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JasonR newbie... looking for advice!
#11
RE: JasonR newbie... looking for advice!
I think with your very low pressure need and history of CAs, I will suggest starting at EPR 1 or 2 and not jump straight to 3 cm. Increasing minimum pressure to 6 or 7 will stabilize therapy.
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#12
RE: JasonR newbie... looking for advice!
It's been a while so I thought I would give an update and see if there are any settings I can tweak. My most recent charts attached!

I've been adjusting the pressure over the last while and I think 7 works well for me. EPR off, otherwise my CA's increase. Maybe I'll introduce EPR 1 at some point but I don't feel like I really need to. I'm surprised how different I feel on days when my AHI is < 1 vs > 1. Mask leaks have been an issue recently which I'm attributing to the fact that my headgear is now 6-months old and perhaps the velcro has stretched.

I was wondering if there is any benefit to lowering my max to around 9 to stop the machine from pushing too much air when a mask leak does occur? (according to my stats 9.44 was the 95% rate for the last 30 days)

Any hints or tips are appreciated!


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#13
RE: JasonR newbie... looking for advice!
I bumped up the pressure to 7.2 and I feel even better. More vivid dreams if that's an indication of anything! There was an increase in CA's but I don't feel the drag in the afternoon that I was at 7.

Recent charts attached.

Be well!   Jason


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#14
RE: JasonR newbie... looking for advice!
You are doing much better, congratulations. Your central are low and in fact they may not be real centrals by now. When we turn over or pull up a blanket we hold our breath and those are recorded as centrals (ca).

I would like you to look at the flow limits chart. A flow limit IS APNEA just like any obstruction type of apnea (both O and H events). They can and do cause sleep disturbances so once you get to the point you are at I would like to see if we can make the flow limits less.

Flow limits are made less using EPR. Yours is turned off. I would like you to turn it on and set it to 1. See how that effects your flow limits. And also see if it effects you centrals. If after a couple days and both look better go up to EPR 2. And if again, things are going well move to 3.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#15
RE: JasonR newbie... looking for advice!
Thanks for the advice staceyburke!

I've set my EPR to 1 for the past two night. New charts attached. How can I tell if it's making a difference? My CA's seems to be around the same.


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#16
RE: JasonR newbie... looking for advice!
Just a personal view, but idiopathic CAs tend to occur more as the more washout of the lungs occurs, as the lungs like to have at least some CO2 left in them. Read forward, this means the more EPR you dial in, the more washout, and the likelihood of CAs that are not brain injury CAs will go up. Your treatment seems very effective at EPR of 0 and of 1.

Brain injury CAs will just be there pretty much alot and all the time. That is clearly not an issue with you.

Welcome, and enjoy wonderful restorative sleep.

QAL
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#17
RE: JasonR newbie... looking for advice!
I would go to EPR 2 and again check for centrals. If the stay under control your therapy will be better and your sleep should improve. Give it a couple of days and see if we need to move EPR UP OR DOWN.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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