Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account

New Posts   Today's Posts

[Symptoms] Insufficient deep sleep
RE: Insufficient deep sleep
I'll try just about anything the next days and weeks, so we'll know.
Post Reply Post Reply

Donate to Apnea Board  
RE: Insufficient deep sleep
    Results from a night with pressure range 11-17 and EPR level 2.

My interpretation is that the max pressure is now high enough (it's never reached), but the low limitations are still there. Maybe increasing the minimum pressure even more will help, possibly with a ramp if that doesn't get me sleeping comfortably.

If I compare with other days: flow limitations has decreased a bit, but compare to a week ago and further, it's not better. So although it's little data to draw conclusions, it looks like the higher EPR (in combination with other settings) actually increases the flow limitations rather than decrease them.
Post Reply Post Reply
RE: Insufficient deep sleep
Imo your conclusion is half correct. Higher EPR appears to caused more flow limitation but where your conclusion is probably wrong is that it probably isn't the EPR (pressure difference between EPAP and IPAP) that is making the flow limitations worse but rather the lower EPAP you have been using because of how these Autoset machines are programmed.

Obstructive apnea/hypopnea/restriction caused by collapses or partial collapses of airways is the main thing CPAP is meant to treat. The primary form of treatment is the constant supply of pressure to help support and keep the airway from collapsing. The key thing to know about this treatment is that EPAP (lowest pressure that occurs during exhalation) is the constant pressure that helps avoid these collapses. If your EPAP is too low then collapse will occur during the exhale portion of breathing and then IPAP (inhalation pressure) has to try and force the airway back open which is much more difficult than just maintaining an open airway.

This is the issue that appears to be affecting you. The reason that increasing EPR had a negative effect is probably not because of the larger pressure difference between EPAP and IPAP but rather because on these autoset machines the set pressure is IPAP and EPAP = IPAP - EPR. When you increased the EPR by 2 you effectively lowered EPAPmin by 2 which caused your airway to start collapsing more regularly. In order to maintain the same EPAP and avoid collapse you should in theory increase min set pressure the same amount you increase EPR. Originally you were using a min pressure of 10 cm with 0 EPR, to maintain the same EPAP you need min pressure of 12 cm with 2 EPR or 13 cm with 3 EPR. At this latest 11 cm min pressure and 2 EPR you are still operating at a lower EPAPmin then you originally were with EPR off and this is most obvious by looking at median EPAP stat in OSCAR (10.58 vs 12.08 with 0 EPR). You need to first find an effective EPAP before you can see any advantages the higher EPR might be giving you.

The presence of both apnea and hypopnea supports that you have an airway that appears to collapse at times and higher EPAP is what is likely to be the best treatment for this. In your case it sounds like you aren't a fan of the way EPR feels so I would stick with EPR of 2 for now and focus on finding an effective min pressure to prevent collapses.

When posting these daily overview shots it is most important for us to be able to see the flow rate chart. In your case flow limits are also important and leak rate does not appear important so I would just move flow limits up don't worry about posting the leak rate graph. I would be curious to see a few 3-5 minute examples showing some of the apnea/hypopnea. For example a view of the 1:30 hypopnea cluster, 6:45 apnea/hypopnea cluster and 8:30 central apnea cluster.
Post Reply Post Reply
RE: Insufficient deep sleep
Hi, I already increased the minumum pressure yesterday and the EPR is now at two. I had a terrible night (probably due to other causes), so it won't give good data. I'll try again tonight.

I did notice though, halfway through the night, that my nasal cavities where very sensitive as was my throat, making me a bit nauseous. But later on the feeling became less prominent. So it seems to me I've reached the upper maximum pressure level that can be used. Which is not a big problem I think, as the graphs now stay below the max.

I'll report in a few days.
Post Reply Post Reply

Donate to Apnea Board  

Possibly Related Threads...
Thread Author Replies Views Last Post
  Sleep PA changing pressure, wants sleep study. Can advice from here hurt my Medicare? midwestguy 82 1,544 5 hours ago
Last Post: Geer1
  Help - daytime sleepiness, frequent deep sighs CrazyDreamer 30 970 08-05-2021, 05:08 PM
Last Post: airbornerider
  Have mild sleep apnea, and sleep therapy center question kconan 7 924 06-10-2021, 10:57 PM
Last Post: ICEMAN
  Deep Sleep rkashyap 32 1,395 05-04-2021, 09:01 PM
Last Post: Geer1
  Central Sleep Apnea and Home Sleep Test Jojoap 3 884 03-15-2021, 06:20 AM
Last Post: chrisj
  Need DEEP data on how Dreamstation BiPAP AutoSV work racprops 2 497 01-06-2021, 09:46 PM
Last Post: racprops
  Do sleep aids effect sleep study results wking 14 1,315 12-01-2020, 05:09 PM
Last Post: mesenteria

New Posts   Today's Posts

About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.