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[Symptoms] Insufficient deep sleep
#21
RE: Insufficient deep sleep
You can try acclimating to EPR by using the machine outside your bedroom during the day or evening while you read or watch TV.

What was your AHI with the introduction of EPR, and what were its components? And did your FL numbers budge? (Actually I'd be curious to see the chart, but I know you may not have time to post it.)

You won't do yourself harm by lowering your minimum as an experiment, but please keep a close eye on OAs, Hs, and FLs.
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#22
RE: Insufficient deep sleep
My AHI values have always been a very predictable 2.5-4, whatever I set the min and max or EPR values to.
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#23
RE: Insufficient deep sleep
You can adjust EPR with the machine running to see/feel the difference and see if any one setting feels best to you. One thing to note is that your awake breathing is not the same as your sleep breathing though and ultimately we are trying to treat your sleep breathing not awake comfort. For one example sleep breathing is shallower and the extra EPR may not be necessary or comfortable when awake but it may be helpful when asleep. Your idea to lower pressure may make sense from an awake comfort point of view but your previous data actually indicated higher pressure may be needed to treat the apnea/hypopnea that were present.

Ultimately how your breathing responds while you are asleep is what matters and the only way we have an idea of how things responds is by what OSCAR shows us.
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#24
RE: Insufficient deep sleep
I'll be experimenting the coming days. As soon as I have the feeling that I have more energy when waking up (and I know that's possible) I'll share the data.

For the moment it looks like the min pressure of 8 is really too low. When lying on my back, my chest becomes too heavy to breathe easily. So I'll increase it to 9. 10 seemed to be too high, so maybe 9 is perfect. We'll see in the morning.
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#25
RE: Insufficient deep sleep
    [attachment=38312]This is with min pressure at 9.0, ramp off and EPR = 2. I still don't sleep very well, and I think it shows in the graph. I am considering increasing the min pressure back to 10.0 and see what happens.
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#26
RE: Insufficient deep sleep
Always best to include flow rate chart, you can adjust the sizes a bit to fit it, leaks and flow limitations (and if you never have substantial leaks it isn't important to post).

This data looks slightly worse and the flow limitations are noticeably higher (95% went from 0.09 to 0.25). This appears to be because of the lower pressure being used allowing partial obstruction to occur, AHI is slightly higher as well. One thing to note is that it is the lower pressure (EPAP, green line) that is what fights obstructions. You went from a min of 10, average 12.08 to a min of 7, average 9.74.

You probably should try a minimum of 11 (EPAP = 9 because EPAP = set pressure - EPR) and then depending on results may need to try even higher.
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#27
RE: Insufficient deep sleep
Thx, I'll try.
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#28
RE: Insufficient deep sleep
Please also consider trying EPR of 3 (adding 1 to your min pressure to compensate). That would be your best bet for reducing FLs, and it can help with Hs too. It may be that the FLs contribute to your sense of getting insufficient deep sleep.

You never did provide details about the O2 information that concerned you. Is that something you could do when you have a moment?
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#29
RE: Insufficient deep sleep
The "interesting" relation between oxygen saturation and the results of the CPAP are not that interesting. It's just that I see that during flow limitation events the saturation also drops a bit. But almost never below 90%.

So I did exactly that, last night. I increased the minimum pressure and also increased the EPR to 3. I had a terrible night. I still need to fetch the data, but the main problem is the reaction of the CPAP to my breathing. When inhaling I can definitely feel pressure in my windpipe and lungs, which is not per sé bad. But as soon as I start exhaling, the pressure feels like completely gone. It makes a very uncomfortable exhaust which provokes hyperventilation to me. I'd rather have a little bit of pressure to breathe against, that makes my breathing more calm.

Next thing I'll try is to decrease the EPR to 1 again (which I think most comfortable for me) and yet increase min and max pressure even more. It will probably make sense as my nasal passage is very slim and I am using a nose mask. Often one of the two nostrils are often blocked during the night. I've had two procedures to remove some mucosal tissue but it still hasn't been resolved completely. Cortisol based nasal sprays don't work for me (believe me, tried it many times, for a long time). Nasal sprays based on xylometazoline do work, but tend to wake me in the middle of the night with a panic attack, due to it's resemblence to epinefrine, so I gave up on it.
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#30
RE: Insufficient deep sleep
Unusual reaction to EPR, but important to take into account, of course. If you increase your minimum pressure, I wonder whether that would give you enough to have calm breathing with an EPR greater than 1. I mention this because the per-breath boost is apparently more effective against FLs than the higher pressure.
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