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[Treatment] Clownbell PAP Journey
#1
Clownbell PAP Journey
I've been on CPAP for 90 days. OSCAR reports virtually all events are hypopneas, with only very rare OSA events of 1-2 per night. I've read the wiki on Optimizing Treatment but do not have a good science background and thus came away with no clear picture. The only thing I have gleaned from the wiki is that EPR does not fight hypopnea, leading me to conclude that I should probably wean myself off EPR. I also read in the wiki that the pressure differential between inhale and exhale pressure helps relieve hypopnea -- but I don't understand what that means (do I need a large differential or a small differential?) or what I should do.

The question: is there a layman's version (for someone without heavy science background) describing how to treat hypopnea with the CPAP machine? I have a ResMed Airsense 10 Autoset. 

Thank you.

Craig
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#2
RE: Treating Hyopnea
Adding EPR without adding the same pressure value to your minimum pressure number will help in causing hypopneas. The Resmed AS10 subtracts the EPR value from your inhale pressure, this lowers your exhale pressure. Basically you need to raise your exhale pressure to overcome hypopneas.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
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Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Treating Hyopnea
Thank you Crimson Nape.

So I will wean myself off the EPR. Given that the Inhale Pressure is automatically set by the machine, is there another step I should take if weaning myself off EPR does not produce enough reduction in hypopneas?

Thanks again for your expertise and the quick reply.
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#4
RE: Treating Hyopnea
I suggest you put up Oscar charts and you will get better help. On the left column of your post you show a min of 5. If that is correct you can’t be using more than 1 for EPR. 

4 is the LOWEST pressure that a Cpap can go.   So if you are at min 5 you can only go down 1.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#5
RE: Treating Hyopnea
It's not that difficult to allow for EPR. Based off your profile pressure range of 5.0 to 9.8, if you set the EPR to '3' then you would adjust the pressure range by +3. In this case, your new pressure range would be 8.0 to 12.8.
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Treating Hyopnea
I understand, Stacey. If my pressure were running at 5, it could not go any lower than 4. However, if my machine were running 9.8 when I exhale, the pressure would drop by 3 to 6.8 -- right?
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#7
RE: Treating Hyopnea
Yep. The pressure setting minus EPR setting. The math is just like you did there.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Treating Hyopnea
I have attached 3 typical nights. Lots of hypopneas but no OSAs.

Thanks again for sharing your knowledge.

   

   

   


Attached Files Thumbnail(s)
   
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#9
RE: Treating Hyopnea
No your min number is the exhale number, you subtract the EPR from the min. The 9.8 is the most the machine will go up to on the inhale.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#10
RE: Treating Hyopnea
The max pressure- your machine will go up to 20 if needed and many people leave it at 20. But many people get centrals when there is a large difference between the min and max pressures. Some people find a straight Cpap settings help their centrals AND set their min and max at the same number without any EPR. So for example the machine will blow all of the time at the same number never changing. (That is how all old cpaps worked)

I thought you had set your to 9.8 to help with centrals. The reason to put up your charts so you could get some educated advise.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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