the 95% were .01 or .02, now they are .00 in 95%. Should I keep setting like this a little longer? I just worry because I wake a little bit headachy and want to make sure it does not have to do with oxygen levels. Also, do other things looks normal? Resp rate, tidal volume, insp rate, etc?
THANKS
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#29
RE: EPR Settings and Flow limits
CA events are above OA and flow limits are non-existent. Pressure is not changing much through the night with less than 1-cm variation between minimum and 95%.. You certainly don't need our permission to reduce pressure to a more comfortable minimum that worked better. If flow limits become present, the Autoset will increase pressure without the need for higher settings. Take it back where you felt best.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#30
RE: EPR Settings and Flow limits
The CAs happened this morning when I was half awake and trying to get back to sleep. 
I guess I am wondering if I should try a lower pressure but keep EPR at 3 or take the EPR down to 2. I think I have more awakenings at 2 but much lower AHI. I know we are not supposed to chase numbers.
Also, just asking advice. I know it is ultimately up to me. I just get very confused.
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