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High Hypopnea update
#1
Hi guys some of you may remember I posted a few days ago about my stubborn high hypopneas and I got some very helpful suggestions about how to deal with it. I've got a bit of an update - and some good news!

I had already tried increasing my pressures slightly and I didn't want to play around with that anymore until I've seen the sleep doc, but AshSF suggested switching on the EPR on my Resmed s9 Auto, which I'd previously not been using. I tried one night on the lowest setting, and lo and behold, the hypopneas dropped! I kept the EPR the same for a couple of nights to make sure it wasn't a fluke, and I've now cranked the EPR up to 2. They dropped again! In just over a week, the hypopneas have reduced from an average 38 per night, to just 7. Hallelujah!!

I know this is mystifying. Many people on here have said that EPR actually INCREASED their hypopneas, but I guess everyone is different. I will keep monitoring things and talk to the sleep Doc but I'm hoping I've cracked it this time. AHI is now hovering around 3, which I think can improve, but finally it's heading in the right direction, and critically, I am starting to FEEL a lot better. Thanks everyone for all your input.

Andy
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#2
This shows the importance of trying things. Sauce for the goose may not be sauce for...well, you get the idea.
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#3
Andy,
I have low apneas and hypopneas but my RERA's were high. This article talks about bipap therapy. My machine does not have it but it has exhale relief like yours. It brought my RERA,s way down by using it.
I hope it gives you some insight.
http://www.apneaboard.com/forums/Thread-...-and-BiPAP

Brad
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#4
(08-24-2015, 05:02 PM)car54 Wrote: Andy,
I have low apneas and hypopneas but my RERA's were high. This article talks about bipap therapy. My machine does not have it but it has exhale relief like yours. It brought my RERA,s way down by using it.
I hope it gives you some insight.
http://www.apneaboard.com/forums/Thread-...-and-BiPAP

Brad

Thanks Brad yes I wonder if the lack of relief on exhalation may have been worsening the hypopneas.
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#5
Andy. I am glad it worked for you. This is exactly what they do in bilevel titration (you can read a PDF document on Respironics website). First raise EPAP to eliminate all obstructive Apneas. Then use PS to raise IPAP to eliminate remaining hypopneas.

This can be used in regular CPAP/Auto machines but PS is limited to 1,2,3cm in Resmed's EPR and PS is fixed at 2cm in Respironics A-flex/C-flex+.

Some people may get some 'Clear Airway' events with PS but for most, they go away soon. Also, one needs to be careful to keep the EPAP at same level after switching on EPR/Aflex by adjusting the machine pressure (Equal to IPAP) accordingly.
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#6
(08-25-2015, 09:47 AM)AshSF Wrote: Andy. I am glad it worked for you. This is exactly what they do in bilevel titration (you can read a PDF document on Respironics website). First raise EPAP to eliminate all obstructive Apneas. Then use PS to raise IPAP to eliminate remaining hypopneas.

This can be used in regular CPAP/Auto machines but PS is limited to 1,2,3cm in Resmed's EPR and PS is fixed at 2cm in Respironics A-flex/C-flex+.

Some people may get some 'Clear Airway' events with PS but for most, they go away soon. Also, one needs to be careful to keep the EPAP at same level after switching on EPR/Aflex by adjusting the machine pressure (Equal to IPAP) accordingly.

Hi Ash yes I have noticed a slight increase in centrals as you predicted, although some of these are at the beginning or end of the cycle. I tend to take a while to fall asleep, and also don't take the mask of straight away when I wake up!
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#7
Central events at sleep onset or while waking up can be safely ignored unless you are getting clusters of them.

Also, as your body adjusts to PS, the real central events will lessen and eventually become rare.
Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#8
Interval training also helps to reduce hypoapnea's significantly

www ncbi.nlm.nih.gov/pmc/articles/PMC4216726/
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