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Newbie - How to balance CAs and EPR and pressure?
#1
Newbie - How to balance CAs and EPR and pressure?
Hi - after solving the stuffy nose issue with auto humidity setting, I am now trying to get the settings right so I don't have Aerophasia + minimize CAs. Hope's it's ok that I started a new threat.

Below last 3 night's charts:
Oct 16 - pressure 6-10 EPR 1
Oct 17 - pressure 7-10 EPR 1 
Oct 18 - pressure 6-10 EPR 2 - to get rid of aerophasia which I had the nights before

Going from EPR 1 to 2 felt really good and also much less aerophasia. Also, my pressure spikes went down for most of the night from the nights before. Wonder why?

Problem for me are the CAs. What should I try to get them down?

Thanks!
  
               
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#2
RE: Newbie - How to balance CAs and EPR and pressure?
Let's try stabilizing your pressure which is being driven by the flow limitations. Set your minimum and maximum pressure to 8.0 and use the EPR you find most comfortable. You do have a higher rate of CA events with higher EPR, however the difference is not that great. Your OA events tend to cluster a bit, so watch for chin-tucking. If you are using multiple pillows or a very tall firm one, try something a bit thinner.
Sleeprider
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#3
RE: Newbie - How to balance CAs and EPR and pressure?
Thank you.

Am I understanding that I should change to a constant pressure of 8, but not by going to CPAP mode but APAP mode with min and max at 8?

Is there an advantage?
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#4
RE: Newbie - How to balance CAs and EPR and pressure?
Sleeprider, I did what you suggested and the results are interesting. 

I still had some bloating and gas, but that was tolerable. My OA and H are way down, CAs are the same or even a bit lower than days before.

Since OAs are so low, should I try to reduce the pressure slowly, e.g. go to 7.4 and then 7.0 ?

Thanks for your help. Much appreciated!

By the way, I have a thin contour pillow, so no chin tucking as far as I can tell.


   
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#5
RE: Newbie - How to balance CAs and EPR and pressure?
I went down in pressure from 8 to 7, both with EPR 2, to see what would happen.
--At 8: CAs 3.36, OAs 0.97, H 0.11
--At 7: CAs 3.7, OAs 2.11, H 0.32  
Both charts attached.

All measures increased, so I guess I should go back to 8. Maybe try EPR 3 to see if bloating/gas is reduced?

Any other suggestions appreciated.  

       
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#6
RE: Newbie - How to balance CAs and EPR and pressure?
Go back to a pressure of 8, but add EPR incrementally, 1, 2, 3.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
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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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#7
RE: Newbie - How to balance CAs and EPR and pressure?
Will do. Thanks.
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#8
RE: Newbie - How to balance CAs and EPR and pressure?
Went back to pressure 8 with EPR 2. I initially tried EPR 1 but felt uncomfortable, so I tried 2 again. Will try 3 tonight and then step down to a 1 when I feel ready.

Was not a good night. Woke up a lot. Consistent pressure of 8 still feels too strong - maybe I just need to get used to it.

I also noted very consistent patterns before OAs occurred (see attached) - do these look like arousals before OAs? Does that mean these are OAs while I am awake?  

       
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#9
RE: Newbie - How to balance CAs and EPR and pressure?
Did the pressure feel too much with Brevida as well? P10 would wake me up frequently due to aggressive air flows. I can better tolerate same pressure with FFM or nasal masks. Currently, my DreamWisp has the most comfortable air flow that I can tolerate pressure range of 9 - 12 (I may have some difficulty when it gets in the high side in the range). I seem to be fairly sensitive to strong air flow, so I went through many masks to find the right one that would flow air comfortably and also provide low AHI without causing clustering OA. My centrals are down as well.

I did have similar issue with Brevida after consecutive days of usage. I felt tired in the morning and I think it may have been due to more frequent awakenings. With the masks, after a few days, you notice if it's working or not.
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#10
RE: Newbie - How to balance CAs and EPR and pressure?
The Brevida feels much less "aggressive" than the P10 when i comes to pressure. I really like the Brevida. 
I think it is the level of pressure in general.
But maybe I should again try nasal and FFM mask which I had tried earlier....thanks for the suggestion.
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