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Snoring and Chasing Pressure
#21
I will be very interested in your experience with different flex settings. I have changed my EPR from 3 to 2 a couple of times, and back again. Both times when my EPR was 2, my AHI went up into the 5 area. When my EPR is 3, the AHI drops back into the 2 to 3 range. This seems to be counter to the usual experience, and I have no explanation for it.
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#22
(08-22-2016, 06:17 AM)pholynyk Wrote: I will be very interested in your experience with different flex settings. I have changed my EPR from 3 to 2 a couple of times, and back again. Both times when my EPR was 2, my AHI went up into the 5 area. When my EPR is 3, the AHI drops back into the 2 to 3 range. This seems to be counter to the usual experience, and I have no explanation for it.

I have the same experience with EPR. When I change the setting to two, one, or off my AHI goes up.

With EPR on three I typically run 0.0-1.2 AHI with a Monthly average of .28.

When I change the EPR to two,keeping all other variables the same my numbers go up to .9 -2.6 AHI with a Monthly average of 1.7

I get similar increases on EPR one and off, but have not run on those settings for 30 days straight to validate with the larger sample

I also notice some increase irritation in my upper respiratory system when EPR is off and have never had an single night with AHI below 3.0 with EPR off.

Sleep-well

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#23
Used a Flex setting of 3 last night. AHI of 5, RDI of 7. Feel like someone hit me in head with a 2x4 then dragged me though a hedge. Backwards. Made no discernible difference to the swings in Tidal Volume. Back to off or 1 tonight.

OrangeBear and pholynyk, I have no idea why a higher Flex/EPR is giving you a lower AHI. That is curious indeed. There are not central events, right?
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#24
Thanks for trying the flex and observing the settings. It was not my cuppa tea either. What was the CA vs OS? While Flex was not good for you, it's possible that bilevel could be very good to reduce that RDI and get better ventilation. It's a completely different feel.
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#25
The higher events on on Flex mostly OA (3, 1, and 1 on the three nights) which seems insignificant to me. I get one now and then with no flex.

Last night I went back to having flex off. While it feels slightly odd after using flex for several days (most on 1), I had no difficulty exhaling. My Tidal Volume graph now looks more normal as does my Flow Rate graph. But... I woke up frequently and had light sleep as evidence by continually remembering my dreams. My AHI was 1.4 and my RDI just over three. I am going to let this settle out a bit and then see if a higher minimum pressure with flex has a good result. I also have my sleep doctor appointment today so I will see if he is at all interested in this.
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#26
Well, you know how it works. Anytime you make a change, there is a period of time that may have higher events. It's best to hold judgement on effectiveness of a change for at least a week.
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#27
Yeah, I don't know what to do now. I can:
  • Stick with Flex off and hope the broken sleep improves.
  • Go back to Flex 3, get longer unbroken sleep and hope AHI goes down
  • Go back to Flex 3, increase min pressure and hope that AHI goes down

I have a titration with CPAP scheduled for Sept 7th now.
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#28
You're not very far out from your test. As far as options, it's your choice, but I kind of like option 2. It gives a fair chance to flex without the variable of more pressure. In theory the machine should increase pressure as needed. Respironics is a bit slow to get there, but it still responds to flow limits, snores and volume changes.
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#29
I had another look at the days when I was using flex. On all of them, the pressure maxed out at 16 and I was still having OA and H. On the night without flex, it maxed out at 14.4. I feel a LOT better today despite the frequent wakings. I am going to leave it as is (no flex) for a night or two then reconsider. I am still wiped out from those flex nights.

The sleep doctor visit was interesting. He had no software to read my SD card and was dismissive of the accuracy of the software on these machines. He did spend a long time talking to me and asking questions, which I was very happy about. He suggested that UARS or PLMD might be behind this. Hopefully the sleep study will shed some light.
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#30
A brief update on this. I went back to a Flex of 3. My AHI has come down, though not as far as before. I also finally got fully off of the Effexor. Wow. That sucked, still sucks. I'd read about floating brain, and brain zaps, and strange sounds in your head. Bunch of wild eyed lunatics I thought. But, no. My head feels and sounds like a sound track for Star Wars. I've come off of anti-depressants a few times before but this is in a class of its own! Today is day 5 or 6. Last night I had the longest, deepest sleep that I can recall in recent years. Between an AHI of 2.8 and withdrawal effects, I don't feel great. But man did I sleep! My graphs are still all over the place, no change there. But I slept! Did I mention that?
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