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Lowering EPAP makes CA's skyrocket
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WakeUpTime Offline

Advisory Members

Posts: 156
Joined: Jan 2014

Machine: PR System One BiPAP S60 Auto 760
Mask Type: Nasal pillows
Mask Make & Model: P10 pillows
Humidifier: PR S1 w Heated Tube+Hose
CPAP Pressure: Auto / Inhale 11-12.5 / Exh 9
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male

Post: #1
Lowering EPAP makes CA's skyrocket
A few weeks ago, I lowered the EPAP settings and just noticed the results. Ugg, the CA events have rocketed up to an average/hour of about 10-12 events from 1-2 events previously.

It's currently: EPAP 7-8 / IPAP 11-12
Was previously: EPAP 9.5 / IPAP 11-12.5

I'm so curious as to why a drop in EPAP pressure would contribute so significantly to just the # of CA's (without much change in OA's, etc.).

(Sorry if this is such an obvious answer.)

Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
04-09-2015 02:13 PM
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AshSF Online

Advisory Members

Posts: 356
Joined: Oct 2014

Machine: PRS1 D560TS
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10, Bkup: Airfit F10 & Quattro Air
Humidifier: PRS1 60 series with Heated Tube
CPAP Pressure: 8 - 8 w/ Aflex 3
CPAP Software: SleepyHead

Other Comments: Using APAP mode with fixed pressure

Sex: Male

Post: #2
RE: Lowering EPAP makes CA's skyrocket
You have increased your pressure support (since IPAP is nearly same while EPAP is down). This sometimes lead to increased washout of CO2. This means your End Tidal CO2 goes down. This reduces your drive to breathe. This means you forget to breathe for a few extra seconds until that co2 bounces back to normal. That forgotten breath is recorded as an Clear Airway Apnea.

If reducing EPAP has not introduced any obstructive events then lowering it was a right decision. But you should keep pressure support constant to begin with. If your H events or RERA events increase, then increase PS but not otherwise. It may increase CAs like it did in your case.

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.
04-09-2015 02:39 PM
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