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Obstruction on Exhallation
#21
I have no issue with the comfort of the expiratory pressure. The only issue I have had with expiratory phase is the airway obstruction..  I turned off AFlex last night and did try the SmartRamp.  The ramp (set at 4 so as not to trigger the pressure drop with expiration) did not succeed.  I started having expiratory obstruction.  I switched off the ramp and with pressure range of 7 - 12, slept the night.  However, lots of "events" on my readout........

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AHI still higher than ideal.  What's next?  Raise minimum pressure? Do I leave max where it is while I do that?  My minimim is set to 7 and my median was 8. Thoughts?
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#22
It looks like you may need a higher minimum pressure. You were below your max pressure all night so it will probably be OK.
For now, I would not use the ramp if possible and keep everything else the same for a few nights to get more data for the experts. If you think you need to change the pressure, setting the minimum to 7.5 probably wouldn't hurt. That is where bonjour thinks you will end up anyway and it is just your Med. pressure.
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#23
OK.  Thanks.  I'll try it.
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#24
With auto CPAP at 7-12 you have a number of obstructive events startings when the machine is at minimum pressure. You need to increase minimum pressure to 8.0 an it may need a nudge upward from there. The Philips machine just keeps dropping below your therapy presure and that triggers events. A higher pressure should help. We're certainly looking for better than 6.7 AHI.
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#25
yep. either ditch the ramp feature or make it start much higher (at least 6 because you already reported that 5.5 still lets your airway collapse on exhale). that is the absolute must do, must do now.
the other things you did, selecting CPAP mode and taking flex off. worked! AHI 6.7 is not great, but ain't bad for first swing at it, I suspect that would shift lower after a couple days.
I totally agree with Sleeprider for continuing to adjust treatment level.

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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