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Sudden Unexplainable Change
#11
I have both the PRS1 760 BiPAP Auto and Aircurve 10 VAuto. I agree. The Resmed device transitions very smoothly and there is not BiFlex setting. With the PRS1 I used to turn off BiFlex and use the Rise Time setting instead. My preference was for a faster rise.
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#12
Wow even though my old RemStar System One is much less expensive and far less advanced the pressure relief setting seems to be better and more advanced on the RemStar than the AirSense.  Thanks Sleeprider for the detailed explanation comparing the two.  It sounds like in addition to your post the C-Flex does not necessary reduce the pressure to a fixed number like the EPR does but instead it depends upon the breath, so you could have C-FLex set at 1 and it could drop it to 3 cm in one breath and then 1 cm in the next which senses and adjusts while you breath whereas the EPR is set in stone.

In regards to your first post, is it possible to have a good night's sleep REM wise but a horrible night apnea wise?  Because last night I recall dreaming and haven't had a dream in a long time.  Does the chart that I posted show that I had a good night's sleep in some ways?
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#13
There is no way to determine periods of REM on the chart you posted with any certainty.  I see some periods at about 16:00 and 19:40 where you have extended undisturbed sleep, and the flow line compresses that may be REM.   Note, your Philips machine uses GMT as the time zone, so you can offset that in the menu at file/Preferences/CPAP and adjust the clock drift setting.  You just have to make a note of the actual time you started a session, and make an adjustment based on when the charts show you started.  For example, assuming you went to bed at 11:00 your time drift is about +12 hours.

[Image: Screen%20Shot%202017-03-12%20at%201.15.2...9ytz6e.png]
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#14
(03-12-2017, 07:23 PM)Sleeprider Wrote: I have both the PRS1 760 BiPAP Auto and Aircurve 10 VAuto.  I agree.  The Resmed device transitions very smoothly and there is not BiFlex setting.  With the PRS1 I used to turn off BiFlex and use the Rise Time setting instead.  My preference was for a faster rise.

You think that the A10 Auto with EPR set to 3 would be equivalent to what you have now: A10 VAuto with PS set to 3?

I thought the only reason for a bi-level is to be able to get a PS above what you'd get with EPR or C-Flex. (Oh, or when you need a pressure greater than 20).
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#15
Hey your suggestion to turn off EPR worked!  After having four nights in a row of close to 10 or more AHI, last night it dropped dramatically back to 2.4 AHI!

Thank you, I was thrilled with the result and I am grateful for the advice.  I decided to turn off EPR as opposed to raising the pressure since that pressure number was prescribed based on the titration study.  Maybe I'll experiment with raising it in the future since 1cm shouldn't hurt, but I needed a good night's sleep for now.  

The only thing I don't understand is I had turned on EPR about a month ago and everyday my AHI was great at around 1-2.  Why all of a sudden did having it on become a bad thing?  Maybe my position changed?

Just wondering.  I'm going to post the screen shots tomorrow as it did not write to the SD card.

Thanks,

Scott
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#16
(03-12-2017, 03:12 PM)Sleeprider Wrote: Hi Scott, welcome.  You have some pretty impressive OA that occurs in clusters, and appears to disrupt your sleep and cause a break in therapy.  There are two possible suspects here.  First, I think you may be sleeping better, and this is allowing your chin to sag towards your chest cutting off your airway.  This form of positional apnea is common, and can be resolved by using a special pillow or soft cervical collar to keep your head, neck and body better aligned.  It can happen on your back or side.  Support under the neck is key to alignment, and some people also need the nudge from a collar to keep their chin up.

Second possibility is when you added 1-cm of EPR, that actually reduced a critical pressure called EPAP (expiratory positive air pressure).  When you exhale, your machine drops from 8 to 7 cm.  It is the EPAP pressure that must support the airway, and without an auto machine, it may be you crossed a threshold that keeps your airway patent.  EPR does make CPAP more comfortable, so just raise your pressure by 1 to 9 cm, and your EPAP will again be 8 cm.

You are using an Elite model and might want to update your profile to show Elite instead of CPAP. The Resmed CPAP does not provide this efficacy data.  Also take a look at the links in my signature on how to organize and post data.  You can minimize the calendar (triangle in the date line), hide the right sidebar (F10) and the Pie Chart (file/preferences/appearance), and much more useful information will replace those fields.
Since we diverted into some other topics along the way, I thought I'd bring my original post here forward.  When someone is properly titrated in a clinical study, then they add EPR, it changes the prescription.  There will be normal variations of good nights and bad, but in your case, the CPAP pressure is pretty close to the point where OA can occur if pressure is not maintained.  People with Auto CPAP will not have the same problem because the CPAP will compensate for EPR, but with fixed CPAP this is a problem I have commented on in the past.  EPR needs to be offset with a commensurate pressure increase. 
I also think your head/neck position affects your results.  You may still want to find ways to prevent your head from tilting forward, and it could be your good nights were a result of a stable head position, and eventually you had a night like March 12.  Good luck!  Glad it's working out for you.
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#17
Hi Trish,


Thank you, happy to be here and looking to contribute as I learn more.

Melman that would be great if there’s a pillow that might keep me better aligned. I’ve tried different pillows including a memory foam pillow that has the CPAP cutout but didn’t end up liking it. The buckwheat pillow sounds like it might work. I couldn’t find “chaff” anywhere but found other buckwheat pillows - are they all pretty much the same? There’s a Hullo buckwheat pillow that’s more expensive but seemed to get better reviews.

Thanks,

Scott
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#18
I got the CPAPfit pillow, which works well for me. I'm sure there are others just a good. The CPAPfit has many more reviews than the Hullo and just as good. I suspect both are good but I wouldn't spend the extra $$$. An important feature is that it have a zipper so you can remove or add chaff to adjust the loft to your needs.  The CPAP fit is over filled to assure you can configure it as needed. I removed about 1/3 of the fill. I saved what I removed as I suspect the chaff and pieces of foam will compress over time.

Some have said buckwheat chaff pillows have an unpleasant smell. Mine does not.

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#19
I think that the CPAPfit sounds great and I like the price.  There's no need to spend $100 just for a pillow.  I had a the CPAP pillow contour one that I hated.  The concept of it sounds great, it leaves you room for the cpap mask, but it didn't end up working out and it's like having a pillow with holes in it.  At least the one that you mentioned comforms to your mask or hose as opposed to just having an empty space there.  I never ended up using that pillow again after the first night.  Thanks
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#20
(03-12-2017, 09:36 PM)Sleeprider Wrote: There is no way to determine periods of REM on the chart you posted with any certainty.  I see some periods at about 16:00 and 19:40 where you have extended undisturbed sleep, and the flow line compresses that may be REM.   Note, your Philips machine uses GMT as the time zone, so you can offset that in the menu at file/Preferences/CPAP and adjust the clock drift setting.  You just have to make a note of the actual time you started a session, and make an adjustment based on when the charts show you started.  For example, assuming you went to bed at 11:00 your time drift is about +12 hours.

[Image: Screen%20Shot%202017-03-12%20at%201.15.2...9ytz6e.png]


I took a screenshot of a most recent sleep session to compare to the old.  If there's any data that should be made clearer please let me know.  Thanks

https://www.dropbox.com/s/vr00bsywphbbjr...M.png?dl=0
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