Too many CA with EPR off

[sleepymind]

I am using my CPAP for 6 months now. When I was new on this forum someone told me to turn off the EPR. When I turn off EPR my CA becomes too high ~9AHI. When I switch to EPR 2 it becomes ~1-2. But after few days with EPR 2 my AHI becomes ~5. If I change my setting for a day or two like EPR 3 or 1 then it is around 6 and when I go back to 2 it is ~1-2 and again goes back to ~5. Did anyone experience such a thing? I am attaching the sleepyhead photos with EPR3 and the day I switched to EPR2.

[Sleeprider]

It's really hard to say what might be the cause. I think your EPR does not have a lot of effect and you get good therapy at low pressures. I think I'd just set the pressure to 7 and use EPR 2 or whatever feels best. I think a more steady pressure is probably going to do more for you than the changing auto pressure, and EPR is not really connected to events in a meaningful way. Your event rate would not suggest you need a change in therapy approach. Numbers aside, how are you feeling?

[sleepymind]

It's really hard to say what might be the cause. I think your EPR does not have a lot of effect and you get good therapy at low pressures.  I think I'd just set the pressure to 7 and use EPR 2 or whatever feels best.  I think a more steady pressure is probably going to do more for you than the changing auto pressure, and EPR is not really connected to events in a meaningful way.  Your event rate would not suggest you need a change in therapy approach.  Numbers aside, how are you feeling?

Thanks for the reply. I would surely try keeping the pressure steady. I am feeling fine but still need at least 10 hrs sleep. There is one more thing I want to ask. I am an International Student here in Boston originally from Pakistan. This problem started after coming to the US. I went back to my country last month and for a month-long, the AHI was from 0.5 to 1.5 and I felt refreshed in 5-6 hr sleep even if I slept without CPAP. Is there a change that my problem might be because of Cold weather or stress?

[Sleep2Snore]

Could be an effect of atmospheric pressure, diet or just the change in lifestyle.
Pakistan has a high elevation compared to Boston's 40mtrs and Pakistan's 600 to 900mtrs so that might have a lot to do with it.

[Rcgop]

I am using my CPAP for 6 months now. When I was new on this forum someone told me to turn off the EPR. When I turn off EPR my CA becomes too high ~9AHI. When I switch to EPR 2 it becomes ~1-2. But after few days with EPR 2 my AHI becomes ~5. If I change my setting for a day or two like EPR 3 or 1 then it is around 6 and when I go back to 2 it is ~1-2 and again goes back toen5. Did anyone experience such a thing? I am attaching the sleepyhead photos with EPR3 and the day I switched to EPR2.

Yes. But the bunching included all three types of events, not just CAs. I would be half awake and and dismissed it as sleep/wake junk. To solve this, I did the following:
1. Changed pillow size to large. DME fitted me with a small. 
2. Upped my min pressure to 6 cm.
3. Upped my starting ramp pressure to 6 cm. Thus eliminating  ramp at pressures below 6cm. 
4. Tried all 4 EPR settings. 0 and 1 were less than comfortable. 2 was comfortable as well as 3, however, 3 was not more comfortable. 

As a result EPR 2 and 6 min pressure is my sweet spot as far as comfort is concerned. This means my min Exhale pressure is 4 cm. This was too low to control obstructive apnea’s so I gradually raised my minimum pressure to 6.4 cm. 

Now, with obstructive apnea’s under control, I then raised/lowered my max pressure to my 90% pressure. 

This is the point where I could sleep, and once I could sleep, the sleep/wake junk slowly went away. 

Last 2 nights my AHI was .1 each night. Only 1 event each night. One 10 second CA and 1 10 second HA. 

Also, I might add, I only make changes once per month. It takes time for a body to adjust.